Comparison of the nutritional indicators of critically Ill patients on extracorporeal membrane oxygen (ECMO) / 한국영양학회지

Purpose@#This study aimed at investigating the nutritional status, nutritional support, and nutritional indicators of critically ill patients on extracorporeal membrane oxygen (ECMO) in intensive care units (ICU). @*Methods@#This descriptive study obtained data from the medical records of 37 patients who were treated using ECMO at a university hospital in Korea. The patients were admitted to the Korea University Anam Hospital ICU with acute or serious damage to vital organs from January 1, 2014 to June 30, 2016. @*Results@#Although 32 patients (86.5%) were at a high risk of malnutrition, 26 patients (70.3%) were considered normal in terms of nutritional status by the nutritionist at the beginning of their ICU stay. However, after two weeks, nine patients had passed away and only one patient maintained normal status. Parenteral nutrition was started first but took 4.25 ± 6.95 days till initiation. Only eight patients (21.6%) were able to meet their requirement for both calories and protein. The group provided with adequate calorie and protein showed significantly longer use of the ECMO and respirator and longer ICU and total hospital stay than their counterparts. Normal levels of serum albumin and protein of the group at low-risk for malnutrition on the day of initiation of ECMO, which were significantly higher than the high-risk group, declined by the last day of ECMO leading to a lack of significant differences between the two groups. @*Conclusion@#Considering that the nutritional indicators of patients deteriorated as the days on ECMO increased, more aggressive nutritional management to ensure adequate nutritional support should be emphasized from the beginning and throughout the ICU stay.

Concept Analysis of Colleague Solidarity among Nurses during the Coronavirus Pandemic / 간호행정학회지

Purpose@#This study aimed to define and clarify the concept of colleague solidarity experienced by nurses during the COVID-19 pandemic. @*Methods@#A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical phase, 20 articles selected through literature review by including nursing and related disciplines were analyzed. For the fieldwork phase, in-depth interviews were conducted with nine nurses who took care of infected patients with COVID-19 at Infectious Diseases Specialized Hospital. @*Results@#The dimensions identified were consistently observed in the field phase, however, more attributes were found newly from the fieldwork phase. In the final phase, the concept of colleague solidarity among the nurses was found to have three dimensions with nine attributes. The interaction dimension had four attributes as voluntary support, mutual respect, open communication, and virtuous circle. The motivation dimension had two attributes of sense of communion and calling. Lastly, the relationship dimension had three attributes of unity, mutually equal relationship, and comradeship. @*Conclusions@#This study is meaningful in observing how the concept of colleague solidarity, which is relatively unfamiliar to domestic nurses, appears in the clinical field during a national crisis and analyzing the concept.

Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial

PURPOSE: This randomized control trial was designed to examine the effect on the self-managing ability for promoting bone health of mobile typeebone health intervention (mobile typeeBHI). METHODS: The mobile typeeBHI consisted of amobile application called “Strong bone, Fit body” (SbFb) and group education. A total of 82 college women with low bone mass (Z score <−1) participated. They were assigned randomly to three groups, experimental group I, (n = 28), experimental group II (n = 32), and control group (n = 22). This study ran from June 2014 to January 2015. The outcome variables were bone mineral density, minerals related to bone metabolism (calcium, phosphorus, vitamin D), biochemical markers related to bone remodeling (osteocalcin, C-terminal telopeptide, sclerostin), food intake diary by 24 hours recall, and psychosocial variables related to bone health (knowledge, health belief and selfefficacy). Data were analyzed using SAS program and a computer aided nutritional analysis program. RESULTS: Both the experimental group I, who used mobile typeeBHI, and experimental group II, who only received group education, showed outcomes regarding knowledge of the benefits of exercise and calcium as compared with the control group. The two experimental groups also demonstrated results in the serum levels of calcium, vitamin D, and sclerostin compared to those of the control group. CONCLUSION: Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on selfmanagement ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.

Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

PURPOSE: This study compared the effects of robotic single-port cholecystectomy (RC) and 3-port laparoscopic cholecystectomy (LC) on patients' surgical pain, postoperative complications, and satisfaction. METHODS: One hundred twenty patients with gallbladder disease scheduled for either LC or RC were recruited. Each patient was followed up for 1 week after hospital discharge. RESULTS: Time stayed in operating room was longer in patients with RC, however their hospital stay was shorter than those with LC (t = 3.01, P = 0.003). Since patients with RC received more analgesics during the surgery (t = 3.98, P < 0.001), all participants' surgical pain level were analyzed by using analysis of covariance. Patients who underwent RC reported less surgical pain consistently at 6 hours and first day after surgery and 2 days and 1 week later than patients in the LC. Repeated measure analysis of variance also demonstrated that the RC with single-port might cause less pain throughout the postoperative period (F = 25.68, P < 0.001). Participants' conditions appeared stable without complications such as infection or bleeding regardless of the surgical type however, overall satisfaction with RC showed significantly higher than those with LC except for one item, “the cost of surgery.” CONCLUSION: These results suggested that the RC might be a better choice for people who concern about surgical pain and early hospital discharge. Since there were no differences in postoperative health status between the 2 groups, health care providers as an advocate can provide more reliable information to their patients.

CORRIGENDUM: Correction of the affiliation name. Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

In the original publication, The authors found a mistake in funding statement. Also in the title page (1st affiliation) and main text, the authots would like to revise the affiliation name.

Bone Mineral Density, Biochemical Bone Turnover Markers and Factors associated with Bone Health in Young Korean Women

PURPOSE: This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women. METHODS: Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report. RESULTS: The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score or =0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors. CONCLUSION: Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.

Depression Status of Academic High School Students in Seoul: Mediating Role of Entrapment

PURPOSE: Purpose of this study was to investigate the status of depression in academic high school students and path analysis model for exploring the mediating role of entrapment to depression in relation to academic stress and perceived social support. METHODS: Measurements were four reliable questionnaires measuring academic stress, social support, entrapment, and depression. Data were collected from students in 17 high schools in Seoul. RESULTS: Students (n=5,346) completing the questionnaires indicated depression & entrapment from academic stress. Depression was more prevalent in girls, those whose parents' household income was less than two million won, who did not live with father or mother or both due to divorce, separation, or death, and those who smoked or used alcohol. Entrapment was more prevalent in students similar to cases of depression and in seniors. According to the proposed path model, 48.6% of depression was explained by academic stress, social support, and entrapment. The indirect effect of entrapment as a mediator between academic stress and depression was verified and larger than the direct effect of academic stress on depression. CONCLUSION: Considering levels of depression and entrapment demonstrated by these students, better mental health programs with diverse strategies should be developed for their psychological well-being.

Anger, Anger Expression, and Biopsychosocial Health in Korean Adolescents / 정신간호학회지

PURPOSE: The purpose of this study was to explore status and relationships of anger and its expression type to biopsychosocial health in Korean adolescents. METHODS: This cross-sectional study used four reliable survey questionnaires that measure anger, depression, resilience, and psychosomatic symptoms. Data were collected from 18,752 students of 36 middle schools and 23 high schools located in 23 administrative districts in Seoul, Korea. RESULTS: The Korean adolescents who completed the questionnaires indicated moderate level of trait anger. 45% of them demonstrated using one of three undesirable types of anger expression such as dysfunctional anger-in and anger-out, high level anger-in, or high level anger-out. Also, level of trait anger and types of anger expression were significantly associated with resilience, depression, and psychosomatic health status. CONCLUSION: School-based mental health education such as anger management programs for Korean adolescents might be necessary to help them develop desirable and effective coping skills and strategies.

Anger, Anger Expression, and Biopsychosocial Health in Korean Adolescents / 정신간호학회지

PURPOSE: The purpose of this study was to explore status and relationships of anger and its expression type to biopsychosocial health in Korean adolescents. METHODS: This cross-sectional study used four reliable survey questionnaires that measure anger, depression, resilience, and psychosomatic symptoms. Data were collected from 18,752 students of 36 middle schools and 23 high schools located in 23 administrative districts in Seoul, Korea. RESULTS: The Korean adolescents who completed the questionnaires indicated moderate level of trait anger. 45% of them demonstrated using one of three undesirable types of anger expression such as dysfunctional anger-in and anger-out, high level anger-in, or high level anger-out. Also, level of trait anger and types of anger expression were significantly associated with resilience, depression, and psychosomatic health status. CONCLUSION: School-based mental health education such as anger management programs for Korean adolescents might be necessary to help them develop desirable and effective coping skills and strategies.

Relationship Between Survivors' Perceived Health Status Following Acute Coronary Syndrome and Depression Symptoms During Early Recovery Phase

PURPOSE: To examine and describe perceived health status and depression symptoms among Acute Coronary Syndrome (ACS) survivors, and to examine their relationship during survivors' recovery phase. METHODS: A prospective design was used to test changeability of the key variables over a 1-month period for a cohort group of 82 post ACS patients, prior to their hospital discharge (Time 1) and at 4 weeks post discharge (Time 2). The revised version of Short Form-12 Health Survey and Beck Depression Inventory were used to measure the perceived health status and depression symptoms. The data were collected between 2003 and 2004. RESULTS: Perceived health status including mental health and physical health significantly improved over the 4-week period (t=-2.58, p < .05). Perceived health status during the hospitalization and length of hospital stay were significant predictors of depression symptoms during the early recovery phase. CONCLUSIONS: Patients' own perceptions about their health status need to be closely evaluated during the hospitalization in order to reduce the occurrences of later depression symptoms. Consequently, reducing depression symptoms and improving perceived health status should be addressed both in acute and chronic phases of ACS.

Comparison of Cardiovascular Health Status and Health Behaviors in Korean Women based on Household Income

PURPOSE: In this study cardiovascular health status and health behavior of Korean women based on their household income were explored. METHODS: For this cross-sectional study, 91 women residing in the community were recruited to complete survey questionnaires and biophysical tests including blood pressure (BP), body mass index (BMI), body fat rate, waist circumference (WC), and blood chemistry tests. RESULTS: Compared to non-low income women (NLIW), low income women (LIW) were more likely to be older, less educated, and jobless, and further more LIW were postmenopause and reported having been diagnosed with hypertension or hypercholesterolemia. Significant differences were found in systolic BP, triglyceride level, BMI, body fat rate, and WC between the groups. Two fifths of the LIW had indications for metabolic syndrome. Their 10-yr risk estimate of myocardioal infarction or coronary death demonstrated a higher probability than that of NLIW. Although these significant differences were due to age gap between the groups, advanced age is known to be one of the key characteristics of LIW as well as a non-modifiable risk factor. CONCLUSION: Effective community programs for vulnerable women at risk of cardiovascular disease should be based on strategies targeting unhealthy behaviors and modifiable risk factors.

Resilience in Patients with Parkinson's Disease / 성인간호학회지

PURPOSE: The aim of this study was to investigate the level of resilience and related factors in patients with Parkinson's disease (PD) in Korea. METHODS: Data were obtained from 148 patients using the Resilience Scale (RS), Beck's Depression Inventory (BDI), and Spielberger's Anxiety Inventory (AI). RESULTS: The mean scores of the RS, BDI, and AI were 127.7+/-21.6, 12.9+/-9.3, and 41.9+/-11.1, respectively. The RS score was strongly correlated with the BDI score (r=-.531, p<.001) and the AI (r=-.572, p<.001). The resilience was significantly revealed by household income (F=4.002, p=.009) and presence of a hobby (t=-3.300, p=.001). In addition, resilience was significantly correlated with age of disease onset (r=.164, p=.046), years of living with PD (r=-.262, p=.001), and the length of treatment with levodopa (r=-.283, p<.001). From the stepwise multiple regression analysis, the most important factors related to the RS score were the AI score, household income, and length of treatment with levodopa. CONCLUSION: Understanding these factors is essential for developing effective interventions to improve resilience in patients with PD.

Critical Thinking of Clinical Nurses / 기본간호학회지

INTRODUCTION: Critical thinking involves identifying problem(s), assessing resources, and generating possible solutions and allows clinical nurses to decide which solution is the most reasonable under the given circumstances, taking into consideration the "what ifs" and how they will affect the end result. This research was conducted to further understanding and identification of subjective factors in critical thinking in clinical nurses. METHODS: The research design was a Q-Methodological Approach. Q-population was formulated from a non-structured questionnaire and interviews from 17 experienced clinical nurses. Thirty selected Q-statements were sorted by 30 experienced clinical nurses. RESULTS: Four factors for critical thinking were identified: (1) Deductive reasoning based on causal relation, (2) Construction of an effective model based on patients' responses, (3) Formulating categories based on priorities for effective interventions, and (4) Judging validity of the situational significance on clinical performances. CONCLUSION: Critical thinking is an attitude and reasoning process. From this study, the frame of reference for clinical nurses in formulating critical thinking within the context of clinical settings is identified and indicates the way nurses utilize thinking skills when they care for patients and areas that need further exploration as nurses and faculty develop education systems to advance clinical performance competency.