A systematic review and meta-analysis of studies on extended reality-based pediatric nursing simulation program development

Purpose@#This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness. @*Methods@#A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program. @*Results@#XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001). @*Conclusion@#Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Types of perception toward non-face-to-face clinical practice among nursing students / 한국간호교육학회지

Purpose@#This study aimed to identify the types of perception toward non-face-to-face clinical practice and to characterize the types of students who experienced online clinical practice during the coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#Q-methodology was used in this study, and 270 Q populations were formed based on in-depth interviews with 10 nursing students who had experienced non-face-to-face clinical practice, as well as related literature. Interviews were performed from August 1 to 31, 2022. A total of 42 Q samples were extracted, and Q sorting was performed on 33 nursing students who had experienced non-face-to-face clinical practice. A Q factor analysis was performed using the PC-QUANL program. @*Results@#The nursing students’ perceptions of non-face-to-face clinical practice were classified into the following five types: “future professional competency-focused type,” “realistic convenience priority type,” “task burden awareness type,” “negative critic type,” and “limited experience dissatisfaction type.” @*Conclusion@#This study revealed non-face-to-face clinical practice’s positive and negative aspects in nursing education. Moreover, it identified the aspects of clinical practice that cannot be replaced by non-face-to-face clinical practice and the elements of non-face-to-face practice that can complement clinical practice. These findings can be used as fundamental data to establish a stable and efficient system for improving the quality of clinical practice in the post-COVID-19 era and to implement effective non-face-to-face clinical practice according to student types.

Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19

Purpose@#This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19. @*Methods@#This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program. @*Results@#The perception of subjects toward quarantine measures was classified into the following six types: ‘passive acceptance’, ‘social stigma perception’, ‘appreciation of daily life through awareness of the realities of illness’, ‘why me?’, ‘fearful perception’, and ‘positive meaning’. @*Conclusion@#The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.

An electronic medical record-based fall risk assessment tool for pediatric inpatients in South Korea: Improved sensitivity and specificity

Purpose@#To develop a fall risk assessment tool to predict fall risk in pediatric inpatients. @*Methods@#Three tools widely used in clinical practice (Humpty Dumpty Fall Scale, General Risk Assessment for Pediatric Inpatient Falls, and Seoul National University Hospital Pediatric Fall Risk Scale) were examined, and assessment items were extracted. Employing a case-control design, 29 children who experienced falls during hospital stays were selected as the "fall" group, and a control group (93 children) was selected based on age and sex matching. The sensitivity, specificity, and positive and negative predictive values of the newly developed tool ("Newfs-PI") were analyzed. @*Results@#The Newfs-PI consisted of seven items: age, activity, history of falls, length of hospital stay, and medication. The total score ranged from 0 to 15. Its sensitivity and specificity were 62.07% and 74.19%, respectively. @*Conclusion@#The Newfs-PI has high specificity and sensitivity, which are essential for a fall risk assessment tool that complements existing tools. These values are high relative to those of existing assessment tools and satisfy both sensitivity and specificity criteria. As the EMR enables monitoring of the components of the Newfs-PI, the tool can be used as a fall risk assessment and prevention scale for pediatric inpatients.

Development of the Nursing Start-up Attitude Scale for Student Nurses / 간호행정학회지

Purpose@#The purpose of this study was to develop and psychometrically test the nursing start-up attitude scale for student nurses. @*Methods@#The initial items were based on the second analysis of systematic review of previous studies and in-depth interview data with 9 nurse entrepreneurs. In total, 25 items were derived based on the pilot survey.Psychometric testing was conducted with 324 student nurses. Data were analyzed using validity and reliability test methods. @*Results@#Six factors, including 12 items explaining 74.4% of the total variance, were verified. The factors were opportunity of self actualization, network building, enhacing start-up competencies, outcomes of start-up, preparation for start-ups, and risk taking. Cronbach's ⍺ was .75. @*Conclusion@#As validity and reliability have been verified through various methods, the developed scale in this study can contribute to assessing student nurses’ attitudes to nursing start-ups.

