某科大護理學生生命教育介入情境導向學習之研究
研究背景:
護理教育者有一個責任，灌輸生命意義，正向信念及幸福感於衛生教育課程，以及增進護理學生身體，心理，靈性及社會之衛生教育及健康促進。研究目的是包括探討衛生教育課程的教學設計在於生命教育介入情境導向學習對於研究對象之生命意義，正向信念及幸福感的立即及延宕效果。
研究方法:
研究方法是採用實驗組及對照組之準實驗設計於前測，後測，及後後測。研究樣本是採取立意取樣。研究對象是55個五專三年級的護理學生分派為實驗組參與衛生教育課程接受生命教育介入情境導向學習，以及59個五專三年級的護理學生分派為對照組參與關懷照護課程沒有接受生命教育介入情境導向學習。研究問卷是一份56題的問卷，被使用於探討護理學生於生命意義，正向信念及幸福感。研究問卷的專家內容效度是七位專家學者建立於0.95。研究問卷信度在生命意義Cronbach’s α 0.96，正向信念Cronbach’s α 0.95，以及幸福感Cronbach’s α 0.96。研究統計是使用23.0 SPSS社會科學統計套裝軟體。研究分析是使用頻率次數，百分比，前測平均數及標準差，後測平均數及標準差，後後測平均數及標準差，卡方檢定，t檢定及廣義估計方程式。
研究結果:
研究結果是呈現如下: (1)護理學生之實驗組及對照組的分佈比較是沒有顯著性差異。(2)在前測t檢定分析，護理學生在實驗組及對照組對於生命意義是有顯著性差異，正向信念是沒有顯著性差異及幸福感是有顯著性差異。(3)護理學生之實驗組及對照組差異比較，實驗組是顯示於生命意義之前測平均數-11.84，後測平均數4.56及後後測平均數14.09；正向信念之前測平均數-3.11，後測平均數2.53及後後測平均數6.10；幸福感之前測平均數-10.73，後測平均數3.60及後後測平均數12.94。(4)在廣義估計方程式分析，護理學生之實驗組及對照組比較，實驗組對於生命意義在於前-後測及前-後後測；正向信念在於前-後測及前-後後測；幸福感在於前-後測及前-後後測，全部都顯示有顯著性差異。(5)生命教育介入情境導向學習的教學設計於生命意義，正向信念及幸福感，是包括：課程描述，操作定義，教學總目標，教學目標，生命教育介入情境導向學習，教學內容及教學活動。
研究結論:
護理學生在實驗組於衛生教育課程在生命教育介入情境導向學習，顯示顯著性進步在於生命意義，正向信念及幸福感之立即及延宕效果。相反方面，護理學生在對照組於關懷照護課程沒有生命教育介入情境導向學習，顯示沒有顯著性進步在於生命意義，正向信念及幸福感之立即及延宕效果。研究結論是護理學生在實驗組顯示生命教育介入情境導向學習於生命意義，正向信念及幸福感之學習成效對於身體，心理，靈性及社會之衛生教育及健康促進。

Background:
A nursing educator has the responsibility to instill meaning of life, positive beliefs, and well-being in the health education curriculum, as well as to enhance nursing students’ physical, psychological, spiritual, and social health education and promotion. The research purpose included exploring the teaching design of the health education curriculum with simulated directed-learning in the life education intervention among research participants on their meaning of life, positive beliefs, and well-being in relation to the immediate and delayed effects.
Methods:
This research adopted a quasi-experimental design with experimental and control groups for the pre-test, posttest, and post-posttest. A purposive sample was used in this research. The 55 research participants were 3rd-year nursing students in a five-year program with a health education curriculum, receiving simulated directed-learning in the life education intervention and assigned to the experimental group. Another 59 research participants were 3rd-year nursing students in the five-year program in a caring care curriculum without receiving simulated directed-learning in the life education intervention and assigned to the control group. A 56-item questionnaire was used to explore nursing students’ views on the meaning of life, positive beliefs, and well-being. The content validity index (CVI) of the research questionnaires was established at 0.95 by seven expert scholars. The reliability of Cronbach’s α on the meaning of life was 0.96, positive beliefs 0.95, and well-being 0.96. The 23.0 statistical product and service solutions (SPSS) was used to analyze all the research data. Frequencies, percentages, pre-test mean and SD, posttest mean and SD, post-posttest mean and SD, Chi-squared test, t-test, and Generalized Estimating Equation (GEE) were used for data analysis in the research.
Results:
The research results were as follows: (1) the experimental and control groups had no significant differences on the distribution of nursing students. (2) On the t-test with pre-test analysis, nursing students in both groups had significant differences on their meaning of life, no significant differences on their positive beliefs, and significant differences on their well-being. (3) On their meaning of life, nursing students with significant differences in the experimental and control groups presented a compared mean score on the pre-test of -11.84, posttest of 4.56, and post-posttest of 14.09; their positive beliefs had a compared mean score on the pre-test of -3.11, posttest of 2.53, and post-posttest of 6.10; their well-being had a compared mean score on the pre-test of -10.73, posttest of 3.60, and post-posttest of 12.94. (4) On the GEE analysis, nursing students in the experimental group indicated significant differences to the control group on their meaning of life on the pre-posttest and pre-post posttest, positive beliefs on the pre-posttest and pre-post posttest, and well-being on the pre-posttest and pre-post posttest. (5) The teaching design of simulated directed-learning in the life education intervention on the meaning of life, positive beliefs, and well-being included course description, operational definitions, teaching goal, teaching objectives, simulated directed-learning in the life education intervention, teaching contents, and teaching activities.
Conclusions:
Nursing students in the experimental group following the health education curriculum and in the simulated directed-learning with life education intervention indicated significant improvement on their meaning of life, positive beliefs, and well-being, in their immediate and delayed effects. On the other hand, nursing students in the control group following the caring care curriculum and non-simulated directed-learning with life education intervention indicated no significant differences on their meaning of life, positive beliefs, and well-being, in their immediate and delayed effects. In the conclusions of the research, nursing students in the experimental group indicated positive learning effects with simulated directed-learning in the life education intervention on the meaning of life, positive beliefs, and well-being for physical, psychological, spiritual, and social health education and promotion.

