The relationship between intrinsic motivation and learning outcomes in problem-based learning / 한국간호교육학회지

Purpose@#The purpose of this study was to identify the relationship between intrinsic motivation and learning outcomes of nursing college students who took the Fundamentals of nursing as a problem-based learning method. @*Methods@#In this cross-sectional study, we identified the intrinsic motivations of 114 nursing students who completed problem-based learning using the Intrinsic Motivation Inventory. The t-test was conducted to identify differences according to intrinsic motivation, and correlation analysis was performed to confirm the relationship between intrinsic motivation and learning outcomes. @*Results@#The group with higher intrinsic motivation showed higher scores in all domains of self-assessed learning outcomes than the lower group. It was the ‘Relatedness with an instructor’ that showed the highest correlation with the learning outcomes in the domains of intrinsic motivation. @*Conclusion@#Problem-based learning is an effective learning method for cultivating the competencies needed for nurses. The intrinsic motivation of students is an important factor in the performance of problem-based learning. For the efficiency of problem-based learning, efforts should be made to develop and apply autonomy-supportive interventions that can enhance intrinsic motivation.

Differences in Awareness, Attitude and Knowledge toward Muscle Health according to General Characteristics

PURPOSE: To understand awareness, attitude and knowledge levels of muscle health of adults over 18 years old. METHODS: This study was a cross-sectional study using questionnaires. A total of 401 questionnaires were included for final analysis. Mean and standard deviation of the continuous variables were analyzed and frequency analysis of categorical variables was performed. To identify differences according to general characteristics, t-test was used. RESULTS: Awareness scores about the importance of muscle health and exercises were 8.3 and 13.0, respectively. Attitude score and knowledge score were 12.4 and 15.0, respectively. There were differences in attitude toward muscle health according to gender, age, physical activity, and diet habits. However, there was no difference in attitude toward muscle health according to educational level, smoking, drinking, or sleeping. CONCLUSION: It is necessary to seek a strategy to improve awareness and attitude toward muscle health based on knowledge, not merely to raise knowledge level about muscle health. Since nurses play a central role in health promotion and disease prevention, they should also play an important role in strategic development and application of intervention.

Optimal Cutoffs of Cardiometabolic Risk for Postmenopausal Korean Women

PURPOSE: The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS: The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS: Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%). CONCLUSIONS: For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.

Prevalence of Depression and its Risk Factors among Aged at Social Service Centers in One Urban Community / 재활간호학회지

PURPOSE: The purpose of this study was to identify the prevalence of depression and its risk factors among older adults using social service centers in one urban community. METHODS: The participants were 326 older adults who were aged 60 and older in one urban Korean community. Depression was measured by Korean version of short form Geriatric Depression Scale. RESULTS: The prevalence of depression was 33.74% in this study. Logistic regression analysis showed that older adults who were taking prescribed medications, experiencing more symptoms, being educated less than elementary school and having low family function were more likely to have depression as compared to their counterparts. CONCLUSION: The findings of this study were expected to promote the screening or preventing strategies for older adults at the risk of depression in the community-dwelling older adults.

Serosurveillance for Japanese encephalitis virus in wild birds captured in Korea

Climate change induced by recent global warming may have a significant impact on vector-borne and zoonotic diseases. For example, the distribution of Japanese encephalitis virus (JEV) has expanded into new regions. We surveyed the levels of hemagglutination-inhibition (HI) antibodies against JEV (Family Flaviviridae, genus Flavivirus) in wild birds captured in Korea. Blood samples were collected from 1,316 wild birds including the following migratory birds: Oceanodroma castro (n = 4), Anas formosa (n = 7), Anas penelope (n = 20), Fulica atra (n = 30), Anas acuta (n = 89), Anas crecca (n = 154), Anas platyrhynchos (n = 214), Aix galericulata (n = 310), and Anas poecilorhyncha (n = 488). All were captured in 16 locations in several Korea provinces between April 2007 and December 2009. Out of the 1,316 serum samples tested, 1,141 (86.7%) were positive for JEV. Wild birds captured in 2009 had a higher seroprevalence of ant-JEV antibodies than those captured in 2007. Wild birds with an HI antibody titer of 1 : 1,280 or higher accounted for 21.2% (280/1,316) of the animals tested. These findings indicated that wild birds from the region examined in our study have been exposed to JEV and may pose a high risk for introducing a new JEV genotype into Korea.

Type 2 Diabetes in Urban and Rural Districts in Korea: Factors Associated with Prevalence Difference

The purpose of this study was to examine the urban-rural differences in the prevalence and associated factors with type 2 diabetes mellitus (T2DM) in Korean adults. A total of 1,060 adults >30 yr of age from urban (189 males and 331 females) and rural districts (219 males and 321 females) were recruited. Anthropometric measures, blood pressure, lipid profiles, and fasting and 2-hr after 75-g oral glucose load blood glucose were obtained. The crude- and age-standardized prevalence of T2DM was 15.4% and 14.5%, and 11.7% and 8.6% in urban and rural districts, respectively. Diabetic subjects were older and obese, and had a higher triglyceride level, and systolic blood pressure compared to non-diabetes in both population. Multivariate regression analysis revealed that older age, high triglyceride levels, central obesity, and hypertension were significantly associated with T2DM in both areas. Low monthly incomes were significantly associated with T2DM in urban population, while a family history of T2DM was significantly associated with T2DM in rural area. T2DM is more prevalent in urban than in rural population, and low economic status or genetic factor is differently associated with T2DM in both population, respectively.

Experimental infection of chickens, ducks and quails with the highly pathogenic H5N1 avian influenza virus

Highly pathogenic avian influenza viruses (HPAIV) of the H5N1 subtype have spread since 2003 in poultry and wild birds in Asia, Europe and Africa. In Korea, the highly pathogenic H5N1 avian influenza outbreaks took place in 2003/2004, 2006/2007 and 2008. As the 2006/2007 isolates differ phylogenetically from the 2003/2004 isolates, we assessed the clinical responses of chickens, ducks and quails to intranasal inoculation of the 2006/2007 index case virus, A/chicken/Korea/IS/06. All the chickens and quails died on 3 days and 3-6 days post-inoculation (DPI), respectively, whilst the ducks only showed signs of mild depression. The uninoculated chickens and quails placed soon after with the inoculated flock died on 5.3 and 7.5 DPI, respectively. Both oropharyngeal and cloacal swabs were taken for all three species during various time intervals after inoculation. It was found that oropharyngeal swabs showed higher viral titers than in cloacal swabs applicable to all three avian species. The chickens and quails shed the virus until they died (up to 3 to 6 days after inoculation, respectively) whilst the ducks shed the virus on 2-4 DPI. The postmortem tissues collected from the chickens and quails on day 3 and days 4-5 and from clinically normal ducks that were euthanized on day 4 contained the virus. However, the ducks had significantly lower viral titers than the chickens or quails. Thus, the three avian species varied significantly in their clinical signs, mortality, tissue virus titers, and duration of virus shedding. Our observations suggest that duck and quail farms should be monitored particularly closely for the presence of HPAIV so that further virus transmission to other avian or mammalian hosts can be prevented.

Quality of Life in Low Income Korean Aged

PURPOSE: The purpose of this study was to identify the quality of life and its predictors in low income Korean aged. METHODS: This was a predictive correlational study. An accessible sample from the population of people who were 65 and over and were supported by the basic livelihood security system was 1,040. Quota sampling with strata of state division in the nation was chosen. Quality of life and its predictors in the subjects were measured. RESULTS: The mean quality of life in the subjects was 47.0+/-10.7. Predictors of this study significantly explained 54.3% of the total variance of quality of life. Depression was the most significant predictor of quality of life. Health problems, district, social support, leisure activity, and health behavior had effects on quality of life. CONCLUSION: This finding indicates that quality of life in lower income Korean aged is different from other populations by economic status. Demographics, health status and social status were predictors of quality of life in the aged with a small income.

Health Status, Depression and Social Support of Elderly Beneficiaries of the National Basic Livelihood Security System / 성인간호학회지

PURPOSE: The purpose of this study was: 1) To investigate health status(health behavior, health problem and cognition), depression and social support of elderly beneficiaries of the National Basic Livelihood Security System. 2) To identify the relationships among health status, depression and social support. METHODS: This descriptive study used a cross-sectional design. The study sample was a total of 883 elderly recipients supported from the National Basic Livelihood Security System. Quotas for sampling were designed and conducted nationwide throughout Korea. RESULTS: The mean age was 76.2 and the 79.6% of the sample were female. The scores for the health behavior, health problem, ADL, and cognition were 23.9, 4.4, 39.6 and 24.9, respectively. Additionally, the depression score was 19.8 and the social support score was 63.2. Gender, age, education, religion, marital status and monthly income were found as important variables in increasing health status and in decreasing depression among the elderly. Furthermore, depression showed a positive correlation with health problems, but showed negative correlations with health behavior, ADL, and cognition. The upper 25% of social support recipients suffered less depression than the lower 25% of the recipients. Subjects with more social supports had higher ADL scores and less health problem. CONCLUSION: These findings provide significant practical implications for nursing intervention, including social support for the elderly receiving assistance from the National Basic Livelihood Security System.

