Psychometrics Properties of Ways of Coping Questionnaire-Korean among College Students

Background@#The purpose of this study was to investigate the validity and reliability of the Ways of Coping Questionnaire-Korean (WCQ-K) among college students. @*Methods@#A cross-sectional survey design was employed to validate psychometrics properties of the WCQ-K among 248 students from a university-affiliated health-care center in Suwon, Korea. Structured questionnaires were used for psychometric evaluation. Item analysis, exploratory factor analysis, and known-groups validity were performed for validity. The Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC) were used for reliability. @*Results@#A seven-factor model with 36 items explained 50.8% of the variance. The Cronbach’s alpha was 0.90; the ICC for 2-weeks test-retest reliability was 0.80. Students with stable ways of coping tended to have a lower score on the perceived stress and depressive symptoms than their counterparts (all P<0.05). @*Conclusions@#The findings of this study provide evidence for the adequate psychometric properties of the WCQ-K. The WCQ-K may be used in school or clinical settings to examine the potential role of stress-coping strategies in enhanced stress management among Korean college students.

Psychometrics Properties of Ways of Coping Questionnaire-Korean among College Students

Background@#The purpose of this study was to investigate the validity and reliability of the Ways of Coping Questionnaire-Korean (WCQ-K) among college students. @*Methods@#A cross-sectional survey design was employed to validate psychometrics properties of the WCQ-K among 248 students from a university-affiliated health-care center in Suwon, Korea. Structured questionnaires were used for psychometric evaluation. Item analysis, exploratory factor analysis, and known-groups validity were performed for validity. The Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC) were used for reliability. @*Results@#A seven-factor model with 36 items explained 50.8% of the variance. The Cronbach’s alpha was 0.90; the ICC for 2-weeks test-retest reliability was 0.80. Students with stable ways of coping tended to have a lower score on the perceived stress and depressive symptoms than their counterparts (all P<0.05). @*Conclusions@#The findings of this study provide evidence for the adequate psychometric properties of the WCQ-K. The WCQ-K may be used in school or clinical settings to examine the potential role of stress-coping strategies in enhanced stress management among Korean college students.

Efficacy of Feeding Pump for Patients on Enteral Tube Feeding: A Systematic Literature Review and Analysis / 대한소화기학회지

BACKGROUND/AIMS: This study was conducted to establish a guideline on the utilizing of feeding pump in patients requiring enteral tube feeding. METHODS: As a first step, textbooks on nutrition and guidelines from regional clinical nutrition societies were analyzed. Afterwards, data on the efficacy, safety, and practicality of feeding pump application were collected and evaluated by systematically reviewing the related literature. As data sources, 8 domestic databases including KoreaMed and global databases such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were utilized. A total of 2,016 related articles was selected by applying the keyword "(enteral feeding.mp AND pump.mp)". RESULTS: Textbooks and guidelines were not able to draw conclusions on the effects of the feeding pump because the injection speed, tube size, and etcetera were different for enteral feeding. Feeding pump assisted enteral tube feeding was an efficient, safe, and practical procedure for reducing maladjustment-related complications of enteral tube feeding, which are obvious obstacles for maintaining nutritional balances in patients requiring tube feeding. CONCLUSIONS: Feeding pump application can be considered an efficient and safe measure that is acceptable in patients on small intestinal tube feeding, critically-ill patients on gastro-intestinal tube feeding, premature babies, and critically-ill or severely malnourished children (recommendation grade D).

Comparison in Care Burden, Fatigue, and Life Contentment of Caregivers by Gender Relationship with Demented Elders / 여성건강간호학회지

PURPOSE: This study was done in order to examine the differences in gender respect to care burden, fatigue, and life contentment of family caregivers of elderly with dementia. METHODS: The setting of the study was a community-based dementia care center providing daycare services. One hundred ninety four caregivers were recruited for the survey. A structured questionnaire was used which included demographic information, care burden, fatigue, and general contentment scales. Caregivers were classified into 4 groups by gender relationship with care recipients. RESULTS: The majority of the caregivers were middle-aged and elderly. More than twice as many were female rather than male caregivers. The results showed that women caregivers expressed more fatigue than men overall (p< .05). In the gender relationships, a different combination of man-woman appeared to have more burdens than that of a woman-woman group (p< .05). For fatigue, the man caregiver-woman elderly group showed a higher fatigue score than a woman-man group (p< .05). However, there was no significant difference in life contentment among groups. CONCLUSION: These results suggest that caregiver's gender and gender relationship with elders could be considerable factors when the nurses make a plan in the community for dementia nursing management services.

Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard

PURPOSE: The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). METHODS: This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. RESULTS: Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. CONCLUSION: The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

Factors Influencing the Hospital Presentation Time of Stroke Patients / 성인간호학회지

PURPOSE: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. METHODS: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. RESULTS: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(chi-square=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. CONCLUSION: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.

Comprehensive Predictors of Fatigue for Cancer Patients / 간호학회지

PURPOSE: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. METHODS: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. RESULTS: The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. CONCLUSIONS: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.

Comparison of Glucose Concentration of Tracheal Secretions by Measuring Times and Feeding Methods in Enterally Fed Patients / 성인간호학회지

PURPOSE: The purpose of this study was to investigate differences between a pulmonary aspiration group and a non-pulmonary aspiration group in glucose concentration of tracheal secretions by measuring time and feeding methods. METHOD: The subjects were 36 ICU patients who were receiving formula via nasogastric tubes and had endotracheal tubes or tracheostomy tubes. Tracheal secretions were collected by connecting suction traps to a suction catheter in three different times(within 1 hour after feeding, between 1 to 2 hours after feeding, and between 2 to 3 hours after feeding) for 2 days, overall six times. Glucose concentration of tracheal secretions was measured with the glucometer(Accucheck II). RESULTS: Glucose concentration of tracheal secretions increased in progression after feeding. The mean of specimens collected last(between two to three hours after feeding) was shown to be the highest value(M= 61.61 mg/dl) in the pulmonary aspiration group. Significantly(p=.000) more subjects(94.44%) in the pulmonary aspiration group received formula via a 50cc syringe than those in the non-pulmonary aspiration group(22.22%). CONCLUSION: Critically ill patients may need more time for head-elevation after tube feeding to prevent pulmonary aspiration. In practice, enteral formula should not be given the patients via a 50cc syringe anymore, instead a feeding bag or infusion pump should be used to prevent pulmonary aspiration.

Comparison of Glucose Concentration of Tracheal Secretions by Measuring Times and Feeding Methods in Enterally Fed Patients / 성인간호학회지

PURPOSE: The purpose of this study was to investigate differences between a pulmonary aspiration group and a non-pulmonary aspiration group in glucose concentration of tracheal secretions by measuring time and feeding methods. METHOD: The subjects were 36 ICU patients who were receiving formula via nasogastric tubes and had endotracheal tubes or tracheostomy tubes. Tracheal secretions were collected by connecting suction traps to a suction catheter in three different times(within 1 hour after feeding, between 1 to 2 hours after feeding, and between 2 to 3 hours after feeding) for 2 days, overall six times. Glucose concentration of tracheal secretions was measured with the glucometer(Accucheck II). RESULTS: Glucose concentration of tracheal secretions increased in progression after feeding. The mean of specimens collected last(between two to three hours after feeding) was shown to be the highest value(M= 61.61 mg/dl) in the pulmonary aspiration group. Significantly(p=.000) more subjects(94.44%) in the pulmonary aspiration group received formula via a 50cc syringe than those in the non-pulmonary aspiration group(22.22%). CONCLUSION: Critically ill patients may need more time for head-elevation after tube feeding to prevent pulmonary aspiration. In practice, enteral formula should not be given the patients via a 50cc syringe anymore, instead a feeding bag or infusion pump should be used to prevent pulmonary aspiration.