Aaberg, V. (2016). The state of sexuality education in baccalaureate nursing programs. Nurse Education Today, 44, 14-19.
Abongomera, G., Cook, A., Musiime, V., Chabala, C., Lamorde, M., Abach, J., Thomason, M., Mulenga, V., Kekitiinwa, A., Colebunders, R., Kityo, C., Walker, A., & Gibb, D. (2017). Improved adherence to antiretroviral therapy observed among HIV-infected children whose caregivers had positive beliefs in medicine in Sub-Saharan Africa. AIDS and Behavior, 21(2), 441-449.
Abu-Hilal, M., Al-Bahrani, M., & Al-Zedjali, M. (2017). Can religiosity boost meaning in life and suppress stress for Muslim college students? Mental Health, Religion and Culture, 20(3), 203-216.
Aflakseir, A., Soltani, S., & Mollazadeh, J. (2018). Posttraumatic growth, meaningfulness, and social support in Women with breast cancer. International Journal of Cancer Management, 11(10), 1-5.
Aggar, C., & Dawson, S. (2014). Evaluation of student nurses’ perception of preparedness for oral medication administration in clinical practice: a collaborative study. Nurse Education Today, 34(6), 899-903.
Aho, J. M. E., Ruparel, R. K., Graham, E., Zendejas-Mummert, B., Heller, S. F., Farley, D. R., & Bingener, J. (2015). Mentor-guided self-directed learning affects resident practice. Journal of Surgical Education, 72(4), 674-679.
Allan, B. A. (2015). Balance among character strengths and meaning in life. Journal of Happiness Studies, 16(5), 1247-1261.
Allison, S. (2014). Religious literacies in a secular literacy classroom. Reading Research Quarterly, 49(2), 233-250.
Alorani, O. I., & Alradaydeh, M. F. (2018). Spiritual well-being, perceived social support, and life satisfaction among university students. International Journal of Adolescence and Youth, 23(3), 291-298.
Alvarez-Camacho, M., Gonella, S., Ghosh, S., Kubrak, C., Scrimger, R., Chu, K., Wismer, W., Scrimger, R. A., Chu, K. P., & Wismer, W. V. (2016). The impact of taste and smell alterations on quality of life in head and neck cancer patients. Quality of Life Research, 25(6), 1495-1504.
Ambrosi-Randic, N., & Junakovic, I. T. (2018). Felt age, desired, and expected lifetime in the context of health, well-being, and successful aging. International journal of aging and human development, 87(1), 33-51.
Ariane, N. C., Daiana, F. D. S., & Marlene, G. T. (2018). The care towards individuals in psychosocial intervention unit: meanings assigned by the nursing team. Revista de Pesquisa: Cuidadoe Fundamental, 10(4), 951-957.
Arpanantikul, M., & Luecha, Y. (2010). Problem-based learning: undergraduate Thai nursing students’ perceptions. Pacific Rim International Journal of Nursing Research, 14(3), 262-276.
Baldacchino, D. R. (2008). Teaching on the spiritual dimension in care: The perceived impact on undergraduate nursing students. Nurse Education Today, 28(4):501-512.
Baptista, R. C. N., Martins, J. C. A., Pereira, M. F. C. R., & Mazzo, A. (2014). Students’ satisfaction with simulated clinical experiences: validation of an assessment scale. Revista Latino-Americana de Enfermagem, 22(5), 709-715.
Barnoy, S., Biton, A., & Itzhaki, M. (2017). Social inclusion of children with down syndrome: jewish and muslim mothers’ knowledge, attitudes, beliefs, and behavioral intentions. Journal of Pediatric Nursing, 35, 50-56.
Ben-Arye, E., Lear, A., Hermoni, D., & Margalit, R. S. (2007). Promoting lifestyle self-awareness among the medical team by the use of an integrated teaching approach: a primary care experience. Journal of Alternative and Complementary Medicine, 13(4), 461-469.
Benedict, N., Schonder, K., & McGee, J. (2013). Promotion of self-directed learning using virtual patient cases. American Journal of Pharmaceutical Education, 77(7), 1-9.
Bergan-Roller, H. E., Galt, N. J., Chizinski, C. J., Helikar, T., & Dauer, J. T. (2018). Simulated computational model lesson improves foundational systems thinking skills and conceptual knowledge in biology students. BioScience, 68(8), 612-621.
Boyraz, G., Horne, S. G., & Waits, J. B. (2015). Accepting death as part of life: meaning in life as a means for dealing with loss among bereaved individuals. Death Studies, 39, 1-11.
Brannagan, K. B., Dellinger, A., Thomas, J., Mitchell, D., Lewis-Trabeaux, S., & Dupre, S. (2013). Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge. Nurse Education Today, 33(11), 1440-1447.
Braden, A., Overholser, J., Fisher, L., & Ridley, J. (2017). Life meaning is predictive of improved hopelessness and depression recovery in depressed veterans. Journal of Social & Clinical Psychology, 36(8), 629-650.
Breitbart, W., Pessin, H., Rosenfeld, B., Applebaum, A., Lichtenthal, W. G., Li, Y., Saracino, R. M., Marziliano, A. M., Masterson, M., Tobias, K., & Fenn, N. (2018). Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: a randomized controlled trial in patients with advanced cancer. Cancer, 124(15), 3231-3239.
Britton, G., Neale, S. E., & Davey, G. C. L. (2018). The effect of worrying on intolerance of uncertainty and positive and negative beliefs about worry. Journal of behavior therapy and experimental psychiatry, 7(62), 65-71.
Brolin, R., Brunt, D., Rask, M., Syren, S., & Sandgren, A. (2016). Striving for meaning: life in supported housing for people with psychiatric disabilities. International Journal of Qualitative Studies on Health and Well-being, 11.
Canty, D., Barth, J., Yang, Y., Peters, N., Palmer, A., Royse, A., & Royse, C. (2019). Education: comparison of learning outcomes for teaching focused cardiac ultrasound to physicians: a supervised human model course versus an eLearning guided self-directed simulator course. Journal of Critical Care, 49, 38-44.
