Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing Examination / 보건의료교육평가

PURPOSE: The purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge. METHODS: We conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory. RESULTS: A total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%–100% for 12 items; 60%–80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below −2.0), easy for 8 items (−2.0 to −0.5), medium for 6 items (−0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate. CONCLUSION: We surmised that the low reliability of the mock examination was influenced by the timing of the test for the examinees and the inappropriate difficulty of the items. Our study suggested a methodology for the development of future case-based items for the Korean Nursing Licensing Examination.

Factors Influencing Sleep Quality in Nursing Students and non Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to identify sleep quality according to a sleep model, to examine factors influencing sleep quality in nursing students and non nursing students. METHODS: A cross sectional study was conducted with 154 nursing students and 155 non nursing students at several universities and college in Seoul. A self administrated questionnaire was used for data collection and data were analyzed descriptive statistics, t test or ANOVA, and regression with SPSS/WIN 14.0 program. RESULTS: Sleep quality of nursing students is lower than non nursing students. Sleep qualities showed significant differences according to academic self efficacy, stress, depression and daytime sleepiness in nursing students and stress, depression and daytime sleepiness in non nursing students. Significant factors influencing sleep quality of nursing students was stress and for non nursing students, daytime sleepiness. CONCLUSION: The findings indicated the importance of sleep hygiene education for nursing students is that results in sleep quality.

The Teachers' Attitudes, Discrimination and Causes of Prejudice Towards People with Mental Illnesses / 정신간호학회지

PURPOSE: The purpose of this study was to investigate the teachers' attitudes, discrimination, and causes of prejudice towards people with mental illnesses. METHODS: A cross-sectional study design was used and participants included 158 teachers who were recruited from four schools in S and G cities, Korea. From October to December, 2011, data on general characteristics, attitudes, discrimination and causes of prejudice towards people with mental illnesses were collected using self-administered questionnaires. SPSS/WIN 18.0 version was used for descriptive analysis, t-test, one-way ANOVA, and Pearson correlation. RESULTS: The mean scores of teachers' attitudes towards people with mental illness were, authoritarianism, 3.24, benevolence, 2.96, social restrictiveness, 3.44 and community mental health ideology, 2.75. There were significant differences in benevolence according to age. The experience of meeting people with mental illness contributed to positive attitudes towards people with mental illness in the benevolence subscale. There were significant differences in social restrictiveness according to residence. There were significant differences in discrimination according to age. Subscales of attitudes were significantly correlated with discrimination. CONCLUSION: These results emphasize a need for continuous education not only of teachers but also of the general population.

Factors related to Happiness in First year Women Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to investigate factors related to happiness in first year women nursing students. METHODS: The sample consisted of 209 first year women nursing students in three colleges located in S and C cities. Data were collected during October and November 2011. The major variables for this study were depression, self-esteem, optimism, interpersonal relation, and happiness. Data were analyzed using descriptive analysis, independent t-test, one-way ANOVA, correlation coefficient, and multiple stepwise regression with SPSS/WIN 17.0. RESULTS: There were significant differences in student happiness according to economic status, satisfaction with major, satisfaction with the present college, and health status. Happiness was significantly correlated with depression, self-esteem, optimism, and interpersonal relations. Self-esteem, optimism, interpersonal relations, and satisfaction with major were significant predictors of happiness for first year women nursing students and these four factors accounted for 71% of the variance in happiness. CONCLUSION: Self-esteem, optimism, interpersonal relations, and satisfaction with major should be considered when addressing ways to increase happiness in first year women nursing students.

