The Influence of Reality Shock and Educational Specialist Nurse's Social Support on Organizational Socialization of New Nurses / 임상간호연구

Purpose@#The purpose of this study was to identify related factors in the organizational socialization of new nurses, focusing on the reality shock of new nurses and social support by education specialist nurses. @*Methods@#Participants were 122 new nurses with clinical experience of 1 year or less as nurses working in a general hospital that is carrying out a pilot project for a new nurse training system. Data were collected using self-report questionnaires which included identification of participants' characteristics, social support of education specialist nurse, reality shock and organizational socialization. @*Results@#The organizational socialization score was 3.07±0.45 points. The results of the stepwise multiple regression showed that factors affecting organizational socialization of new nurses were social support by gender, education specialist nurse and reality shock. These three variables accounted for 72.0% of organizational socialization. @*Conclusion@#These findings suggest that the social support of education specialist nurses be enhanced to increase the organizational socialization of new nurses. There is also a need for a program to decreased the reality shock of new nurses.

The Influence of Reality Shock and Educational Specialist Nurse's Social Support on Organizational Socialization of New Nurses / 임상간호연구

Purpose@#The purpose of this study was to identify related factors in the organizational socialization of new nurses, focusing on the reality shock of new nurses and social support by education specialist nurses. @*Methods@#Participants were 122 new nurses with clinical experience of 1 year or less as nurses working in a general hospital that is carrying out a pilot project for a new nurse training system. Data were collected using self-report questionnaires which included identification of participants' characteristics, social support of education specialist nurse, reality shock and organizational socialization. @*Results@#The organizational socialization score was 3.07±0.45 points. The results of the stepwise multiple regression showed that factors affecting organizational socialization of new nurses were social support by gender, education specialist nurse and reality shock. These three variables accounted for 72.0% of organizational socialization. @*Conclusion@#These findings suggest that the social support of education specialist nurses be enhanced to increase the organizational socialization of new nurses. There is also a need for a program to decreased the reality shock of new nurses.

Moderating Effects of Career Commitment in the Relationship between Work Engagement and Organizational Citizenship Behaviors of the Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of the study was to investigate the effect of work engagement (WE) on organizational citizenship behaviors (OCB) and ability to control career commitment (CC) in the relationship between work engagement and OCB. METHODS: Data were collected using structured self-report questionnaires from 205 nurses currently working at three national hospitals. Data were analyzed using descriptive statistics, ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis using the SPSS 21.0 program. RESULTS: Mean scores for each variable were: WE 3.77 (on a 7-point scale), OCB 3.41 (on a 5-point scale), and CC 3.05 (on a 5-point scale). As a result, comparison showed that all research variables were higher with age, OCB was higher with total clinical career, and CC was higher with higher education level. Total clinical career, WE and CC had a significant effect on OCB, and CC had a moderate effect on work engagement and OCB. These variables had a total explanatory power of 38% for OCB. CONCLUSION: The nurses' WE had a positive effect on OCB, and the CC showed a moderating effect on the relationship between WE and OCB. Therefore, we suggest that CC is an important factor in improving nurses' OCB.

Effects of Aromatherapy on Stress Responses, Autonomic Nervous System Activity and Blood Pressure in the Patients Undergoing Coronary Angiography: A Non-Randomized Controlled Trial / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG). METHODS: A non-equivalent control group with a pretestposttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance. RESULTS: Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p < .005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II. CONCLUSION: The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

Perception of Patient Safety Risk Factors and Performance Level of Safety Care Activities among Hospital Nurses / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the level of perception of safety risk factors and the degree of performance of safety nursing activities in order to develop an education program to improve the safety of patients. METHODS: The subjects were 217 nurses from 3 university hospitals in Incheon. Data were collected with structured questionnaires and analyzed using descriptive analysis, t-test, and ANOVA using SPSS 22.0. RESULTS: The level of perception of patient's safety risk factors and safety care activities was 2.93 and 4.68, respectively. Perception of patient safety risk factors which belonging to the risk type of therapeutic devices, equipment, service and infrastructure all scored below average; also in addition, behavior, performance, and violence risk type and work system, information and communication risk type showed relatively low perception levels. Safety nursing activities showed a low level of performance in accurate communication among medical teams, management of fire and disaster, security management, use of restraints, identification of patients, and correct performance of operations and procedures. CONCLUSION: Based on these results, it is necessary to improve the safety of patients by taking proper management measures along with education.