Cardoso, A. F., Moreli, L., Braga, F. T. M. M., Vasques, C. I., Santos, C. B., & Carvalho, E. C. (2012). Effect of a video on developing skills in undergraduate nursing students for the management of totally implantable central venous access ports. Nurse Education Today, 32(6), 709-713.
Chang, C. M., Ou, M. H., Chao, C. S., & Chang, S. P. (2018). Relationship among sports participation level, sleep quality and well-being in the road running participants. Journal of Management Practices and Principles, 12(1), 26-42.
Chang, W. C. (2014). Developing curriculum and instructions of life education in self-study research. Life Education Research, 6(2), 31-61.
Chen, F. (2013). The curriculum ideas and teaching practice of life education in the university. Taiwan Journal of General Education, 39-61.
Chen, F. (2017). The curriculum angles and teaching structure of life education in the university. Taipei Chengshih University of Science and Technology Journal of General Education, 323-345.
Chen, S. H., Chen, S. C., Lee, S. C., Chang, Y. L., & Yeh, K. Y. (2017). Impact of interactive situated and simulated teaching program on novice nursing practitioners’ clinical competence, confidence, and stress. Nurse Education Today, 55, 11-16.
Chen, C. C., & Liu, Z. X. (2015). Effect of meditation on life meaning, health perception, job stress and teaching performance for kindergartens teachers. Journal of work and Leisure, 4(2), 141-155.
Chen, W. R., Yang, H. L., Chen, C. L., & Chen, P. W. (2015). From developing affective competence to cultivating life wisdom: training social skills through life education. Special Education, 9-19.
Chen, D., Zou, F., Wang, J., & Yuan, W. (2016). SAMCCTLBO: a multi-class cooperative teaching-learning-based optimization algorithm with simulated annealing. Soft Computing-A Fusion of Foundations, Methodologies & Applications, 20(5), 1921-1943.
Cheng, S. I., & Cheng, B. J. (2018). The current situation of the psychological capital and subjective wellbeing of technical college students and their relatedness: using three private universities of science and technology as examples. Journal of Liberal Arts and Social Sciences, 14(1), 1-28.
Cheng, C. K., & Lee, Y. C. (2018). Integrating life education issues into picture book teaching: using the mixed-up chameleon as an example. The Elementary Education Journal, 65(2), 107-129.
Chiang, C. H., & Liu, C. H. (2008). Stress adjustment emotional intelligence and mental health promotion in adolescences. Chia Nan Annual Bulletin, 34, 595-607.
Chiang, L. T. (2014). Self-awareness and realization of one’s life meaning. Journal of life education, 6(2), 1-29.
Choi, Y. S., Lee, K., & Kim, A. (2018). Effects of public education of hospice and palliative care on meaning in life, depression, and death anxiety according to age groups in the Republic of Korea. Indian Journal of Public Health Research and Development, 9(8), 835-840.
Chou, W. S. (2017). Context and reflection of life education in university: an example of YunTech University. Life Education Research, 9(1), 23-42.
Chu, Y., Xu, M., & Li, X. (2015). Psychometric properties of an instrument to measure nursing students’ quality of life. Nurse Education Today, 35(7), e1-e5.
Chuang, S. P., Wu, J. Y. W., Wang C. S., & Pan, L. H. (2017). Health-promoting lifestyles and psychological distress associated with well-being in community adults. American Journal of Health Behavior, 41(4), 446-453.
Clancy, S., & Lord, B. (2018). Making meaning after the death of a child. Dealing with Death and Dying, Child and Adolescent Psychiatric Clinics of North America, 27(4), xv-xxiv.
DeCorby-Watson, K., Mensah, G., Bergeron, K., Abdi, S., Rempel, B., & Manson, H. (2018). Effectiveness of capacity building interventions relevant to public health practice: a systematic review. BMC Public Health, 18(1), 1-15.
De-La-Croix, A., & Skelton, J. (2013). The simulation game: an analysis of interactions between students and simulated patients. Medical Education, 47(1), 49-58.
De Natale, M. L., & Klevay, A. M. (2013). The humanbecoming connection: nursing students find meaning in the teaching-learning processes. Nursing Science Quarterly, 26(2), 125-129.
Dobrikova, P., & West, D. J. (2015). The effect of social support and meaning of life on the quality of life care for terminally ill patients. The American Journal of Hospice & Palliative Care, 32(7), 767-771.
Donato, A. A., Kaliyadan, A. G., & Wasser, T. (2014). Self-directed study using MP3 players to improve auscultation proficiency of physicians: a randomized controlled trial. Journal of continuing education in the health professions, 34(2), 131-138.
Encarnacao, P., Oliveira, C. C., & Martins, T. (2017). A generalized resistance resource: faith a nursing view. Health Promotion International, 32(3), 577-580.
Eriksson, M., Lindstrom, B., & Hoqskolan, V. (2011). From health education to healthy learning: implementing salutogenesis in educational science.
Scandinavian Journal of Public Health, 39(6), 85-92.
Eriksson-Sjoo, T., Cederberg, M., Ostman, M., & Ekblad, S. (2012). Quality of life and health promotion intervention: a follow up study among newly-arrived Arabic-speaking refugees in Malmo, Sweden. International Journal of Migration, Health and Social Care, 8(3), 112-126.
Fahrenwald, N. L., Bassett, S. D., Tschetter, L., Carson, P. P., White, L., & Winterboer, V. J. (2005). Teaching core nursing values. Journal of Professional Nursing, 21(1), 46-51.
Fidanci, B. E., Akbayrak, N., & Arslan, F. (2017). Assessment of a health promotion model on obese Turkisk. Journal of Nursing Research, 25(6), 436-446.
Fisak, B., & Hammond, A. (2013). Are positive beliefs about post-event processing related to social anxiety? Behaviour change, 30(1), 36-47.
Forgeard, M. J. C., Pearl, R. L., Cheung, J., Rifkin, L. S., Beard, C., & Bjorgvinsson, T. (2016). Positive beliefs about mental illness: associations with sex, age, diagnosis, and clinical outcomes. Journal of Affective Disorders, 204, 197-204.
Fortuna, J. (2018). Integrating art and narrative to enhance quality of life in palliative care…Lacie Lee Wallace. Journal of Occupational Therapy, 6(4), 1-4.
