A Survey on Undergraduate Nursing Students Safety during Fundamentals of Nursing Practicum / 기본간호학회지

Purpose@#This study was done to investigate the experience of physical and emotional safety in nursing students during fundamentals of nursing practicum. @*Methods@#A descriptive cross-sectional study was conducted from March to September 2019. A total of 553 nursing students, who had completed fundamental nursing laboratories, participated in this study. Data were collected using self-report questionnaires which included questions about general characteristics, physical and emotional safety during fundamental nursing laboratories along with an informed consent given prior to the practicum. @*Results@#Of the students, 26 experienced physical safety accidents, and 18 reported emotional safety accidents. Students' mean stress score for physical safety was 1.95, and the mean score for emotional safety was 1.92. Of the students, more than 59.1% agreed to volunteer as practice models in certain nursing procedures’ training. Of the students, 55.8% were satisfied with using their bodies to train fundamental nursing skills. 61.8% of students reported that informed consent was obtained during the nursing laboratory, and 88.6% of students thought that informed consent needs to be obtained. @*Conclusion@#To prevent safety accidents during the fundamentals of nursing practicum and systematically manage accidents, standardized safety guidelines for nursing practicum should be developed. Establishing various training strategies using advanced models or simulators to increase education efficiency and satisfaction is necessary.

Predictors of Depression in Disability with Hearing Impairment / 재활간호학회지

Purpose@#The purpose of this study was to identify the influencing factors on Predictors of depression in disability with hearing impairment. @*Methods@#Data from the secondary data (The 2014 National Survey of the Disabled Persons) were obtained, and subjects of hearing impaired 190,323 who responded certainly yes or no answer to the question were selected. x2 and t-test analysis were used to compare the potential predictors between depression and non-depression group. Significant factors were entered in Logistic regression analysis to identify the predictors of depression. @*Results@#The prevalence of depression was 5.7% (n=10,769) in disability with hearing impairment. Life satisfaction, go out alone, subjective economic status, medical examination, level of disability, disability aids from social services, satisfaction of leisure activities, awareness of discrimination, disability awareness in healthcare provider, hearing aids use and age were shown significant differences in depression and non-depression. Life satisfaction (OR=11.04 [10.20~11.96]) and go out alone (OR=3.52 [3.22~3.83]) were found to be the most influential risk factors for depression in disability with hearing impairment. @*Conclusion@#To prevent depression in disability with hearing impairment, affected factors such as life and leisure activities satisfaction, level of physical dependence, economic status, hearing aids, and social inequalities should be monitored.

A Review II for Standardization of Textbooks of Fundamentals of Nursing: Medication Administration, Infection Control, Pressure Injury / 기본간호학회지

Purpose@#The purposes of this study were to analyze and compare the textbooks of fundamentals of nursing and practice in order to standardize them for medication administration, infection control, and pressure injury. @*Methods@#The current study is a literature review of the ten textbooks published after 2013. Ten textbooks were the ones selected by the Korea Health Personnel Licensing Examination Institute as major textbooks. Three items were reviewed: medication administration, infection control, and pressure injury, with a focus on differences in numbers, range, direction, and others. @*Results@#For medication administration, there were some discrepancies in the size of needle and syringe, maximum dosage depending on injection methods, replacement period of catheter and infusion set, depth of insertion for vaginal medication administration. For infection control, items with discrepancies included length of time for hand washing, concentration of chemical sterilant, frequency of ventilation to prevent airborne disease, distance to prevent droplet-borne infection, the latent period of infectious disease, and methods to treat medical wastes. For pressure injury, the discrepancies were exhibited in the degree and duration of pressure for pressure injuries, range of scores for risks in pressure injury assessment tools, and temperature of the solution to irrigate pressure injuries. @*Conclusion@#Standardized textbooks for these three parts will be useful teaching aide for students and nurses to carry out consistent and professional nursing for patients’ safety.

Factors Associated with Practice of Health Information Protection among Nursing Students / 기본간호학회지

Purpose@#Health information protection policy has received increased emphasis in the medical environment. Nursing students are required to access personal health information in practical training to achieve the necessary credits. This study was done to identify the effects of nursing students’ ethical index and their awareness of health information protection on their practice in terms of health information protection. @*Methods@#Participants for this cross-sectional descriptive design study were 238 nursing students who had undergone clinical practice at four universities in J province. Information ethics index, awareness of health information protection, and its practice were measured using self-report questionnaires. Collected data were analyzed using descriptive statistics, Pearson correlations, and multiple regression analysis. @*Results@#Among the participants, 88.2% were female and 55.0% identified as religious. A positive correlation was found between awareness of health information protection and the information ethics index (r=.60, p<.01). In the multiple regression model, 37.4% of the variance in students’ health information protection behavior was predicted by religion (β=.13, p=.033), the respect domain of the information ethics index (β=.22, p=.033), and awareness of health information protection (β=.61, p<.001). @*Conclusion@#To improve health information protection behavior in nursing students, religion, awareness of health information protection, and the respect component of the information ethical index should be considered when developing systematic education programs.

An Item Response Theory Analysis of the Korean Version of the CRAFFT Scale for Alcohol Use Among Adolescents in Korea

PURPOSE: This study aimed to validate the psychometric properties of the CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble) by using item response theory (IRT) and further examine gender differences in item-level responses.METHODS: This study used the 13(th) (2017) Korea Youth Risk Behavior Survey data conducted by the Korean Centers for Disease and Prevention and analyzed data of 8,568 students who reported drinking alcohol in the previous 30 days. IRT assumptions including unidimensionality, local independence, and monotonicity were tested. A one-factor two-parameter IRT model was fitted for item parameterization (M₂ = 76.92, 20 df, p < .001, root mean square error of approximation = 0.02). Graphics for item characteristic curves and item and test information curves were provided. Differential item functioning (DIF) analysis was evaluated to measure item equivalence between boys and girls.RESULTS: Unidimensionality and local independence were satisfied, and the dominant factor eigenvalue and variance were 2.48 and 41.3% in boys and 2.08 and 34.7% in girls, respectively, and residual correlations in paired items were less than .2. The discrimination parameters were estimated as 1.32–3.59 for boys and 1.30–3.64 for girls. The severity parameters estimated verity as −0.23 to 1.67 for boys and −0.32 to 2.17 for girls. DIF was detected for four of six items, “Car,” “Relax,” “Forget,” and “Family/friends.” However, its impact on the total score was negligible.CONCLUSION: The CRAFFT is a valid and reliable screening tool to identify alcohol use problems for both boys and girls, exhibiting good discrimination, good coverage of severity, and negligible DIF.

Review of Diabetic Foot Complication Assessment Tools Developed from 2007 to 2016 / 기본간호학회지

PURPOSE@#The purpose of this study was to analyze the attributes and psychometric properties of newly developed diabetic foot complication assessment tools. The attributes of diabetic foot complication assessment tools were evaluated using a systematic review.@*METHODS@#The search terms: “diabetes mellitus” and “foot ulcer” were retrieved using Boolean operators of “and”, “or”, and “not”. The search was limited to articles published between 2007 and 2016. The literature was analyzed by division of methodological characteristics, instrumental characteristics, and item and stratified outcome characteristics.@*RESULTS@#Six assessment tools were found for diabetic foot complications. Only three of the six tools presented the evidence in terms of validity and reliability. In all six tools, “ulcer” was the measured item with the highest frequency, but the contents of items varied. The six identified tools focused on assessing current physical symptoms, but not on predicting diabetic foot complications.@*CONCLUSION@#Preventive foot self-care should be used to predict diabetic foot complications before symptoms appear. Moreover, the reliability and validity of existing tools should be verified in terms of discrimination, prediction, and evaluation.

Occurrence of Constipation during the Rehabilitation Stage in Patient with Cerebral Vascular Disease / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the occurrence of first onset of constipation during the rehabilitation stage and risk factors for constipation in patients with cerebral vascular disease (CVD). METHODS: Participants for this retrospective study were 214 CVD patients admitted to rehabilitation units. First onset of constipation and factors influencing constipation such as dependency level were recorded for 14 days during the rehabilitation stage. Survival analysis with Cox proportional hazard model and descriptive statistics were conducted. RESULTS: Age, patients'severity, types of diet, and dependency level were different between constipation and non-constipation groups. In survival analysis, 99% of participants developed constipation within 14 days after admission to rehabilitation units. Median constipation occurrence time was 7.4 days. Patients who were immobile and had tube feedings were more likely to develop constipation 4.07 times (95% CI: 1.018~16.301, p=.047) and 2.09 times (95% CI: 1.001~4.377, p=.050) respectively compared to patients who were independent and had a regular diet, respectively. CONCLUSION: Most CVD patients experienced constipation within 2 weeks after entering the rehabilitation stage. Constipation was linked to types of diet and dependency level. These factors associated with constipation should be considered when caring for patients in rehabilitation.

Psychometric Properties of the Hypertension Self-Care Behavior Scale for Elders with Hypertension in Korea / 기본간호학회지

PURPOSE: The purpose of this study was to evaluate the psychometric properties of the Hypertension Self-Care Behavior Scale for older adults with hypertension in Korea. METHODS: A cross-sectional descriptive study was used with 196 participants. Translation and back-translation were performed by bilingual nursing professionals and a nutritionist. Reliability and validity such as content validity, construct validity, and concurrent validity were conducted. To evaluate the concurrent validity, the correlation coefficients between the Korean version of Hypertension Self-Care Behavior and concurrent scales (hypertension adherence scale and self-efficacy scale) were calculated. RESULTS: The total 20 items for the Korean version of the Hypertension Self-Care (HBP-SC) Behavior Scale were retained during item-analysis. In explanatory factor analysis, a two-factor solution was proposed and the two factors named, ‘HBP-SC Diet behavior’ and ‘HBP-SC Health behavior (except diet)’. The two factors accounted for 48.9% of the variances. The Korean version of the Hypertension Self-Care Behavior Scale correlated with concurrent variables such as hypertension adherence and self-efficacy. For reliability of the Korean version of the Hypertension Self-Care Behavior, Cronbach's α=.92. CONCLUSION: Findings show that the Korean version of the Hypertension Self-Care Behavior is reliable and valid for measuring self-care behavior of older adults with hypertension.

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form / 기본간호학회지

PURPOSE: The purpose of this study was to evaluate the reliability and validity of the Korean version of Diabetes Empowerment Measurement Scale Short Form (DES-SF) for use with diabetic patients in Korea. METHODS: A cross-sectional descriptive study was used with 107 participants. Bilingual nursing professionals performed translation and reverse translation. Reliability and validity such as face validity, construct validity, and concurrent validity were conducted. To assess the concurrent validity, the correlation coefficients between the Korean version of the DES-SF and a concurrent scale (Diabetes Self-Efficacy Scale, DSES) were calculated. RESULTS: In the explanatory factor analysis, a uni-dimension was proposed, the one factor accounted for 49.4% of total variances. The Korean version of the DES-SF correlated with a concurrent variable such DSES for reliability of the Korean version of the DES-SF, Cronbach's α=.85. CONCLUSION: The findings show that the Korean version of the DES-SF is reliable and valid for evaluating empowerment in patients with diabetes in Korea.

Influence of Cognitive Function and Depressive Symptoms on Instrumental Activities of Daily Living in Community-dwelling Older Adults / 재활간호학회지

PURPOSE: The purpose of this study was to explore the influence of cognitive function and depressive symptoms on instrumental activities of daily living (IADL) in addition to identify the factors associated with IADL in community-dwelling older adults. METHODS: This was a descriptive study with cross-sectional design. Data were collected from July 2013 to June 2014. A total of 143 participants without dementia, depression and disability were enrolled in this study. Cognitive function was measured using Seoul verbal learning test (SVLT), digital span (forward/backward) and fist-edge-palm test. The Korean-IADL and Short Geriatric Depression Scale (S-GDS) were used. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression. RESULTS: Overall, a multiple regression model revealed that approximately 27.4% of total variability in IADL in the sample of community-dwelling older adults could be explained by the significant 12 variables in this model (R²=0.274, F=5.467, p<.001). Age, having religion and cognitive function were the predictors of IADL in community-dwelling older adults. CONCLUSION: This study suggest that we need to monitor cognitive function in older to maintain the ability for IADL in older adults. Also, individualized program for improving older adults' IADL should be included in nursing intervention.

Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes

PURPOSE: This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea. METHODS: Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency. RESULTS: For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability. CONCLUSION: The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.

Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes

PURPOSE: The purpose of this study was to define the concept for psychological insulin resistance in the Korean population with diabetes. METHODS: The Hybrid model was used to perform the concept analysis of psychological insulin resistance. Results from both the theoretical review with 26 studies and a field study including 19 participants with diabetes were included in final process. RESULTS: The preceding factors of psychological insulin resistance were uncontrolled blood glucose and change in daily life. The concept of psychological insulin resistance was found to have three categories with 8 attributes such as emotional factors (negative feeling), cognitive factors (low awareness and knowledge, low confidence for self-injection) and supportive factors (economic burden, dependency life, embarrassing, feeling about supporters, feeling of trust in, vs mistrust of health care providers). The 8 attributes included 30 indicators. CONCLUSION: The psychological insulin resistance of population with diabetes in Korea was defined as a complex phenomenon associated with insulin therapy that can be affected by emotional factors, cognitive factors, and supportive relational factors. Based on the results, a tool for measuring psychological insulin resistance of Koreans with diabetes and effective programs for enhancing insulin adherence should be developed in future studies.

The Moderating Effect of the Leisure Satisfaction in the Job Stress on Job Satisfaction of Nurses on Shift Work / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the moderating effect of leisure satisfaction on the relationship between job stress and job satisfaction. METHODS: A cross-sectional study was performed with 292 nurses having experienced shift work at least for 6 months. Data were collected from August to September in 2014. Descriptive statistics, t-test, correlation coefficient, and hierarchical regression analysis were performed. RESULTS: The study showed that job satisfaction was significantly correlated with job stress (r=.-320, p<.001) and leisure satisfaction (r=.317, p<.001). Leisure satisfaction had a significant moderating effect on the relationship between job stress and job satisfaction (F=25.087, p<.001). CONCLUSION: This study concluded that the role of leisure satisfaction may moderate the relationship between the two. That is, the nurses who perceived higher satisfaction on their leisure life tend to have higher satisfaction to their job even in stress situation. Therefore, the strategies for improving leisure satisfaction are needed to increase job satisfaction in stressful conditions.

Revision of the Measurement Tool for Patients' Health Information Protection Awareness / 대한의료정보학회지

OBJECTIVES: Despite the importance of the protection of patients' health information in clinical settings, little is known about the awareness of this concept in nursing students due to the lack of a suitable measurement tool. Hence, this study attempted to redevelop the Patients' Health Information Protection Awareness Scale, and evaluate its construct validity and reliability for nursing students. METHODS: A cross-sectional descriptive study was conducted. Nursing students who were in their 3rd and 4th year were recruited from 10 universities in Korea to assess the construct validity, and 30 experts (27 nurses and 3 faculty members) participated in the content validation process. RESULTS: The content validity assessment indicated that 23 items were ideal. The assessment of construct validity using exploratory factor analysis revealed three factors: communication, management, and referrals. They together accounted for 54.1% of the variance in scale scores. The three-factor scale had good fit in the confirmatory factor analysis. Scale reliability was confirmed, with a Cronbach's alpha of 0.94 for all items. CONCLUSIONS: This study was the first attempt to redevelop the Patients' Health Information Protection Awareness Scale for student nurses. The 23-item scale was shown to be a reliable and valid tool. It facilitates the assessment of nursing students' awareness of patient information protection. Academic nursing programs and health organizations can use its scores to implement adequate education plans to safeguard information in nursing students.

Methodological Issues in Questionnaire Design

PURPOSE: The process of designing a questionnaire is complicated. Many questionnaires on nursing phenomena have been developed and used by nursing researchers. The purpose of this paper was to discuss questionnaire design and factors that should be considered when using existing scales. METHODS: Methodological issues were discussed, such as factors in the design of questions, steps in developing questionnaires, wording and formatting methods for items, and administrations methods. How to use existing scales, how to facilitate cultural adaptation, and how to prevent socially desirable responding were discussed. Moreover, the triangulation method in questionnaire development was introduced. RESULTS: Steps were recommended for designing questions such as appropriately operationalizing key concepts for the target population, clearly formatting response options, generating items and confirming final items through face or content validity, sufficiently piloting the questionnaire using item analysis, demonstrating reliability and validity, finalizing the scale, and training the administrator. Psychometric properties and cultural equivalence should be evaluated prior to administration when using an existing questionnaire and performing cultural adaptation. CONCLUSION: In the context of well-defined nursing phenomena, logical and systematic methods will contribute to the development of simple and precise questionnaires.

Review of Meta-analysis Research on Exercise in South Korea

PURPOSE: The purpose of this study was to evaluate the quality of meta-analysis regarding exercise using Assessment of Multiple Systematic Reviews (AMSTAR) as well as to compare effect size according to outcomes. METHODS: Electronic databases including the Korean Studies Information Service System (KISS), the National Assembly Library and the DBpia, HAKJISAand RISS4U for the dates 1990 to January 2014 were searched for 'meta-analysis' and 'exercise' in the fields of medical, nursing, physical therapy and physical exercise in Korea. AMSTAR was scored for quality assessment of the 33 articles included in the study. Data were analyzed using descriptive statistics, t-test, ANOVA and chi2-test. RESULTS: The mean score for AMSTAR evaluations was 4.18 (SD=1.78) and about 67% were classified at the low-quality level and 30% at the moderate-quality level. The scores of quality were statistically different by field of research, number of participants, number of databases, financial support and approval by IRB. The effect size that presented in individual studies were different by type of exercise in the applied intervention. CONCLUSION: This critical appraisal of meta-analysis published in various field that focused on exercise indicates that a guideline such as the PRISMA checklist should be strongly recommended for optimum reporting of meta-analysis across research fields.

Psychometric Evaluation of Hill-Bone Medication Adherence Subscale

PURPOSE: Medication adherence is an essential part of the management and control of high blood pressure (HBP). Although the Hill-Bone Medication Adherence (HBMA) scale is one of the most frequently used instruments for measuring HBP medication adherence, the psychometric properties of the scale have never been tested among Korean Americans, a population that experiences a disproportionately high prevalence of HBP. Therefore, the objective of this study is to validate a Korean version of the HBMA subscale (HBMA-K). METHOD: We used two, independent samples of Korean Americans (KAs) (combined n = 525) who participated in community-based intervention trials for HBP control. To develop the HBMA-K, the original scale was translated into Korean and then back translated into English. Reliability was assessed by calculating the Cronbach's alpha. Exploratory factor analysis (EFA) was done to assess construct validity. We also calculated the Pearson's correlation coefficients between the scale and theoretically driven variables such as blood pressure, knowledge, and HBP belief to test concurrent validity. RESULTS: The EFA revealed a one-factor solution with eight items, explaining 35.4% of the variance. Cronbach's alpha was .80. The 8-item HBMA-K scale was significantly associated with systolic blood pressure (BP) (r = .18, p < .01), diastolic BP (r = .24, p < .01), HBP knowledge (r = -.13, p < .01), and HBP belief score (r = -.18, p < .05). CONCLUSIONS: The 8-item HBMA-K scale is a valid and reliable instrument for measuring medication adherence among KAs with HBP. It can be easily administered at community and clinical settings to screen hypertensive patients with low medication adherence.

A Correlation Study on Self-Efficacy, Disposition to Critical Thinking and Nursing Competency of New Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to identify self-efficacy, disposition to critical thinking and level of nursing competency in new nurses and to exam the correlation among these variables. METHOD: The sample was composed of 286 new nurses who had worked at E hospital for 1 year. Descriptive and correlation analysis using the SPSS program were used to analyze the data. RESULTS: The mean score for self-efficacy was 67.10, disposition to critical thinking, 3.01 and nursing competency,3.02. There were significant differences in scores for 3 variables between nurses with College degrees and nurses with Baccalaureate degrees. There was a significant positive correlation between disposition to critical thinking and nursing competency scores. CONCLUSION: Further study of the various components that influence nursing competency is necessary. Also based on the disposition to critical thinking, there is a need to develop education programs to strengthen curiosity and other related variables. The results of this study confirmed the necessity of developing a clinical model of nursing competency ability.

Clinical Application of Objective Structured Clinical Examination (OSCE) for Novice Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to develop and examine the feasibility of OSCE for novice nurses. METHOD: The study was designed using a methodological design. Data were collected from January to February, 2005. Nine stations were developed for the examination. Five minutes was allowed for each station. The examination was administered to 2 groups of novice nurses. RESULTS: OSCE for clinical performance improvement which consisted of nine 5-minute long stations, was developed. Those stations were tested by 79 beginning nurses who were divided into 2 groups. Reliability ranges for Cronbach's alpha were 0.399~0.811 and the mean value was 0.797. Total mean score for the OSCE was 66.75. Total score for the 2nd group was significantly higher than the 1st group. The nurses were satisfied with the OSCE method and process. CONCLUSION: The OSCE can be an effective tool for evaluating clinical nursing skills in novice nurse. More reliable and valid stations need to be developed and then repeated evaluation of the nurses can be done.

Effects of Delivery Nursing Care using Essential Oils on Delivery Stress Response, Anxiety during Labor, and Postpartum Status Anxiety / 간호학회지

OBJECTIVES: This study was designed to investigate the effect of delivery nursing care using essential oils on labor stress response, labor anxiety and postpartum status anxiety for primipara. METHODS: This study used nonequivalent control group pretest-posttest design. The subjects of this experiment consisted of forty eight primipara with single gestation, full term, & uncomplicated pregnancies. Twenty four primipra were in the experimental and control group each. Their mean age was 27.9 years old, their mean gestation period 279.9 days. As a treatment, delivery nursing care using essential oils was applied by nurses. Data collected epinephrine, norepinephrine, anxiety during labor. In the 24 hours after birth, the data for the postpartum mother's status anxiety was collected. Data was analyzed by t-test, repeated measures ANOVA, Mann-Whitney U test, & Wilcoxon signed ranks test with SPSS Program. RESULTS: Plasma epinephrine, norepinephrine were significantly low in the experimental group (P=0.001, P=0.033, respectively). There was no significant difference between the two groups in anxiety during labor and postpartum mother's status anxiety. CONCLUSION: These findings indicate that delivery nursing care using essential oils could be effective in decreasing plasma epinephrine, norepinephrine. But, that could not be verified in decreasing mother's anxiety.