Mediating Effect of Psychological Empowerment in Relationship between Professional Self-concept and Burnout in Psychiatric Nurses / 정신간호학회지

PURPOSE: The purpose of this study was to examine the mediator role of psychological empowerment in the relationship between professional self-concept and burnout in psychiatric nurses. METHODS: A cross-sectional correlational survey was conducted in S city and G province with 127 psychiatric nurses working in mental hospitals. Data were collected from March 8 to 16, 2012. The instruments used were the Psychological Empowerment Questionnaire, the Professional Self-concept of Nurses Instrument, and the Tedium Measurement. The collected data were analyzed using t-test, ANOVA, Pearson correlation coefficients and multiple regression with PASW 20.0. RESULTS: Statistically significant relationships were found among professional self-concept, psychological empowerment, and burnout. Psychological empowerment functioned as a mediator between professional self-concept and burnout. CONCLUSION: The implication of the results is that interventions that focus on psychological empowerment will contribute to the reduction of burnout in psychiatric nurses. This study also contributes to knowledge about the conditions that precede burnout, and shows the important role of psychological empowerment in the relationship between professional self-concept and burnout.

Anger, Depression and Self-esteem among Female Students in Nursing College / 정신간호학회지

PURPOSE: The purpose of this study was to investigate relationships among anger, depression, and self-esteem in female college students. METHODS: First-semester nursing students (N=248) completed surveys to estimate correlations of anger, depression, and self-esteem. Participants were recruited from two colleges in S and G cities, Korea. Data were collected from April 10 to 30, 2011. Measurement tools were for anger, Novaco Anger Scale (NAS), for depression, Beck Depression Inventory (BDI), and for self-esteem, Rosenberg Self-esteem Scale. SPSS/WIN 17.0 version was used for descriptive analysis, t-test, one-way ANOVA, Pearson correlation, and multiple regression. RESULTS: There were significant differences in self-esteem according to mood of family. Anger was significantly correlated with depression and self-esteem, which were significant predictors (30.0%) of anger. CONCLUSION: These results indicate that health promotion programs conducted by nurses for college student health care should target depression while bolstering self-esteem to promote anger management.

Effectiveness of an Interpersonal Relationship Program on Interpersonal Relationships, Self-esteem, and Depression in Nursing Students

PURPOSE: The purpose of this study was to examine the effectiveness of an interpersonal relationship program on interpersonal relationships, self-esteem, and depression in nursing students. METHODS: This was a quasi-experiment with a nonequivalent control group pre-posttest design. Sixty-four nursing students participated in the study with 31 in the experimental group and 33 in the control group. They were from 3 different colleges of nursing located in Seoul. The interpersonal relationship program was held 10 times over 10 weeks, taking 90 minutes per session. The interpersonal relationship change scale developed by Schlein and Guemey, Rosenberg's self-esteem scale, and CED-S for depression were the instruments used in the study. The data collection period was from January 4 to March 8, 2011, and the collected data were analyzed with SPSS 14.0 using the X2-test, t-test, and paired t-test. RESULTS: The results showed a significant difference between the experimental group and the control group in terms of the degree of interpersonal relationships, self-esteem, and depression. CONCLUSION: The results indicate that interpersonal relationship programs have positive effects for improving interpersonal relationships and self-esteem, and decreasing depression in nursing students.

The Effect of a Health Promotion Program through Multi-level Health Promotion

PURPOSE: This study was carried out to investigate the effects of improvement in self-rated health, self-efficacy, perceived benefit and health promotion behavior by running a health promotion program through the coalition of industries, universities and districts. METHODS: This study was designed as non-equivalent control group research. Data were collected from 62 participants in a health promotion program who were enrolled in a community center (experimental group: 29, control group: 33). The program was applied from October to November, 2008. The health promotion program was composed of value, competence, action, and policy based on a multi-level health promotion model. Collected data were analyzed through chi2 test, t-test, and Wilcoxon test. RESULTS: After participating in the health promotion program, the experiment group showed statistically significant increases in self-efficacy, perceived benefit and health promotion behavior but not in self-rated health. CONCLUSION: It was proven that the health promotion program enhanced the health promotion level in the community.

Risk Factors for Fatty Liver in Obese Children

PURPOSE: The incidence of obese patients has increased recently in Korea. Obesity is associated with hypertension, hyperlipidemia, insulin resistance, and fatty liver. Since recent investigators have revealed that not only fat accumulation but also fibrosis and nonspecific hepatitis can be found in the livers of obese children, fatty liver is currently considered as an important complication. The purpose of this study is to investigate the risk factors in obese children as a predictor of fatty liver. METHODS: The objects were 146 obese children, ranging from 7 to 16 years of age, who visit obesity clinics of Ewha Womans University Hospital. They were divided into two groups, with fatty liver(n=21) and without fatty liver(n=125), as diagnosed by ultrasonography. Body Mass Index(BMI) and blood pressure were measured. Bioelectrical impedance was analyzed to estimate body composition and fat mass. Serum levels of alanine transaminase(AST), aspartate transaminase(ALT), total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, and insulin were evaluated. RESULTS: BMI, blood pressure and abdominal fat percentages were significantly higher in the children with fatty livers. Body composition of intracellular fluid, extracellular fluid, protein, and minerals were also significantly elevated in the children with fatty livers. Total cholesterol, triglyceride, serum insulin and ALT were significantly higher in the children with fatty livers. CONCLUSION: This study confirmed the close relationship between these predictors and fatty liver. Abdominal sonography is helpful to recognize the presence of liver involvement in obese children with hyperlipidemia, hyperinsulinemia, increased ALT levels, and hypertension

A Case of Systemic Amyloidosis

Systemic amyloidosis is an uncommon disease characterized by deposits of fibrillar aggregates of monoclonal immunoglobuloin light chains in vital organs. This amyloid deposit cause cardiac or renal dysfunction and ultimately, death. Cardiac amyloidosis may be asymptomatic or important causes of progressive heart failure and refractory arrhythmia. Cardiac involvement from AL amyloidosis is rapidly fatal. The amyloidoses are classified according to the biochemical nature of the fibril-forming protein. Cardiac amyloidosis is common in primary (AL) and heterofamilial amyloidosis and very rare in the secondary (AA) form. As we experienced a case of systemic amyloidosis affected heart, liver and kidney, which was confirmed by histology. We present a 57-year-old female case with literature review.

Diagnostic Utility of D-dimer Test in Disseminated Intravascular Coagulation with Sepsis

PURPOSE: Disseminated intravascular coagulation(DIC) is a confusing disorder from both a diagnostic and therapeutic standpoint. In order to investigate the effectiveness of D-dimer test in disseminated intravascular coagulation associated with sepsis, D-dimer level and other laboratory tests were performed. METHODS: Fifty patients with disseminated intravascular coagulation associated with sepsis, who were admitted to the department of pediatrics, were evaluated by several tests(total WBC, erythrocyte sedimentation rate, C-reactive protein, blood culture test, prothrombin time, partial thromboplastin time, fibrinogen, fibrin degradation product, and D-dimer). If the test showed abnormal, follow-up study was performed. RESULTS: The positive rate of D-dimer in DIC was 72% and FDP 58%. The false positive rate of D-dimer level in normal children was 3.3% and FDP 6.7%. There was a significant linear correlation between D-dimer and FDP. CONCLUSION: D-dimer test was the most effective test for diagnosing disseminated intravascular coagulation.

Percent of Body Fat by Bioelectrical Impedance Analysis in Healthy Children

PURPOSE: Obesity is a frequent nutritional disorder in children and adolescent and its prevalence is increasing. Bioelectrical impedance analysis is a simple, rapid, non-invasive and reproducible technique. The aim of this study was to measure percent of body fat using bioelectrical impedance in healthy children. METHODS: We measured height, weight and bioelectrical impedance in 1035 children aged 7-18 years(496 males and 539 females). RESULTS: Percent of body fat was decreased in male children, but it was increased during the pubertal period in female. 95th percentiles of percent of body fat by bioelectrical impedance was 32.9% in 7 year olds, 31.6% in 8, 34.7% in 9, 35.1% in 10, 35.8% in 11, 33.1% in 12, 36.1% in 13, 38.2% in 14, 33.3% in 15, 28.3% in 16, 32.8% in 17 and 32.2% in 18 year olds for males. 95th percentiles of percent of body fat by bioelectrical impedance was 25.1% in 7 year olds, 29.6% in 8, 30.5% in 9, 35.6% in 10, 34.5% in 11, 36.5% in 12, 39.1% in 13, 34.1% in 14, 33.7% in 15, 32.8% in 16, 34.5% in 17 and 35.1% in 18 year olds for females. Intraobserver reliability coefficient of bioelectrical impedance analysis was 0.995 and intraobserver reliability of BI(Bioelectrical impedance) analysis was significantly high. CONCLUSION: To measure body fat percentage using bioelectrical impedance analysis in healthy children provides objective data in diagnosing obesity.

