Prophylactic Effect of Transparent Film Dressing on Sacrum and Coccyx in SICU Patients / 기본간호학회지

PURPOSE: This study was done to examine the prophylactic effect of transparent film dressing on the sacrum and coccyx sites to reduce pressure ulcers. METHODS: The participants were 317 patients admitted to an SICU in Seoul, Korea. Of the patients, 175 were assigned to the experimental group and 142 to the control group. For participants in the experimental group, a prophylactic transparent film dressing was applied on the sacrum and coccyx. The control group received the usual care. The nurses checked for pressure ulcers on the sacrum and coccyx at least once every duty. When pressure ulcer occurred, it reported on the record form. The results were analyzed using Poisson and Hierarchical logistic regression. RESULTS: The prevalence and risk of pressure ulcer was lower in the experimental group compared to the control group but the difference was not significant. The ICU length of stay was significantly associated with pressure ulcer risk. CONCLUSION: Findings indicate that prophylactic transparent film dressing helps to reduce pressure ulcer in SICU patients.

The Lifestyle Modification Coaching Program for Secondary Stroke Prevention

PURPOSE: The purpose of this study was to investigate the effects of the lifestyle modification coaching program on self efficacy, lifestyle and physiologic indexes related to the recurrence of stroke in patients with stroke. METHODS: Sixty-one patients with stroke registered with a stroke center participated in this study. Of the participants, 32 were assigned to the experimental group and 29 to the control group. Self efficacy, alcohol drinking, smoking, physical activity, BMI (body mass index), WHR (waist-hip ratio), blood lipid level, and blood pressure were measured both for the baseline, as well as after intervention. The lifestyle modification coaching program consisted of an 8-week telecoaching session following face-to-face education. The control group received only the face-to-face education. RESULTS: There were significant differences in physical activities, WHR, blood pressure within and between groups after intervention. The lifestyle modification coaching program had significant influences on blood pressure even after gender, age, and physical activity had been adjusted. CONCLUSION: The results of the study indicate that lifestyle modification coaching program is effective for physical activity, abdominal obesity and blood pressure. Therefore it can be used by nurses in hospitals and communities as one of the secondary stroke prevention programs for patients with stroke.

Development and Testing of a Nurse Turnover Intention Scale (NTIS)

PURPOSE: The purpose of this study was to develop a measurement tool of nurse's turnover intention. METHODS: Data were collected from questionnaires completed by 678 nurses who worked in 3 university hospitals in South Korea and analyzed using the SPSS 18.0 and AMOS 18 programs. Thirty-seven preliminary items were selected from 161 basic items extracted via a literature review and in depth interviews with 6 hospital nurses. Three steps with factor analysis were undertaken to verify the reliability and validity of the preliminary instruments. Finally, confirmative factor analysis was carried out. RESULTS: As a result of the analysis, 3 factors including 10 items were selected. Cronbach's Alpha for the 10 items was .83, for job satisfaction (4 items), .78, for interpersonal relationships (3 items), .80, and for work performance (3 items), .74, which was stable. CONCLUSION: This study is meaningful because through it a scale reflecting Korean culture was developed to measure turnover intention in nurses. Further studies that test the psychometrics of this scale in more diverse samples are warranted.

Evaluation of the Clinical Usefulness of Critical Patient Severity Classification System and Glasgow Coma Scale for Neurological Patients in Intensive Care Units

PURPOSE: The purpose of this study was to evaluate the clinical usefulness of the Critical Patient Severity Classification System (CPSCS) and Glasgow Coma Scale (GCS) for critically ill neurological patients and to determine the applicability of CPSCS and GCS in predicting their mortality. METHODS: Data were collected from the medical records of 187 neurological patients who were admitted to the intensive care unit of C university hospital. The datawere analyzed through chi-square test, t test,Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and receiver operating characteristic curve. RESULTS: In accordance with patients' general and clinical characteristics, patient mortality turned out to be significantly different depending on intensive care unit stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Hosmer-Lemeshow goodness-of-fit tests were applied to CPSCS and GCS. The results of the discrimination test using the receiver operating characteristic curve were CPSCS0, .743, GCS0 .583, CPSCS24, .734, GCS24 .612, CPSCS48, .591, GCS48 .646, CPSCS72, .622, and GCS72 .623. Logistic regression analysis showed that each point on the CPSCS score signifies a 1.034 higher likelihood of dying. CONCLUSION: Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