Effects of Aromatherapy on Stress Responses, Autonomic Nervous System Activity and Blood Pressure in the Patients Undergoing Coronary Angiography: A Non-Randomized Controlled Trial

PURPOSE@#The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG).@*METHODS@#A non-equivalent control group with a pretestposttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance.@*RESULTS@#Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p < .005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II.@*CONCLUSION@#The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

A Case with Partial Monosomy 6q and Partial Trisomy 14q Derived from Maternal Balanced Translocation / 대한주산의학회잡지

There are several cases of partial monosomy or partial trisomy derived from maternal balanced translocation, but partial monosomy 6q and partial trisomy 14q derived from maternal balanced translocation has not been reported around the world. The authors experienced a case of partial monosomy 6q and partial trisomy 14q derived from maternal reciprocal balanced translocation t (6;14) in a neonate with multiple anomalies including intrauterine growth retardation, facial and cardiac anomalies. We report the case with a brief review of associaed lieratures.

Neuroprotective Effects of Taurine Via Modulation of Nitric Oxide Synthase on Hypoxic-Ischemic Brain Injury in Neonatal Rats / 대한주산의학회잡지

PURPOSE: Taurine is a simple sulfur-containing amino acid and enriched in brain, retina, heart and skeletal muscles. In the central nervous system, taurine has been implicated in major phenomena. Current studies have demonstrated the neuroprotective effect of taurine in adult rat model, but limited data are available for those during the neonatal periods. The aim of this study was to determine whether taurine could reduce hypoxic-ischemic (HI) brain injury in the developing brain via modulation of nitric oxide synthase. METHODS: In in vitro model, embryonic cortical neuronal cell culture procedure was done in Sprague-Dawley (SD) rats at 18 days of gestation. The cells were divided into the hypoxia group, taurine-treated group before and after a hypoxic insult. The each groups compared with normoxia group. In in vivo model, left carotid artery ligation was done in 7-day-old SD rat pups. the pups were exposed to hypoxia, received an injection of 30 mg/kg of taurine, and sacrificed at day 1, day 3, day 7, day 14 and day 28. We assayed the expression of iNOS, eNOS and nNOS mRNA using real-time PCR and western-blotting. RESULTS: In in vitro model, brain cell damage of hypoxia group was more than in the normoxia group. Cell damage's recovery was more in the taurine-treated group before a hypoxic insult than in the taurine-treated group after a hypoxic insult. The expression of iNOS mRNA was less in the hypoxia group than in the normoxia group both in vitro and in vivo models. The expression of eNOS and nNOS was more in the hypoxia group. CONCLUSION: Taurine has neuroprotective property over perinatal HI brain injury due to modulation of NOS, as evidenced by causing a decrease in eNOS and nNOS and increase in iNOS expression. The neuroprotective effect of taurine administration was maximal at day 7 and day 14 after a hypoxic injury.

A Case of Partial Trisomy 9q Derived from Paternal Chromosome

There are few cases of partial trisomy of 9q, known as partial 9q trisomy syndrome with low birth weight, microcephaly, hypotelorism, beaked nose, small lip, long finger, hypertrophic pyloric stenosis, ventricular septal defect, and mental retardation. We report partial trisomy of 9q derived from a paternal chromosome, which has different features of other syndromes, including prematurity, atrial and ventricular septal defect, patent ductus arteriosus, persistent left superior vena cava, congenital hydronephrosis, and scrotal hernia

A Refeeding Syndrome in the Treatment of Anorexia Nervosa Complicated by Spontaneous Gastric Rupture / 대한소아소화기영양학회지

We report a rare case of gastric perforation in a 13-year-old boy with anorexia nervosa. He was admitted to our hospital with the chief complaint of body weight loss. He had lower abdominal pain after 2 days. An abdominal CT revealed diffuse peritonitis. At laparotomy, the stomach was dilated and perforated. Postoperatively, the patient suffered from malnutrition. We monitored electrolytes, minerals, and fluids closely before and during the initiation of feedings to prevent morbidity and mortality associated with refeeding syndrome. We present an extremely rare complication that relates to this phenomenon, describing an acute gastric dilatation that led to gastric necrosis and perforation through an unusual mechanism in an extremely anorectic teenager during hospitalization for refeeding.