Psychometric Evaluation of the Korean Social Support Questionnaire

PURPOSE: Research related to social support in Korea has been hampered by paucity of measurement tools reflecting Korean culture. The aim of the study was to develop Korean social support questionnaire (KSSQ) based on the Korean social support pyramid and to test psychometric properties of the KSSQ. METHODS: The questionnaire was administered to 701 subjects and 658 college students. Psychometric analyses included factor analyses, expert validity, criterion-related validity, internal consistency, and test-retest reliability. RESULTS: A principal components analysis support for construct validity, eliciting a three factor solution accounting for 65.46% of variance in scores. Concurrent and discriminant validity supported criterion-related validity. Internal consistency of reliability was support with Cronbach's alpha of .97-.98 for the entire scale. Test-retest reliability was .76. CONCLUSION: This initial testing of KSSQ to measure Korean social support demonstrates evidence of reliability and validity. Assessment of known-group validity and norm establishment of KSSQ are suggested to provide further sound psychometric properties and practical measurement tools.

Analysis of RN-BSN Students' Clinical Nursing Competency / 간호학회지

PURPOSE: The purpose of this study was to investigate RN-BSN students' clinical nursing competency in order to establish baseline data for developing nursing competency based clinical education for RN-BSN students. METHOD: A survey of 1,453 RN-BSN students from 21 nursing schools was conducted using a self administered questionnaire. RESULT: The mean score of the clinical nursing competency was 2.93. The scores for competency were shown as 2.91 for nursing management, 2.94 for developing professionalism & legal implementation, 2.95 for critical thinking, 2.96 for teaching & leadership, and data collection, basic nursing care, and communication were above 3.00. The items perceived as insufficient competency were physical examination and observation & monitoring in data collection, cardiopulmonary resuscitation, psycho-social care, spiritual care, hospice in basic nursing care, application of knowledge and theory, formulating nursing diagnosis, nursing care planning in critical thinking, education material development, leadership, delegation in teaching and leadership, analysis of organization, planning, infection control, role & job description, evaluation of nursing activities in nursing management, quality improvement, and research in developing professionalism and legal implementation. CONCLUSION: This study will contribute to developing a nursing competency based on clinical education for RN-BSN students who have various education needs and clinical backgrounds.

Fatigue and Its Related Factors in Korean Patients on Hemodialysis / 간호학회지

PURPOSE: This study examined the characteristics of fatigue and the relationship between fatigue and its related factors in Korean patients on hemodialysis. METHODS: A cross-sectional correlational study was conducted with 104 patients on hemodialysis in Seoul, Korea. FINDING: Of a total of 104 subjects, eighty-one (77.9%) complained of fatigue. Fatigue severity was measured by the self-rating Visual Analogue Scale-Fatigue (VAS-F) with a mean score of 36.5 (SD=17.49, range 2 - 81). The mean duration of fatigue was 3.8 hours (SD=5.3, range 0 - 24). Depression was most significantly correlated with fatigue (beta=.43, p<.00), with interdialytic weight gain (beta=.25, p<.05) being the second most significant correlate. CONCLUSION: This study shows that nursing interventions for patients who experience fatigue while on hemodialysis should be focused on both psychological problems, such as depression, as well as on physiological problems, such as interdialytic weight gain.

Health Status among Community Elderly in Korea / 간호학회지

PURPOSE: This study examined the health status among elderly in community. METHOD: This is a survey using cross-sectional design. The subjects were 531 elders who were 65 and over in Pusan, Korea. Data were collected by 17 trained interviewers from April 10 to August 26, 2000. Functional status for physical health status, depression, loneliness, self-esteem for psychological health status, and social support for social health status were measured. RESULT: About forty three percent of the subjects were found as the elderly who need support in physical status. About fifty six percent of the subjects were depressed. The mean score on the Loneliness scale was 40.4, which means relatively higher. For self-esteem, its score was lower than that of elderly who were examined in other studies. The subjects were living in the state of lower social support. The risk factors for vulnerable health status were being female, becoming older, lower income and education, and living alone. CONCLUSION: This finding indicates that the elderly subjects in Korean community were in poor health status in physical, psychological and social aspects.

Development of an Education Program for Hospice Care and Its Performance / 간호학회지

The purpose of this study was to develop an education program for hospice care and to examine the effect of program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with witch terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description after the performance of education. put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.

A Case of Cerebral Infarction due to Carotid Arterial Obstruction following General Anesthesia / 대한마취과학회지

We report a case of acute cerebral infarction after general anesthesia. A 55-year-old man underwent total gastrectomy and splenectomy for advanced gastric cancer. Preoperatively, he has complained headache and dizziness for a year but neurologist, internist and anesthesiologist could not find any sign of cerebrovascular diseases. General anesthesia was induced with thiopental and maintained with 50% N2O and 1.5-2% enflurane in oxygen. After approximately 4h in the recovery room, he was not regained his consciousness. On physical examination, there was right hemiplegia. Immediate brain CT revealed acute cerebral infarction in left MCA and ACA territory. He was transported SICU. The following day he had a carotid Doppler ultrasonography that showed complete obstruction of both ICA. Neurologic examination showed negative eye reflex and pupil full dilation. He was discharged in a hopeless situation.

Inadvertent subdural block in epidural anesthesia: A case confirmed by radiographic contrast material / 대한마취과학회지

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.