Verification of Validity of MPM II for Neurological Patients in Intensive Care Units

PURPOSE: Mortality Provability Model (MPM) II is a model for predicting mortality probability of patients admitted to ICU. This study was done to test the validity of MPM II for critically ill neurological patients and to determine applicability of MPM II in predicting mortality of neurological ICU patients. METHODS: Data were collected from medical records of 187 neurological patients over 18 yr of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009. Collected data were analyzed through chi2 test, t-test, Mann-Whiteny test, goodness of fit test, and ROC curve. RESULTS: As to mortality according to patients' general and clinically related characteristics, mortality was statistically significantly different for ICU stay, hospital stay, APACHE III score, APACHE predicted death rate, GCS, endotracheal intubation, and central venous catheter. Results of Hosmer-Lemeshow goodness-of-fit test were MPM II0 (chi2=0.02, p=.989), MPM II24 (chi2=0.99 p=.805), MPM II48 (chi2=0.91, p=.822), and MPM II72 (chi2=1.57, p=.457), and results of the discrimination test using the ROC curve were MPM II0, .726 (p<.001), MPM II24, .764 (p<.001), MPM II48, .762 (p<.001), and MPM II72, .809 (p<.001). CONCLUSION: MPM II was found to be a valid mortality prediction model for neurological ICU patients.

Mechanisms of Selective Antimicrobial Activity of Gaegurin 4

Gaegurin 4 (GGN4), an antimicrobial peptide isolated from a Korean frog, is five times more potent against Gram-positive than Gram-negative bacteria, but has little hemolytic activity. To understand the mechanism of such cell selectivity, we examined GGN4-induced K+ efflux from target cells, and membrane conductances in planar lipid bilayers. The K+ efflux from Gram-positive M. luteus (2.5microgram/ml) was faster and larger than that from Gram-negative E. coli (75microgram/ml), while that from RBC was negligible even at higher concentration (100microgram/ml). GGN4 induced larger conductances in the planar bilayers which were formed with lipids extracted from Gram-positive B. subtilis than in those from E. coli (p<0.01), however, the effects of GGN4 were not selective in the bilayers formed with lipids from E. coli and red blood cells. Addition of an acidic phospholipid, phosphatidylserine to planar bilayers increased the GGN4-induced membrane conductance (p<0.05), but addition of phosphatidylcholine or cholesterol reduced it (p<0.05). Transmission electron microscopy revealed that GGN4 induced pore-like damages in M. luteus and dis-layering damages on the outer wall of E. coli. Taken together, the present results indicate that the selectivity of GGN4 toward Gram-positive over Gram-negative bacteria is due to negative surface charges, and interaction of GGN4 with outer walls. The selectivity toward bacteria over RBC is due to the presence of phosphatidylcholine and cholesterol, and the trans-bilayer lipid asymmetry in RBC. The results suggest that design of selective antimicrobial peptides should be based on the composition and topology of membrane lipids in the target cells.

The Relationship of Pain, Depression and Anxiety which Patients Recognize on Intravenous Injection: Focus on Pain Relating Factors / 기본간호학회지

PURPOSE: The purpose of this study was to identify factors that have an influence on the pain which patients recognize when receiving an intravenous injection. METHOD: Participants were 111 patients who were admitting to C University Hospital. The collected data were analyzed using the SPSS 11.0 program. RESULTS: For the participants, factors related to administration of medication were the following: Phlebitis scale, who administers the IV injection, failure to complete the IV injection, explaination of the IV injection and rate of injection. Level of pain, depression and anxiety in the participants was as follows: Pain (4.86+/-2.09), depression (35.76+/-9.91), anxiety (32.34+/-8.87). There were positive correlations between pain and depression (r= .437, p< .000), between pain and anxiety (r= .478, p< .000), and between depression and anxiety (r= .544, p< .000). CONCLUSION: Such findings provide new insights into the dynamic relationships between depression, anxiety and pain which patients recognize when having an intravenous injection. Further studies should be conducted to establish the causal relation between depression, anxiety and pain and to determine appropriate nursing interventions.