1. Department of Nursing, Tzu Chi University, Hualien 97004, Taiwan
2. Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970374, Taiwan
3. School of Medicine, College of Medicine, Tzu Chi University, Hualien 970473, Taiwan
4. Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan