ABSTRACT
Purpose@#This study considers the variables related to self-leadership of Korean nursing students and verifies the results of precedent studies through meta-analysis. @*Methods@#This study selected a total of 48 precedent studies regarding the investigation of the correlation between variables related to self-leadership of nursing students conducted between 2009 and 2019 and carried out a meta-analysis. @*Results@#For the effect size of variables related to self-leadership of nursing students, individual characteristics had a medium effect size (ESr=.49) and the effect size was larger for meta-cognition (ESr=.65), emotional intelligence (ESr=.58), and self-efficacy (ESr=.54). The characteristics of nursing competency (ESr=.45) also had a medium effect size and the effect size was larger for professional self-concept (ESr=.60), social support (ESr=.58), and critical thinking (ESr=.56). This result shows that individual characteristics were highly correlated with self-leadership compared to the characteristics of nursing competency. @*Conclusion@#This study is significant in that it verified the effect of variables related to self-leadership and presented the direction and preliminary data for a follow-up study. It is necessary to include variables considering individual characteristics in the development of an educational program for improving self-leadership in the future.
ABSTRACT
BACKGROUND AND PURPOSE: Although plasmapheresis is becoming standard practice as a rescue therapy for neuromyelitis optica (NMO), evidence for the therapeutic efficacy of plasmapheresis is limited, and the effect of plasmapheresis on anti-aquaporin-4 (AQP4) levels in patients with NMO has not been reported. Here, our objective was to evaluate the clinical efficacy of therapeutic plasmapheresis and its effect on anti-AQP4 antibody levels in patients with NMO spectrum disorder (NMOSD). METHODS: We retrospectively reviewed the medical records of 15 patients with NMOSD who had 18 acute attacks and received plasmapheresis because they did not respond to high-dose intravenous methylprednisolone (IVMP) therapy. Anti-AQP4 antibodies were measured before and after plasmapheresis. The primary outcomes were functional improvements immediately and 6 months after plasmapheresis, and the secondary outcome was the change in anti-AQP4 antibody serum levels following plasmapheresis. RESULTS: Plasmapheresis following IVMP therapy led to significant improvement in 50% of the 18 attacks in 15 patients immediately after the procedure was completed, and in 78% (14 attacks) after 6 months. Plasmapheresis was generally well tolerated in all patients. Anti-AQP4 antibody serum levels declined significantly following plasmapheresis, to a mean of 15% of the preplasmapheresis levels. Lower scores on the visual outcome scale recorded before an attack were associated with significant immediate improvement upon the completion of plasmapheresis (p=0.03). CONCLUSIONS: Plasmapheresis following IVMP therapy effectively removed anti-AQP4 antibodies and was accompanied by a substantial improvement in the neurological disability of patients with NMOSD. Lower levels of pre-existing neurological damage may be associated with an improved acute response to plasmapheresis.