Inguinal hernia of ovary and fallopian tube in adult woman / 대한산부인과학회지

Anomalous presence of fully developed female reproductive organs in the inguinal canal is extremely rare. But, early recognition and reduction of an ovary is thought to be important to prevent strangulation of the hernia and necrosis of the ovary. Ultrasound scan diagnose positively the presence of ovaries in the majority of cases. So we advise ultrasound scan must be performed routinely in those female with inguinal hernia. We experienced a case of inguinal hernia of ovary and fallopian tube in a fully developed adult woman. So we present it with a brief review of literature.

An ectopic ureterocele presented as a prolapsed vaginal mass in a 1-month-old girl / 대한산부인과학회지

An ectopic ureterocele is a rare condition in the neonate, especially one that protrudes from the outside of vagina as a site of termination of an ectopic ureter. In such a case, the differential diagnosis with inspection between an ectopic ureterocele and other vaginal mass is difficult. As well, recurrent episodes of urinary tract infection and sepsis are common. Recently, incision of an ectopic ureterocele has led to a decrease in compression due to obstruction of the urinary tract and fewer complications arising from surgery of the urinary system in infant. The authors present an example of a interlabial mass that appeared suddenly in a 1 month old neonate in which marsupialization of the prolapsed ectopic ureterocele was carried out.

The significance of Human Papillomavirus viral load by using hybrid capture II assay in diagnosis of CIN II or above in women with PAP smear showing only ASCUS/LSIL / 대한산부인과학회지

OBJECTIVE: To determine the clinical significance of high risk Human papillomavirus (HPV) DNA viral load measured by hybrid capture (HC) II assay in diagnosis of CIN II or above in women with cervical smear showing only Atypical squamous cells of undetermined significance (ASCUS)/Low-grade squamous intraepithelial lesion (LSIL). METHODS: This study was performed from September 2003 to September 2004 and included 111 patients with ASCUS/LSIL on PAP smear. All of them underwent high risk HPV DNA tests by HC II assay and colposcopy directed cervical biopsies. The histologic results were classified as low grade lesion (normal, CIN I) and high grade lesion (CIN II, III, and invasive cancer). The viral load was transformed into their logarithm (Log10RLU/PC ratio), and categorized as following four groups; negative HPV DNA (Log10RLU/PC or =2.0). We evaluated the relationships of the detection rate and viral load of high risk HPV DNA with histologic severity of cervical lesions. RESULTS: The rate of CIN II or above in 111 patients with ASCUS/LSIL was 25.2%. The detection rate of high risk HPV DNA using HC II assay was 96.4% in high grade lesion, and 66.3% in low grade lesion of histologic test. There was strong correlation between CIN II or above and positivity for HPV DNA when this group was compared with women with only CIN I or normal cervix (OR:13.7, 95% CI:1.7-106.4). The higher the viral load of HPV DNA infection observed, the higher the probability of being associated with stage of CIN (correlation coefficient:0.279). The frequency of high viral load observed in high grade lesion (89.3%) was significantly higher than low grade lesion (33.7%)(OR:16.3, 95% CI:4.5-58.9). When the cutoff of positivity was changed from 1.0RLU/PC ratio to 100.0RLU/PC ratio (Log10 RLU/PC ratio=2.0), the sensitivity for the prediction of high grade lesion was slightly decreased (96.4->89.3%), but pronounced gain in specificity (33.7->66.3%), and reduction in false positive rate (66.3->33.7%). CONCLUSION: The viral load of high risk HPV DNA measured by HC II assay was significantly associated with the severity of histology, and useful in diagnosis of CIN II or above in women referred because of ASCUS/LSIL on PAP smear.