A Comparison of Learning Objectives in Fundamentals of Nursing between 2000 and 2004 year / 기본간호학회지

PURPOSE: The purpose of this study was to compare changes in learning objectives in Fundamentals of Nursing which were established between 2000 and 2004. METHOD: 2000, 2004 learning objectives were analyzed with frequencies and percents. RESULTS: There was an increase in the total number of learning objectives used in 2004(n=534) over 2000(n=527). In 2004 compared to 2000, there was an increase in learning objectives related to nursing process, need of oxygenation, need of nutrition, need of temperature regulation, need of activity and exercise, need of comfort, medication, preoperative care. According to Bloom's taxonomy, learning objectives established in 2004, mainly consisted of three domains, 35.5% for comprehension, 23.6% for synthesis, 20.4% for knowledge. Changes in learning objectives established in 2004 compared to 2000 decreases in the comprehension domain and increases in the synthesis domain. CONCLUSION: The learning objectives established in 2004 showed remarkable change when compared to those established in 2000. But the learning objective domains in Bloom's taxonomy were distributed unevenly. For better learning objectives in Fundamentals of Nursing, constant revision will be needed.

Education on Nosocomial Infection Control within the Content of Courses in Fundamentals of Nursing / 기본간호학회지

PURPOSE: The purpose of this study was to explore the content related to nosocomial infection control in the course on Fundamentals of Nursing. METHOD: Participants were 49 faculty who were teaching courses in Fundamentals of Nursing in universities and colleges in Korea. The questionnaire was composed of 55 items related to nosocomial infection control. RESULTS: Eighteen items out of 55 items were taught in more than 80% of the universities and colleges. These included principles of infection control, principles and effect of hand washing, method of hand washing, hand scrubs, and donning sterile gown and gloves. CONCLUSION: The most effective interventions for infection control, including asepsis, hand washing, infection control for urinary catheterization, and infection control for IV sites were taught in most universities and colleges. However, the time assigned for teaching these items and the importance placed on practice were not considered sufficient.

Prospective Study on the Relating Factors to the Stages of Change in Smoking Cessation and Barriers in Coronary Artery Disease Patients / 간호학회지

PURPOSE: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. METHOD: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. RESULT: In the baseline, the distribution of the subjects' stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. CONCLUSION: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

Features Related to Smoking and Psychological Characteristics of Coronary Artery Patients Associated with the Stage of Change in Smoking Cessation / 성인간호학회지

PURPOSE: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. METHOD: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. RESULT: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD= 6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. CONCLUSION: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

The Effect of Job Stress and Lifestyle on Blood Lipid Levels in Male Aircrew Personnel / 간호학회지

INTRODUCION: Cardiovascular disease has the potential to lead to sudden in-flight incapacitation and permanent grounding. The aims of this study are to examine the relationships between lifestyle, job stress and blood lipid levels of male aircrew personnel of a Korean airline and to identify which factors influence their hyperlipidemia. METHODS: Two hundred sixteen male aircrew personnel completed a questionnaire by self-report and consented to participate in the study. The questionnaire collected data related to job stress, life style, serum cholesterol levels and general characteristics of the aircrew. The cholesterol levels of the subjects were collected from their most recent health check-up records. Subjects were divided into two groups (the desirable group and the risk group) based on their serum cholesterol level, 200 mg/dl. RESULTS: Mean age and marital status were significantly different between the two groups. More subjects in the risk group had habits of eating high lipid foods, while more subjects in the desirable group exercised more frequently than the risk group. In logistic regression analysis, after controlling age and marital status, types of working situation (domestic duty or international duty, odds ratio=.390, p=.018), diet (odds ratio=.429, p=.037), and exercise (odds ratio=.320, p=.055) were influencing factors on aircrew's serum cholesterol levels. CONCLUSIONS: The cholesterol level of aircrew personnel is closely related to their lifestyle, such as lipid diet and exercise. The type of work situations, e.g. staying in an airplane for long periods of time or staying abroad, may influence these diet patterns and exercise habits.