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

Structured Model on the Health related Quality of Life in University Students focused on Personal Competency Health Care / 재활간호학회지

PURPOSE: This research was conducted to construct a model explaining the quality of life (QOL) related to undergraduate students' health. Social support, self-efficacy and self-esteem were used as exogenous variables while health promotion lifestyles, personal health care competency were endogenous variables. METHODS: A survey was conducted with a structured questionnaire including QOL, health promotion lifestyles, personal health care competency, social support, self-efficacy, and self-esteem. Data were collected from 269 undergraduate students with random sampling and then analyzed using structural equation modeling. RESULTS: Personal health care competency, health promotion lifestyles, social support, self-esteem had both direct and indirect effects while self-efficacy had indirect effects on the QOL of undergraduate students. Especially, social support, self-efficacy and self-esteem influenced positively to the QOL while greater health promotion lifestyles and personal health care competency improved QOL. Thus, personal health care competency and health promotion lifestyles were important mediator for positive QOL in undergraduate students. CONCLUSION: Interventions aiming to enhance health promotion lifestyles and personal health care competency, based on the results of this study, are required to help positive QOL in undergraduate students. Our results can serve as basic data for designing such interventions.

Awareness of Nursing Students' Biomedical Ethics and Attitudes toward Withdrawal of Life-Sustaining Treatment

PURPOSE: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. METHODS: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. RESULTS: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. CONCLUSION: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.

The Analysis of Trends and Contents of Nursing Intervention Research for Stroke Patients in Korea / 기본간호학회지

PURPOSE: This study was conducted to provide background information on nursing interventions to further enhance the quality of nursing practice and related professions, based on those performed for stroke patients. METHODS: The analysis was performed in light of 84 researches papers on nursing intervention published between 1990 and 2010, and based on NIC(Nursing Interventions Classification) and NOC(Nursing Outcomes Classification). RESULTS: 1. The quasi-experimental design was used as the most primary form of research design across 69 papers that constitute 82% of the total. 2. The number of nursing intervention methods identified throughout 84 research papers was 144. Based on the NIC that 90(62.5%) of those interventions fell into the physiological basic domain while 53(36.8%) belonged to the behavioral domain. 2) Interventions on activity and exercise management, physical comfort promotion, patient education conducted by class level of NIC were 40(27.78%), 34(23.61%), and 31(21.53%) respectively. 3) Outcomes of mobility, psychological well-being, energy maintenance, health & life quality measured by class of NOC among 317 dependent variables 79(24.92%), 64(20.19%), and 63(19.87%) respectively. CONCLUSION: Most interventions were classified as belonging to few particular domain types, which triggers needs for the development and application of multidisciplinary intervention methods through a more collective approach.

Resilience of Families with Elderly Patients with Dementia / 정신간호학회지

PURPOSE: The purpose of this study was to pave the way for developing nursing intervention strategies to enhance family resilience by identifying unique patterns of resilience in families of elderly patients with dementia. METHODS: The Q-methodology was used to define types and describe characteristics of family resilience. After in-depth interviews with 12 family members of patients with dementia and study of related literature, final 50 Q-samples were selected by collecting the opinions of experts. The selected 50 Q-statements were sorted by 30 family members (P-samples). The PC-QUNAL program was used to analyze Q-sort data. RESULTS: Four distinctive Q-factors for family resilience were identified: I. Seeking positive meaning, II. Developing reasonable cooperation with family members, III. Accepting reality passively, IV. Depending on external resources. CONCLUSION: Families caring for elderly patients with dementia show unique patterns of family resilience, which result from multi-factors, such as their own belief systems or culture, organizational patterns, and communication processes, in dealing with crisis. The results of this study can be useful in confirming the types of resilience of families of patients with dementia and their characteristics, and the underlying data can be used as to develop tailored nursing strategies for strengthening family capacities to master adversity.