Clinical Study of Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this article is to assist in early diagnosis and treatment of ectopic pregnancy. METHODS: We analyzed clinical statistics of 401 patients, who visited Masan Samsung Hospital from January 1, 1998 to December 31, 2002, received treatment under diagnosis of ectopic pregnancy, and were comfirmed by histopathologic examination. RESULTS: During the index period, the occurrence rate of ectopic pregnancy was 1:16.5, with peak age of occurrence between 30 to 34 year-old (34.4%). Previous history of artificial abortion was noted in 76.1%, previous cesarean delivery in 17%, previous pelvic inflammatory disease in 15.7% and history of previous ectopic pregancy in 9.5%. Concerned to clinical manifestations, lower abdominal pain was reported in 93.3%, amenorrhea in 86.5%, and vaginal bleeding in 69.3%. Onset of clinical manifestation was 6-8 weeks from the last menstrual period in 39.7%, being the most common. As the implantation site, fallopian tube was affected in 95.3%, ovary in 3%, and cervix of the uterus in 1%. Total amount of intraperitoneal hemorrhage was less then 500 mL in 45.6%. As an operative treatment, salpingectomy of the affected side was conducted in 76.8%. Average lengths of hospital stay for laparoscopy versus laparotomy were 3.4 and 5.2 days, respectively. CONCLUSION: Ectopic pregnancy, as a common emergent disorders, requires continuous attention for women in reproductive age. With the aid of various diagnostic modalities, early diagnosis and treatment can reduce mortality and morbidity rates, and enhance future fetility.

Prognostic Factor Analysis of Small Cell Lung Cancer: Appropriateness of Two Staging System / 대한암학회지

PURPOSE: The two staging system, which divides the tumors into limited disease (LD) and extensive disease (ED) has been widely accepted as a major prognostic determinant in small cell lung cancer (SCLC). However this system has provoked several controversial issues in defining stage categories, for instance, ipsilateral pleural effusion as LD or ED. Furthermore, identification of favorable subgroups in the same stage has been recognized as an important factor to determine appropriate treatment strategies. In this study, we performed a retrospective analysis in an attempt to resolve the controversial issues about staging and identify the patient group with favorable prognosis based on this two staging system. MATERIALS AND METHODS: The clinical data of 233 patients with SCLC treated from 1990 to 1996 at Korea Cancer Center Hospital were retrospectively analyzed for this study. All patients were treated with chemotherapy containing cisplatin and/or radiotherapy. The independent prognostic factors for survival were identified by multivariate analysis using Cox's proportional hazards model. RESULTS: Performance status (relative risk of death [RR]:2.89), number of metastasis (RR:2.2), response to treatment (RR:2.2) as well as stage (RR:1.77) were identified as independent prognostic factors for survival in patient with SCLC. The median survival of patients with ipsilateral pleural effusion (13 months) which was categorized as ED was similar to that of patients with contralateral mediastinal or supraclavicular lymph nodes (13.8 months) or other LD patients (13.7 months). This result suggests that ipsilateral pleural effusion should be categorized as LD. In LD, response to treatment was the only independent prognostic factor (RR:2.34) and thoracic radiotherapy moderately improved survival as compared with combination chemotherapy alone (17.7 months vs. 10.4 months, p=0.06). In ED, the patient group with a good performance status (ECOG 0-1), normal range of serum alkaline phophatase, and metastasis less than 2 sites showed significantly prolonged survival, comparing with other ED patients (11.2 months vs. 7.2 months, p=0.0001). CONCLUSION: As a result of survival analysis, we confirmed independent prognostic factors such as stage and performance status in SCLC. We could recommend that LD category include patients with ipsilateral pleural effusion as well as those with contralateral lymphadenopathy. In ED, the survival in patients with favorable prognostic factors was comparable to LD, suggesting this patient group may be a candidate for aggressive therapy.