Serum IGF-I, Free IGF-I, IGFBP-1, IGFBP-3 Levels in Children with Intrauterine Growth Retardation / 대한소아내분비학회지

PURPOSE:Most but not all intrauterine growth retardation(IUGR) children has catch-up growth postnatally. However, nothing is known about the predictive parameters on the catch-up growth. The aim of this study was to describe serum IGF-I, free IGF-I, IGFBP-1, and IGFBP-3 levels in IUGR children and to correlate these hormone values with auxologic parameters to investigate their value on the postnatal growth pattern. METHODS:Among children with IUGR born at Ewha Womans University from Jan. 1995 to Aug. 1998, 16 children with IUGR at 3 years of age and 12 age-matched normal controls were studied for auxologic and biologic parameters. We measured height, weight, and serum levels of insulin-like growth factor(IGF)-I, free IGF-I, IGF binding protein(BP)-1, IGFBP-3 using immunoradiometric kits. RESULTS: 1)Among 16 children with IUGR at 3 years of age, 13 children had catch-up growth(81.3%), but 3 children remained short stature(18.7%). The height standard deviation score(SDS) in children with IUGR and control were -0.3+/-0.8 and 0.8+/-0.7, respectively(P0.05). 2)Serum IGF-I levels in children with IUGR at 3 years of age and normal control were 90.9+/-35.4ng/mL and 68.4+/-24.4ng/mL, respectively(p>0.05) and free IGF-I were 0.9+/-0.5ng/mL and 0.6+/-0.3ng/mL(p>0.05), IGFBP-1 were 50.5+/-30.5ng/ mL and 52.3+/-23.2ng/mL(p>0.05), IGFBP-3 were 4,116.7+/-1,062.2ng/mL and 4,058.4+/-808.5ng/mL(p>0.05), respectively. 3)In children with IUGR at 3 years of age, height SDS in IUGR children with catch-up growth and those without catch-up growth were 0.002+/-0.6 and -1.5+/-0.7, respectively(P<0.001), but there were no differences in weight SDS, body mass index, IGF-I, free IGF-I, IGFBP-1 and IGFBP-3. 4)There were no significant correlations between height gain and any growth factors. CONCLUSION: The results show that there is no difference in the levels of IGF-I, free IGF-I, IGFBP-1 and IGFBP-3 in IUGR children at 3 years of age compared to age-matched normal control, suggesting that other factors rather than IGF-I, free IGF-I, IGFBP-1, IGFBP-3 may cause short stature in IUGR.

Serum G-CSF Level Changes in Neonatal Sepsis

PURPOSE: The neonate is susceptible to severe and overwhelming bacterial infections. One of the most important deficiency in the neonatal host defense system seems to be quantitative and qualitative deficiency of the myeloid and the phagocytic system. Granulocyte colony-stimulating factor (G-CSF) has been shown to induce neutrophilia and enhance mature effector neutrophil function. We examined serum levels of G-CSF in neonates with enzyme linked immunosorbent assay (ELISA) method. METHODS: Sera from 42 patients in neonatal neutropenic sepsis (n=13) and non-neutropenic sepsis (n=29), as well as sera from 32 neonates in normal full-term were collected. Total WBC, absolute neutrophil count and serum G-CSF levels were measured at acute and recovery phases in sepsis and at cord blood, day 3 and day 7 in normal full term, respectively. RESULTS: The G-CSF level in normal full-term neonate was 105.6pg/mL at cord blood, and decreased to 35.1pg/mL on day 3, and 28.3pg/mL on day 7. There was statistical correllary relationship between their G-CSF level and peripheral neutrophilic granulocyte count in sepsis and suspected sepsis groups. CONCLUSION: These results suggest that the neonatal neutrophil count in sepsis is stimulated by endogenously secreted G-CSF and exogenous rhG-CSF is not needed.