Francescato, D., & Moro, A. (2017). Dispositional characteristics, relational well-being and perceived life satisfaction and empowerment of elders. Aging and Mental Health, 21(10), 1052-1057.
Gage, N. A., Grasley-Boy, N., Peshak, G. H., Childs, K., & Kincaid, D. (2019). A quasi-experimental design analysis of the effects of school-wide positive behavior interventions and supports on discipline in Florida. Journal of Positive Behavior Interventions, 21(1), 50-61.
Geumsook, O. H., & Jinhwan, O. H. (2018). The effect of perceived meaning of life and social support of nursing students on academic/career decision-making self-efficacy. Research Journal of Pharmacy and Technology, 11(1), 369-374.
Gooding, P. L. T., Callan, M. J., & Hughes, G. (2018). The association between believing in free will and subjective well-being is confounded by a sense of personal control. Frontiers Psychology, 7(9), 623.
Gordon, J., & O’Toole, L. (2015). Learning for well-being: creativity and inner diversity. Cambridge Journal of Education, 45, 333-346.
Gugglberger, L., Flaschberger, E., & Teutsch, F. (2017). Side effects’ of health promotion: an example from Austrian schools. Health promotion International, 32(1), 157-166.
Haegele, J. A., Hodge, S. R., Filho, P. G., Ribeiro, N., & Martínez-Rivera, C. (2018). A phenomenological inquiry into the meaning ascribed to physical activity by Brazilian men with visual impairments. Journal of Visual Impairment and Blindness, 112(5), 519-531.
Hajibabaeei, H. R., Hashemnejad, H., & Ghonche, K. A. (2018). The relationship between spiritual well-being and demographic characteristic of students of Qazvin University of medical sciences. The Journal of Qazvin University of Medical Sciences, 22(3), 50-57.
Hale, J. F., Cahan, M. A., & Zanetti, M. L. (2011). Integration of basic clinical skills training in medical education: an interprofessional simulated teaching experience. Teaching & Learning in Medicine, 23(3), 278-284.
Haugan, G., Moksnes, U. K., & Lohre, A. (2016). Intrapersonal self-transcendence, meaning-in-life and nurse–patient interaction: powerful assets for quality of life in cognitively intact nursing-home patients. Scandinavian Journal of Caring Sciences, 30(4), 790-801.
Hayashida, M., & Youkoi, T. (2018). Meaning and potential of interview data in depiction of life stories: interviews of three mothers caring for children with severe disabilities. Journal of physical Therapy Science, 30(8), 1095-1098.
Hebert, E. A., Dugas, M. J., Tulloch, T. G., & Holowka, D. W. (2014). Positive beliefs about worry: a psychometric evaluation of the why worry-II. Personality and Individual Differences, 56, 3-8.
Heshmati, R., & Maanifar, S. (2018). Metacognition, mindfulness, and spiritual well-being in gifted high school students. Health, Spirituality & Medical Ethics Journal, 5(3), 22-28.
Ho, Y. C. (1990). The life attitude profile: a study of reliability and validity. Journal of National Taiwan Normal University, 35, 71-94.
Hsu, M. K., & Juan, Y. Y. (2014). How to promote the philosophy of life education in vocational high school courses. Mingdao Journal, 9(1), 57-75.
Hsu, Y. C. (2015). A Study of the Life Education Melts into the Tourism School's Device of General Education Courses and its Development-Taiwan Hospitality and Tourism College as Example. Taiwan Journal of General Education, 77-101.
Hsieh, C. J., Chang, C., Shiau, S. J., Miao, N. F., Chang, H. J., Chang, S. C., & Shen, W. W. (2012). Associations among multi-systematic factors and depressive symptoms in adolescent students. Taiwanese Journal of Psychiatry, 26(4), 301-310.
Huang, C. H. (2016). Life education into the curriculum of teaching strategies Chinese - In the Far East University Chinese courses as an example. Far-East General Journal, 10(1), 89-110.
Huang, W. S. (2018). The connotations of life education in “Shi Li Yu Yao”. Journal of National Taipei College of Business, 61-84.
Hue, M. T., & Lau, N. S. (2015). Promoting well-being and preventing burnout in teacher education: a pilot study of a mindfulness-based programme for pre-service teachers in Hong Kong. Teacher Development, 19, 381-401.
Hung, J. T., Chang-Chien, L. L., & Lin, H. M. (2016). The learning effectiveness of a life education course incorporating service-learning: ＂humanity-part 1＂ as a case study. Hungkuang Journal, 85-98.
Hung, J. T., & Tzeng, C. Y. (2018). The relationship of organizational justice, health-promoting lifestyle, and emotional intelligence with well-being in nurses. Hungkuang Journal, 27-46.
Im, S. Y. (2018). The relationships between growth and meaning in life following adversities: Considering multidimensional aspects of meaning in life. Indian Journal of Public Health Research and Development, 9(9), 569-575.
Iren, G. L., & Arild, L. P. (2018). Longitudinal changes among adolescents’ well-being at school and the importance of gender and overweight. International Journal of Educational Administration and Policy Studies, 10(5), 39-47.
Jacobs, L. (2014). The other side of the coin: OT students’ perceptions of problem-based learning. South African Journal of Occupational Therapy, 44(1), 62-67.
Jancey, J. M., Lee, A. H., Howat, P. A., Clarke, A., Wang, K., & Shilton, T. (2008). The effectiveness of a physical activity intervention for seniors. American Journal of Health Promotion, 22(5), 318-321.
Jossberger, H., Brand-Gruwel, S., Boshuizen, H., & van de Wiel, M. (2010). The challenge of self-directed and self-regulated learning in vocational education: a theoretical analysis and synthesis of requirements. Journal of Vocational Education and Training, 62(4), 415-440.
Jou, M. T., Chou, P. C., Lee, D. M., & Chou, L. W. (2018). Discussion on life Education and reconstruction: why the blinders are engaged in the massage industry. Journal of Disability Research, 16(1), 31-45.
Kara, B. (2015). The efficacy of an educational intervention on health behaviors in a sample of Turkish female nursing students: a longitudinal, quasi-experimental study. Nurse Education Today, 35(1), 146-151.