Clinical Implications of the Glucose Test Strip Method for Early Detection of Pulmonary Aspiration in Nasogastric Tube- Fed Patients / 간호학회지

PURPOSE: This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients. METHOD: The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria. RESULT: The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=. 038). More subjects in the no aspiration group (73%) than the aspiration group (56%) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups. CONCLUSION: The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

Clinical Nursing Competency for New Graduate Nurses: A Grounded Theory Approach / 기본간호학회지

PURPOSE: This study was done to provide information about issues of clinical competency from the perspective of new graduate nurses and to make suggestions for improving undergraduate education programmes. It was also done to clarify learning experiences between fundamentals of nursing and the other major areas of nursing. METHOD: For this study, 7 new graduates and 8 experienced nurses participated. The data were collected through in-depth interviews and analysed in terms of Strauss and Corbin's grounded theory methodology. RESULT: Core category and main categories, were delineated. Clinical nursing competency was found to be a dynamic process with each participant actively engaged in acquiring problem solving ability in diverse clinical settings. These findings have value in understanding the embedded meaning of clinical nursing competency. CONCLUSION: Therefore, the educational programs reflecting the experience of new nursing staff should be developed.

The Administration Patterns of Sedatives for Sedation of Mechanically Ventilated Patients and Patient Assessment by Nurses / 기본간호학회지

PURPOSE: The purpose of this descriptive study was to investigate the administration patterns of sedatives and paralytic agents for mechanically ventilated patients. METHOD: The participants were 18 adult patients who received mechanical ventilation therapy for more than 1 day in the MICU. Collected data were type of injected medications, administration interval, injected amount, administration purpose, and patient assessment by nurses. RESULT: Mean age of the patients was 61 years old. Seventy-two percent were male. Only 2 drugs (midazolam and norcuron) were administered to most of subjects. The type of medication administered was less heterogeneous than in previous studies. Most of the patients received sedatives and paralytics intermittently. Six different methods were used by nurses to administer sedatives and paralytics. The mean injection frequency was 9.3 times/day for sedatives and 10.8 times/ day for paralytic agents. The most common purpose for administration of the drugs was full sedation of the patient (57%). CONCLUSION: Since a few patients received sedatives and paralytic agents higher than usual dose and a few patients received those drugs lower than usual dose, nurses need to use proper protocols and guidelines for sedation to avoid oversedation and undersedation.

The Influencing Factors on Health Behavior of Patients with Coronary Artery Disease / 간호학회지

PURPOSE: The purpose of this study was to investigate the influencing factors on health behavior among patients with coronary artery disease. METHOD: The subjects were 95 patients who visited the out-patient department of a university hospital for follow-up. The four health belief concepts (motivation, benefit, barrier, seriousness), general self-efficacy, health behaviors on medication, diet, exercise, stress management, smoking, and drinking were measured. RESULT: There were significant differences in the health behavior scores of subjects according to family support and the experience of surgical procedure. Subjects were found to have a high degree of compliance in taking medication. However subjects reported the lowest degree of compliance in regular exercise. In the multiple regression analysis, surgical procedure and motivation were significant predictors to explain diet. Motivation and barrier were significant predictors to explain exercise. Self-efficacy, motivation and family support were significant predictors to explain stress management. Family support and seriousness explained 16% of variance in drinking. Also, family support explained 30% of variance in smoking. CONCLUSION: Since predicting factors on each health behavior indicator were different, then nurses should consider these differences to construct strategy enhancing patient's recovery.

Relationships among Job Stress, Health Beliefs and Health Behaviors of Aircrews / 성인간호학회지

PURPOSE: The purpose of this correlational study was to identify relationships among job stress, health beliefs and health behaviors of aircrews and contributing factors to aircrew's health promoting behaviors. METHOD: Two-hundred twenty-four aircrew members completed questionnaires. The questionnaires were composed of a demographic form, health behavior scale, self-efficacy scale, perceived benefit scale, perceived barrier scale, job demand scale, and latitude scale. RESULT: The subject's health behavior has shown significant correlations with self-efficacy, benefit, and barrier. Significant negative correlations were found between job stress and self-efficacy. Relationships between job stress and barriers were also statistically significant. In demographic features, statistically significant difference were found between subject's rank and job stress score. Also, there was a significant difference between health behavior and the subject's age. CONCLUSION: Future efforts should focus on the development of a program to consider aircrew's perceived benefits, perceived barriers and self-efficacy to the compliance of health promoting behaviors.

The Administration Patterns of Analgesics and Sedatives for Patients in SICU / 간호학회지

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.