The analysis of Trends and Contents of Nursing Intervention Research for Cancer Patients in Korea

PURPOSE: In this study, the articles which developed and applied nursing interventions for patients with cancer were reviewed and analyzed. METHODS: The analysis was performed in light of 171 pieces of literature on nursing interventions for patients with cancer published between 1991 and 2010. RESULTS: Approximately half of the studies have been published between 2006 and 2010. The quasi-experimental designs using nonequivalent control group and no-synchronized design were the most common form of research design among the 71 papers constituting 41.52% of the total. The most commonly used nursing intervention was education (25.2%), followed by massage (20.4%) and exercise (11.5%). The most common outcome variable was anxiety (11.8%), followed by pain (8.0%) and nausea and vomiting (7.3%). CONCLUSION: The results of this study can provide useful information for the development of nursing interventions in specialized areas. Systematic literature review or meta-analysis is needed in this area.

Patterns of Anger Expression among Middle-aged Korean Women: Q methodology

PURPOSE: The purpose of this study was to identify the characteristics of anger expression in middle-aged Korean women by categorizing their patterns of expression while considering the complexity and multidimensionality of anger, and by investigating the characteristics relative to the patterns. METHODS: The research design was a descriptive design using Q methodology, which is a method of measuring subjectivity. A convenience sample of 42 participants aged 40-60 years and living in the community in Korea was recruited. The PC-QUANL software program (a factor analysis program for the Q technique) was used to analyze the Q-sort data. RESULTS: Four factors were extracted that described different expressions of anger among middle-aged Korean women; these factors explained 50.1% of the total variance. The frames of reference of the four factors were a) direct diversion, b) silent masking with remaining anger, c) self digestion, and d) controlling anger with objectification. CONCLUSION: In this study has identified patterns and characteristics of anger expression among middle-aged Korean women were identified, which will aid the development of effective anger-management programs for controlling anger in this population. In future studies, it would be helpful to investigate how the patterns of anger expression established herein are associated with specific health problems such as cardiovascular disorder and cancer.

Factors Influencing Fatigue in Elderly People with Chronic Pain / 정신간호학회지

PURPOSE: This study was done to examine fatigue in elderly people with chronic pain and identify factors influencing fatigue. METHODS: Participants in the study were 296 elders suffering from pain for more than 6 months. The data were collected by personal interviews using questionnaires and were analyzed using Pearson correlation coefficients, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 15.0 version. RESULTS: The mean score for fatigue was 30.5, and fatigue showed a significant positive correlation with depression (r=.57, p<.001), perceived stress (r=.12, p=.035) and pain disability (r=.52, p<.001), but a negative correlation with social support (r=-.21, p<.001) and ADL (r=-.22, p<.001). Depression was found to be a significant predictor of fatigue. CONCLUSION: The results of this study show that psychological factors like depression have more influence on fatigue in elders than physical activities or daily capability. Therefore, it is important to consider psychological factors which influence fatigue as well as the fatigue itself in order to efficiently control fatigue.

Factors Influencing Coping Strategies of Elders According to Types of Pain Belief / 기본간호학회지

PURPOSE: This study was done to identify factors (pain stress, perceived stress, pain disability, fatigue, depression) strategies used by elders to cope with pain based on their type of pain belief. METHOD: Data were collected from 314 elders in community settings in Seoul from September to December of 2007. Cluster analysis, t-test, and ANOVA were used to analyze data. Result: The types of pain belief were classified as the following groups: Self-blame, Enduring & Mysterious, and Short-term & Understandable. Perceived stress (t=2.36, p=.02), social support (t=2.24, p=.03), extent of pain relief (t=2.39, p=.02), and duration of pain relief (t=2.09, p=.04) were important factors for active and passive coping in the Self-blame group. Pain stress (t=2.39, p=.01) and depression (t=-3.99, p=.00) were significantly related to the active coping in the Enduring & Mysterious group. Perceived stress (t=2.55, p=.01) was an important factor in the passive coping in the Short-term & Understandable group. CONCLUSION: Considering different types of pain belief in elders and factors that are significantly related to different coping strategies, future nursing interventions should be population specific to encourage active coping strategies and to decrease passive coping strategies.