Kazlauskiene, A., Gaucaite, R., & Poceviciene, R. (2016). Preconditions for sustainable changes in didactics applying self-directed learning in the general education school. Journal of Teacher Education for Sustainability, 18(2), 105-118.
Kelly, M., Wills, J., Jester, R., & Speller, V. (2017). Should nurses be role models for healthy lifestyles? Results from a modified Delphi study. Journal of Advanced Nursing, 73(3), 665-678.
Kim, E. (2018). Effect of simulation-based emergency cardiac arrest education on nursing students' self-efficacy and critical thinking skills: roleplay versus lecture. Nurse Education Today, 61, 258-263.
Kim, S. J., Han, K. T., Kim, S. J., Park, E. C., Seung, J. K., Kyu-Tae, H., Kim, S. J., & Park, E. C. (2017). Pay-for-performance reduces health care spending and improves quality of care: analysis of target and non-target obstetrics and gynecology surgeries. International Journal for Quality in Health Care, 29(2), 222-227.
Kirdok, O., & Bolukbasi, A. (2018). The role of senior university students’ career adaptability in predicting their subjective well-being. Journal of Education and Training Studies, 6(5), 47-54.
Ko, E., & Kim, H. Y. (2017). Effects of simulation-based education combined team-based learning on self-directed learning, communication skills, nursing performance confidence and team efficacy in nursing students. Journal of Korean Academy of Fundamentals of Nursing, 24(1), 39-50.
Konicki, T., & Miller, E. (2016). Use of a simulation intervention to examine differences in nursing students' hand hygiene knowledge, beliefs, and behaviors. Nurse Education Today, 45, 96-101.
Kopka, J. A., Aschenbrenner, A. P., & Reynolds, M. B. (2016). Helping students process a simulated death experience: integration of an NLNACE.S evolving case study and the ELNEC curriculum. Nursing Education Perspectives, 5, 180-182.
Kurtmollaiev, S., Pedersen, P. E., Fjuk, A., & Kvale, K. (2018). Developing managerial dynamic capabilities: a quasi-experimental field study of the effects of design thinking training. Academy of Management Learning & Education, 17(2), 184-202.
Lane, K., Teng, M. Y., Barnes, S. J., Moore, K., Smith, K., & Lee, M. (2018). Using appreciative inquiry to understand the role of teaching practices in student well-being at a research-intensive university. Canadian Journal for the Scholarship of Teaching and Learning, 9(2), 1-10.
Lannin, D. G., Vogel, D. L., & Heath, P. J. (2017). Can reflecting on personal values online increase positive beliefs about counseling? Journal of Counseling Psychology, 64(3), 261-268.
Lavorato-Neto, G., Rodrigues, L., Gomes-Campos, C. J., & Turato, E. R. (2018). The free spirit: spiritualism meaning by a nursing team on psychiatry. Revista Brasileira de Enfermagem, 71(2), 280-288.
Lee, C. H., Chang, F. C., Chi, H. Y., & Huang, L. J. (2018). Evaluating the effects of school-pharmacist partnerships to improve medication knowledge, efficacy and behavior. Taiwan Journal of Public Health, 37(2), 196-205.
Lee, C. M., Chang, F. C., Miao, N. F., Shyu, M. L., Lee, S. C., Chang, Y. C., Lin, S. H., Chen, Y. T., Hsu, M. C., & Ruo, J. P. (2011). Effects of a Community Prevention Intervention on Public Awareness, Knowledge, and Risk Perception of Club Drug Use by Youth in Taiwan. Substance Use and Misuse, 46(10), 1265-1274.
Lehnbom, E. C., Douglas, H. E., & Makeham, M. A. B. (2016). Positive beliefs and privacy concerns shape the future for the personally controlled electronic health record. Internal Medicine Journal, 46(1), 108-111.
Levine, M. (2018). Intentionally designing communities for health and well-being: a vision for Today. Journal of Law, Medicine and Ethics, 46(3), 685-690.
Li, P. H., Chu, L. H., & Yu, M. N. (2017). Joy share with others is more joyful: interpersonal relationship as a mediator between optimistic explanatory style and well-being. Chinese Journal of Guidance and Counseling, 53-77.
Liaw, S. Y., Chan, S. W. C., Scherpbier, A., Rethans, J. J., & Pua, G. G. (2012). Recognizing, responding to and reporting patient deterioration: transferring simulation learning to patient care settings. Resuscitation, 83(3), 395-398.
Lin, C. L. J., Chang, F. C., Lee, C. M., & Chi, H. Y. (2016). Effectiveness of correct medication education among elementary school students in Taiwan. Chinese Journal of School Health, 69, 87-111.
Lin, Y. H., & Chen, S. C. (2015). The impact of the death experience on the attitudes toward death and meaning of life in college students. Health Promotion and Health Education Journal, 39, 39-62.
Lin, W. T., & Yu, M. N. (2016). The study of positive psychology intervention effects for promoting college students’ well-being. National Chen-Gchi University, Department of Education, Master’s Thesis.
Livesay, K., & Lawrence, K. (2018). Staff perception of the sustainability of a mature simulation program in nursing and midwifery education: a phenomenological analysis. Nurse Education Today, 71, 145-150.
Lotrean, L. M., Ailoaiei, R., & Stan, O. (2016). Use of information technology by adolescents and young people and its effect on health promotion. Balneo Research Journal, 7(3), 76-80.
Malkoç, A., & Aslan, A. E. (2018). The effect of a subjective well-being intervention program on happiness. European Journal of Education Studies, 5(2), 11-26.
Mantovani, N., Pizzolati, M., & Gillard, S. (2017). Engaging communities to improve metal health in African and African Caribbean groups: A qualitative study evaluating the role of community well-being champions. Health and Social Care in the Community, 25(1), 167–176.
Marhemati, Z., & Khormaei, F. (2017). Explaining eudaimonic well-being: the role of religiousness and patience. Health, Spirituality and Medical Ethics Journal, 4(4), 24-30.
Mason, H. D., & Nel, J. A. (2015). Promoting professional quality and meaning in life among nursing students: a mixed methods study. Journal for New Generation Sciences, 13(1), 54-69.