Study of Epstein Barr Virus Antibodies in Patients with Kawasaki Disease

PURPOSE: The etiology of the Kawasaki disease remains unclear, many strong clinical and epidemiologic characteristics suggest an infectious etiology. However, conventional bacterial and viral cultures and extensive serologic studies have not revealed a consistent causative agent. Thus we studied the Epstein Barr virus(EBV), one of the most important pathogens, to access the association between the EBV and Kawasaki disease. METHODS: Seventy-two patients with Kawasaki disease were studied between June 1993 and July 1994 at Ewha Womans University Hospital. The control children were composed of 145 patients who have no evidence of Kawasaki disease or EBV infection. The VCA -IgM and IgG titer were measured in both groups by Enzyme Linked Immunosorbent Assay. RESULTS: 1) The positive rate of VCA-IgG was significantly higher in Kawasaki disease group (75.0%) compared with the control group(59.4%). 2) The positive rate of VCA-IgM, the indicator of acute EBV infection, was significantly higher in Kawasaki disease(13.9%) compared with the control group(2.1%). CONCLUSIONS: The high positive rate of EBV antibody measured in Kawasaki disease patients suggested that EBV might be etiologic pathogen of Kawasaki disease. While the stereotyped nature of Kawasaki disease makes the multiple pathogenesis, more extensive research for identifying the cause of Kawasaki disease will be necessary.

Concentrations and Placenta Transferability of Subclasses of IgG in Newborn Infants with Gestational Age

No abstract available.

Agenesis of corpus callosum-two cases report

No abstract available.

A case of incontinentia pigmenti

No abstract available.

The effect of ultrasonic nebulized salbutamol in the first attacked wheezy infants

No abstract available.

Clinical Study of Intussusception in Childhood (1967.1~1977.8.)

An analysis presented 86 cases of intussuscetion in Korean infants and children, treated at the Department of Pediatrics and the Surgery, Ewha Woman's University Hospital from January 1, 1967 to August, 1977, The following findings were noted. 1) The male outnumbered the females nearly 2.1/1. 2) In our survey, 82.5% of 86 patients were 1year or gounger and the peak incidence was between the 3 rd and 6th month of life (40.8%). 3) Seasonal distribution revealed as the highest in spring.(34.9%). 4) Thirity-seven cases(55.2%) of the intussusception were idipoathic. In 30 cases, a local cause was demonstrated. A wandering cecum was pesonted in 14 patients(20.9%) and proved to be the most common local cause. 5) It is significant that 58 cases(67.4%) of the patients were treated within 24 hours after onset of symptoms. However, seven patients(8.1%) had symptoms for more than 72 hours prior to hospital admission. 6) Vomiting and bloody stool were most common clinical signs(87.2% and 75.6%). Others were colicky abdominal pain (72.1%) and abdominal mass(50.0%). The positive results on the rectal exmination was 91.9 percent. 7) The demonstrable anatomic type of intussusception was ileocecal (38.4%) and proved to be the most common type. In addition to this type, there ileoclic(33.7%), ileocecocolic(11.6%), ileoileocolic(7.0%), ileoileal (5.8%), ileoileocecal(2.2%) in orders. 8) Simple abdomen X-ray on admission showed gaseous distension(45.5%). No specific findings were noted in 8 cases(12.1%) of the patients. 9) Nineteen (22.2%) of the patients underwent barium reduction and remainder were treated by surgical reduction. There were 58 patients(67.4%) who required manual reduction lreduction and 9 cases(10.4%) by intestinal resection for definitive therapy. 10) There were complications in 11.7 percents of the patients. The recurrence was 5 cases(5.8%) and proved to be the common complication. No deaths was encountered in our small series.