May-West, E. M., Craig, P. J., & Wilder, A. (2018). The meaning of cross-country skiing for persons with significant visual impairment: a phenomenological study. Therapeutic Recreation Journal, 52(4), 349-373.
Mazmanian, P., & Feldman, M. (2011). Theory is needed to improve education, assessment and policy in self-directed learning. Medical Education, 45(4), 324-326.
McSharry, P., & Timmins, F. (2016). An evaluation of the effectiveness of a dedicated health and well-being course on nursing students’ health. Nurse Education Today, 44, 26–32.
Meaney, P. A., Sutton, R. M., Tsima, B., Steenhoff, A. P., Shilkofski, N., Boulet, J. R., Davis, A., Kestler, A. M., Church, K. K., Niles, D. E., Irving, S. Y., Mazhani, L., & Nadkarni, V. M. (2012). Simulation and education: training hospital providers in basic CPR skills in Botswana:
acquisition, retention and impact of novel training techniques. Resuscitation, 83(12), 1484-1490.
Meneguin, S., Dionísio de Sousa Matos, T., & da Silva Marques Ferreira, M.
D. L. (2018). Perception of cancer patients in palliative care about quality
of life. Revista Brasileira de Enfermagem, 71(4), 1998-2004.
Michael, S. L., Merlo, C. L., Basch, C. E., Wentzel, K. R., & Wechsler, H.
(2015). Critical connections: Health and Academics. Journal of School
Health, 85(11), 740-758.
Miles, D. A. (2018). Simulation learning and transfer in undergraduate
nursing education: a grounded theory study. Journal of Nursing Education, 57(6), 347-353.
Miller, L. C., Russell, C. L., Cheng, A. L., & Zembles, S. (2018). Testing the efficacy of a scaffolded writing intervention with online degree-completion nursing students: a quasi-experimental design. Nurse Education in Practice, 32, 115-121.
Miller, M., Valenti, M., Schettler, T., & Tencza, B. (2016). A story of health: filling a gap in environmental health literacy for health professionals.
Environmental Health Perspectives, 124(8), 133-136.
Mirfeizi, M., Tourzani, Z. M., Jafarabadi, M. A., Hanjani, S. M., & Hasanzad, M. (2017). Health education in gestational diabetes mellitus and quality of life. Journal of Midwifery & Reproductive Health, 5(4), 1066-1074.
Mulube, S. M., & Jooste, K. (2014). First-year learner nurses' perceptions of learning motivation in self-directed learning in a simulated skills laboratory at a higher education institution. South African Journal of Higher Education, 28(6), 1776-1794.
Nagase M. (2012). Does a multi-dimensional concept of health include spirituality? Analysis of Japan health science council’s discussions on WHO’s definition of health’ (1998). International Journal of Applied Sociology, 2(6), 71-77.
Nezlek, J. B., Cypryanska, M., Cypryanski, P., Chlebosz, K., Jenczylik, K., Sztachanska, J., & Zalewska, A. M. (2018). Within-person relationships between recreational running and psychological well-being. Journal of Sport & Exercise Psychology, 40(3), 146-152.
Nunes, S., Fernandes, H., Fisher, J., & Fernandes, M. (2018). Psychometric properties of the Brazilian version of the lived experience component of the spiritual health and life-orientation measure (SHALOM). Psicologia: Reflexaoe Critica, 31(1), 1-13.
Oberle, E. (2018). Early adolescent’s emotional well-being in the classroom: the role of personal and contextual assets. The Journal of School Health, 88(2), 101-111.
Ou, T. Y., Huang, C. K., Wu, J. S., & Chih, W. L. (2016). Exploring the nursing students’ love conceptions of life attitudes in life education with multimedia. Journal of Global Technology Management and Education, 5(1), 44-59.
Ozveren, H., Cerit, B., & Ertop, N. G. (2013). Differences in health promoting lifestyle behavior of health management students based upon early diagnosis coverage in a cancer course. Asian Pacific Journal of Cancer Prevention, 14(10), 5769-5773.
Palsson, Y., Martensson, G., Swenne, C. L., Adel, E., & Engstrom, M., (2017). A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study. Nurse Education Today, 51, 81-87.
Park, H. R., Park, J. W., Kim, C. J., & Song, J. E. (2017). Development and validation of simulation teaching strategies in an integrated nursing practicum. Collegian, 24(5), 479-486.
Park, S. N., Chu, M. S., Hwang, Y. Y., Kim, S. H., & Lee, S. K. (2015). Effects of integrated nursing practice simulation-based training on stress, interest in learning, and problem-solving ability of nursing students. Journal of Korean Academy of Fundamentals of Nursing, 22(4), 424-432.
Pedersen, T. H., Kasper, N., Roman, H., Egloff, M., Marx, D., Abegglen, S., & Greif, R. (2018). Simulation and education: self-learning basic life support: a randomized controlled trial on learning conditions. Resuscitation, 126, 147-153.
Peralta, L. R., & Rowling, L. (2017). Implementation of school health literacy in Australia: a systematic review. Health Education Journal, 77(3), 363-376.
Petty, J. (2013). Addressing learning needs in neonatal care: an overview of resources for self-directed learning. Infant, 9(3), 102-107.
Plastow, N. A., Joubert, L., Yushmika, C., Nowers, A., Greeff, M., Strydom, T., Theron, M., & Van N. E. (2018). The immediate effect of African drumming on the mental well-being of adults with mood disorders: an uncontrolled pretest-posttest pilot study. American Journal of Occupational Therapy, 72(5), 1-6.
Polat, U., Ozen, S., Kahraman, B. B., & Bostanoglu, H. (2016). Factors affecting health-promoting behaviors in nursing students at a university in Turkey. Journal of Transcultural Nursing, 27(4), 413-419.
Presnilla-Espada, J. (2014). An exploratory study on simulated teaching as experienced by education students. Universal Journal of Educational Research, 2(1), 51-63.
Rao, S. K., & Rockwood, K. (2017). Is it better to be happy or not depressed? Depression mediates the effect of psychological well-being on adverse health outcomes in older adults. International Journal of Geriatric Psychiatry, 32(9), 1000-1008.
Robinson, B. K., & Dearmon, V. (2013). Evidence-based nursing education: effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. Journal of Professional Nursing, 29(4), 203-209.
Saarnio, L., Bostrom, A. M., Gustavsson, P., & Ohlen, J. (2016). Meanings of at-homeness at end-of-life among older people. Scandinavian Journal of Caring Sciences, 30(2), 312-319.
Sacco, S. J., Park, C. L., Suresh, D. P., & Bliss, D. (2014). Care of patients with heart failure: living with heart failure: psychosocial resources, meaning, gratitude and well-being. Journal of Acute and Critical Care, 43(3), 213-218.
Samawi, Z., Haras, M. S., & Miller, T. L. (2012). Age-appropriate health promotion education: roots firmly established in baccalaureate nursing pediatric rotation. Journal of Pediatric Nursing, 27(1), 44-49.
Saunders, A., Green, R., & Cross, M. (2017). Making the most of person-centred education by integrating flipped and simulated teaching: an exploratory study. Nurse Education in Practice, 27, 71-77.
Schutte, L., Wissing, M. P., & Ellis, S. M. (2016). Rasch analysis of the meaning in life questionnaire among adults from South Africa, Australia, and New Zealand. Health and Quality of Life Outcomes, 14, 1-16.
Seema, R., Sircova, A., & Baltin, A. (2014). Transcendental future: Is it a healthy belief or a time perspective? The transcendental-future time perspective inventory (TTPI) in Estonian. Trames, 18(1), 57–75.
Shepherd, C. K. (2010). Investigating the use of simulation as a teaching strategy. Nursing Standard, 24(35), 42-48.
Shih, D. Y., & Tsai, Y. M. (2014). A narrative study on college students’ development of positive mindsets and life values through tzu chi humanities camps: a social capital perspective. Tzu-Chi University Journal of the Educational Research, 10, 61-96.
Shin,Y. H., Choi, J., Storey, M. J., & Lee, S. G. (2017). Effectiveness of self-directed learning on competency in physical assessment, academic self-confidence and learning satisfaction of nursing students. Journal of Korean Academy of Fundamentals of Nursing, 24(3), 181-188.
Silva, J. L. G., & Oliveira-Kumakura, A. R. S. (2018). Clinical simulation to teach nursing care for wounded patients. Revista Brasileira de Enfermagem, 71, 1785-1790.
Silverman, A. M., Pitonyak, J. S., Nelson, L. K., Matsuda, P. N., Kartin, D., & Molton, L. R. (2018). Instilling positive beliefs about disabilities: pilot testing a novel experiential learning activity for rehabilitation students. Journal Disability and Rehabilitation, 40(9), 1108-1113.
Sinclair, B., & Ferguson, K. (2009). Integrating simulated teaching/learning strategies in undergraduate nursing education. International Journal of Nursing Education Scholarship, 6(1), 1-11.
Skar, L., & Soderberg, S. (2016). Swedish nursing students’ perceptions of the concept of health: a phenomenographic study. Health Education Journal, 75(4), 385-395.
Stanley, M. J., & Rojas, D. (2014). Teaching undergraduate nursing students about environmental health: addressing public health issues through simulation. Journal of Nursing Education, 53(1), 48-51.
Stockmann, C., & Diaz, D. A. (2017). Students’ perceptions of the psychological well-being of a transgender client through simulation. The Journal of Nursing Education, 56(12), 741-744.
Su, F. P. C., Chang, L. H., Mao, H. F., & Hwang, E. J. (2018). Development of the Taiwanese version of the health enhancement lifestyle profile (HELP-T). PLoS One, 13(6): e0199255. doi:10.1371/journal.pone.0199255
Subramaniam, T., Valuyeetham, P. S., & Siang, T. J. (2018). Students’ feedback on effectiveness of combined flipped classroom and high fidelity simulated teaching on airway and ventilation during accident and emergency posting. Education in Medicine Journal, 10(2), 5-13.
Sullivan, B. J., & Bettger, J. P. (2018). Community-informed health promotion to improve health behaviors in Honduras. Journal of Transcultural Nursing, 29(1), 14-20.
Sun, J. H. C. (2013). Ideas and strategies of life education in universities. Life Education Research, 5(2), 1-37.
Sun, F. K., Long, A., Huang, X. Y., & Chiang, C. Y. (2011). A quasi-experimental investigation into the efficacy of a suicide education programme for second-year student nurses in Taiwan. Journal of Clinical Nursing, 20(5), 837-846.
Sundler, A. J., Pettersson, A., & Berglund, M. (2015). Undergraduate nursing students’ experiences when examining nursing skills in clinical simulation laboratories with high-fidelity patient simulators: a phenomenological research study. Nurse Education Today, 35(12), 1257-1261.
Tada, T., Moritoshi, P., Sato, K., Kawakami, T., & Kawakami, Y. (2018). Effect of simulated patient practice on the self-efficacy of Japanese undergraduate dietitians in nutrition care process skills. Journal of Nutrition Education and Behavior, 50(6), 610-619.
Tan, L., Chen, J., Xia, T., & Hu, J. (2018). Predictors of suicidal ideation among children and adolescents: roles of mental health condition and meaning in life. Child Youth Care Forum, 47(2), 219-231.
Tharani, A., Husain, Y., & Warwick, I. (2017). Learning environment and emotional well-being: a qualitative study of undergraduate nursing students. Nurse Education Today, 59, 82-87.
Taylor, J. S. (2011). The moral aesthetics of simulated suffering in standardized patient performances. Culture, Medicine and Psychiatry, 35(2), 134-162.
Tee, S., & Ozcetin, Y. S. U. (2016). Promoting positive perceptions and
person centred care toward people with mental health problems using co-
design with nursing students. Nurse Education Today, 44, 116–120.
Tsai, F. J., Chen, C. Y., Yeh, G. L., Hu, Y. J., Tseng, C. C., & Chen, S. C. (2018). Nursing students' relationships among meaning in life, well-being, and positive beliefs: A cross-sectional survey study. Medicine, 97(40): e12914-e129914 (1P).
Tseng, L. Y. (2016). Ideas recognition of university life education and application of digital multimedia material: thanksgiving. Journal of China University of Science and Technology, 111-143.
Tsingos-Lucas, C., Bosnic-Anticevich, S., & Smith, L. (2016). A retrospective study on students’ and teachers’ perceptions of the reflective ability clinical assessment. American Journal of Pharmaceutical Education, 80(6), 1-10.
Tulis, M., Steuer, G., & Dresel, M. (2018). Positive beliefs about errors as an important element of adaptive individual dealing with errors during academic learning. Educational Psychology, 38(2), 139-158.
Valler-Jones, T., Meechan, R., & Jones, H. (2011). Simulated practice - a panacea for health education? British Journal of Nursing, 20(10), 628-631.
Vess, M., Hoeldtke, R., Leal, S. A., Sanders, C. S., & Hicks, J. A. (2018). The subjective quality of episodic future thought and the experience of meaning in life. Journal of Positive Psychology, 13(4), 419-428.
Vincent-Onabajo, G. O., & Malgwi, W. S. (2015). Attitude of physiotherapy students in Nigeria toward persons with disability. Disability and Health Journal, 8(1), 102-108.
Vitayasak, S., & Pongcharoen, P. (2018). Performance improvement of teaching-learning-based optimization for robust machine layout design. Expert Systems with Applications, 98, 129-152.
Vos, J., & Vitali, D. (2018). The effects of psychological meaning-centered therapies on quality of life and psychological stress: a meta-analysis. Palliative & Supportive Care, 16(5), 608-632.
Wachelder, E. M., Moulaert, V. R. M. P., Van Heugten, C., Gorgels, T., Wade, D. T., & Verbunt, J. A. (2016). Clinical paper: Dealing with a life changing event: the influence of spirituality and coping style on quality of life after survival of a cardiac arrest or myocardial infarction. Resuscitation, 109, 81-86.
Wang, C. Y. (2017). Research of health-related fitness of college students: a case study of NUTC. NCHU Institutional Repository CRIS, 1-12.
Wang, W., Sun, R., Mulvehill, A. M., Gilson, C. C., & Huang, L. L. (2017). Handing Internet-based health information: improving health information web site literacy among undergraduate nursing students. Journal of Nursing Education, 56(2), 110-114.
Weaver, R. G., Webster, C. A., Beets, M. W., Brazendale, K., Chandler, J., Schisler, L., & Aziz, M. (2018). Initial outcomes of a participatory-based, competency-building approach to increasing physical education teachers’ physical activity promotion and students’ physical activity: a pilot study. Health Education Behavior, 45(3), 359-370.
Wei, C. O. (2017). Health Promotion Lifestyle Model of Undergraduates at Science and Technology Universities in Kaohsiung Area. Leisure and Society Research, 1-12.
Wertli, M. M., Held, U., Lis, A., Campello, M., & Weiser, S. (2017). Both positive and negative beliefs are important in patients with spine pain: finding from the occupational and industrial orthopaedic center registry. Spine Journal, 17, 30487-30494.
Wertli, M. M., Held, U., Lis, A., Campello, M., & Weiser, S. (2018). Both positive and negative beliefs are important in patients with spine pain: findings from the occupational and industrial orthopaedic center registry. Spine Journal, 18(8), 1463-1474.
WHO (1998). Health promotion glossary. World Health Organization: Geneva, 1-36.
Willman, A., Petzall, K., Ostberg, A. L., & Hall-Lord, M. L. (2013). The psycho-social dimension of pain and health-related quality of life in the oldest old. Scandinavian Journal of Caring Sciences, 27, 534-540.
Woo, K., Conceicao de Gouveia Santos, V. L., & Alam, T. (2018). Optimising quality of life for people with non-healing wounds. Wounds International, 9(3), 6-14.
Wosinski, J., Belcher, A. E., Durrenberger, Y., Allin, A. C., Stormacq, C., & Gerson, L. (2018). Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review. Nurse Education Today, 60, 67-74.
Wu, H. T., & Liao, P. H. (2015). A study of relationships between belief in afterlife and meaning in life of primary teachers: the attitude toward death as moderator. Kaohsiung Normal University Journal, 38, 1-25.
Wu, H. Y., Hsin, Y. Z., Chen, W. Y., Chien, C. L., & Jone, K. Y. (2017). Effects of gratitude program on gratitude, well-being and resilience of undergraduate students. Bulletin of Educational Psychology, 49(1), 23-41.
Wu, M. Y., Chen, H. T., Lu, Y. Y., & Hong, Z. R. (2018). Relationships between the self-perceptions of health awareness, body image, and well-being among adolescents in Kaohsiung. Journal of Research in Education Sciences, 63(1), 33-67.
Wu, P. H., Chen, R. F., Weng, Y. C., Chang, H. Y., & Hong, R. M. (2017). Briefly introduction situated simulation teaching between Taiwan and Australia: examples of nursing programs at CQU and CGUST. Chang Gung Journal of Sciences, 27, 87-96.
Xing, Z. J., & Xu, W. T. (2010). Teaching-the expansion and deepening of case teaching. Future and Development, 9, 85-87.
Yang, F. J. (2016). Developing and refining film appreciation instruction for feminist and life education films. Journal of Education Practice and Research, 29(2), 173-207.
Yang, Y., Jin, G., Yao, L. Y., & Niu, Y. Y. (2018). A retrospective study of smoking cessation intervention among university students. Medicine, 97(26): e11259 doi: 10.1097/MD.0000000000011259
Yu, W. C., & Chang, T. C. (2015). Research on essence of life education in taoism and ideas of environmental ethics. Holistic Education Journal, 57-82.
Zainuddin, Z. (2018). Students’ learning performance and perceived motivation in gamified flipped-class instruction. Computers & Education, 126, 75-88.
Zlotos, L., Thompson, I. D., & Boyter, A. C. (2015). Integration of an online simulated prescription analysis into undergraduate pharmacy teaching using supplemental and replacement models. American Journal of Pharmaceutical Education, 79(3), 1-7.
Zou, F., Wang, L., Hei, X., & Chen, D. (2015). Teaching-learning-based optimization with learning experience of other learners and its application. Applied Soft Computing, 37, 725-736.