Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists / 보건의료교육평가

PURPOSE: This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. METHODS: A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects' responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. RESULTS: Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. CONCLUSION: Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience.

A Web-based Health Promotion Program for Patients with Metabolic Syndrome

PURPOSE: The population of metabolic syndrome is increasing in Korea. The prevalence is related to lifestyle, such as lack of physical activity and irregular diet. Most patients with metabolic syndrome know that lifestyle intervention is important to managing the condition. However, they do not always follow the intervention for various reasons, including lack of knowledge on how to change their lifestyle and lack of accessibility to that knowledge. The purpose of this study was to test the web-based health promotion program we developed. METHODS: Fifty-six adult workers from eight areas of business were recruited. They all had a confirmed metabolic syndrome diagnosis after being registered at a university hospital for annual health checkups. Twenty-nine workers were assigned to the experimental group, and the others were assigned to the control group. The web-based program was applied to the experimental group as an intervention for 8 weeks.Waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, and blood pressure were measured before and after the program. Data were analyzed using chi-square test, Fisher's exact test, and t test. RESULTS: There were statistically significant differences between the two groups in waist circumference and high-density lipoprotein cholesterol (t = -4.43, p < .001; t = 2.22, p = .031, respectively). Of the 29 participants, 13 (44.83%) in the intervention group had less than two indices for metabolic syndrome. CONCLUSIONS: This study suggests that a web-based program is useful for patients with metabolic syndrome to improve physiologic parameters related to metabolic syndrome. The web-based program may be easily applicable to community as well as clinical setting.

Effects of a Home-based Exercise Program for Patients with Stomach Cancer Receiving Oral Chemotherapy after Surgery

PURPOSE: The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy. METHODS: The home-based exercise program was developed from the study findings of Winningham (1990) and data from the Korea Athletic Promotion Association (2007). The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy. Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul. Patients were randomly assigned to either the experimental group (11) or control group (13). The effects of the home-based exercise program were measured by level of cancer related fatigue, NK cell ratio, anxiety, and quality of life. Data were analyzed using SPSS/WIN 13.0 version. RESULTS: The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group. The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased. CONCLUSION: This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy.

Trends in Research Studies Published in Journal of Korean Academy of Fundamentals of Nursing: 2009-2011 / 기본간호학회지

PURPOSE: The purpose of this study was to identify the trends in research studies published in Journal of Korean Academy of Fundamentals of Nursing from 2009 to 2011. METHODS: A total of 156 studies published between 2009 and 2011 were reviewed using analysis criteria developed by the researchers. RESULTS: Quantitative studies accounted for 90.4% and qualitative studies, 8.3%. The research designs for the quantitative studies were experimental, 28.0% and survey, 63.8%. IRB approval was received for only 25.6% of the studies and 61.0% of studies presented participant criteria. Questionnaires were used for data collection in 90.8% of studies. Individual or group education was the most frequent intervention in the experimental studies. CONCLUSION: The results indicate that more randomized controlled trials with a low risk of bias are needed to support greater evidence-based nursing practice. Considering the low rate of ethical consideration, it is important that stricter application of research methods needs to be encouraged to improve the quality of Journal of Korean Academy of Fundamentals of Nursing.

Job Analysis of Clinical Research Coordinators Using the DACUM Process

PURPOSE: This study was done to analyze the job of clinical research coordinators (CRCs). METHODS: Through the "developing a curriculum (DACUM)" workshop, the definition of CRCs' role was described and CRCs' duties and tasks were identified. Finally, the developed duties and tasks were validated for importance, difficulty, and frequency. RESULTS: A CRC is defined as the one who coordinates and performs tasks related to clinical research/trials among investigators, participants, and sponsors according to the Good Clinical Practice at institutions conducting clinical trials. Twelve duties and 78 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks represented as A, B, and C respectively. Based on determinant coefficient (DC) of the task, the highest ranked task was confirming the eligibility of participants for research (DC=8.03) and the lowest was inventory management for clinical study materials (3.95). CONCLUSION: In this study, the job of a CRC was analyzed through the DACUM process and it was found that CRCs were doing various duties and tasks. Based on these results, it is suggested that it is necessary to develop CRC education programs considering the career ladder of CRCs.

Content and Educational Needs for Fundamental Nursing Practice / 기본간호학회지

PURPOSE: The purpose of this study was to identify content of Fundamental Nursing Practice (FNP) and the educational needs for nursing practice items in schools of nursing. METHODS: Participants were 81 professors who were teaching FNP and 166 clinical nurses. The research questionnaire included 148 practice items, which were selected by content analysis of 7 FNP textbooks. Data were collected from May 20 to July 27, 2011 and analyzed using descriptive statistics and t-test with SPSS 17.0. RESULTS: The research findings showed that : 1) the seven items included in the education content of all schools of nursing were putting on sterile gloves, checking radial pulse, checking blood pressure in the arm, Foley catheterization, injection preparation with ampule, intramuscular injection in the buttocks, and mixing intravenous fluid. Fifty items were included in the content in more than 80% of the schools. 2) Educational domains needing emphasis were medication, infection control, health assessment, oxygenation, urinary elimination, activity/positioning, and nutrition. There were significant differences in reported educational needs between professors and clinical nurses for 62.8% of practice items. CONCLUSIONS: Results indicated that standardization of FNP education contents using the findings of this study should lead to improvement in quality of FNP education.

Performance and Importance of Nursing Jobs in General Hospitals according to Levels of Work Experience of Nursing Staff / 기본간호학회지

PURPOSE: In this study differences in levels of performance and importance of nursing jobs were explored in relation to levels of work experience. METHOD: The sample was chosen by convenient sampling (N=363) and a cross-sectional study design was used. Frequencies and percentages were used for descriptive statistics. ANOVA was utilized to examine differences in performance and importance of nursing jobs among three groups of nurses, divided based on levels of work experience (less than 1 year, 1 to 4 years, and 5 or more years). RESULTS: Regarding performance of nursing jobs, novice nurses provided more support for patients, but provided less assessment of patients (i.e., investigation of levels of nutrition and exercise, and observation of verbal, and non-verbal behavior, and levels of cognition). Regarding the importance of nursing jobs, nursing linked to exercise and activities, and post-operative and excretion care were considered to be less important among novice nurses than among experienced nurses. CONCLUSION: Different training programs should be developed and provided to nurses according to levels of work experience. By doing so, it will be feasible to minimize differences in quality of nursing care triggered by different levels of work experience.

Factors Influencing Parenting Stress in Mothers of Children with Cerebral Palsy / 재활간호학회지

PURPOSE: This study was aimed at identifying the levels of parenting stress among mothers of children with cerebral palsy and factors influencing parenting stress. METHOD: The research design was cross-sectional survey. Data were collected from 122 mothers of hospitalized children (under 15 years of age) with cerebral palsy at the Y medical center using the questionnaires. The data were analyzed using one way analysis of variance with Scheffe test for post-hoc analysis or t-test, Pearson correlation, and stepwise multiple regression. RESULTS: The mean score of parenting stress was 2.52 (SD=0.79; range: 1~4). The father's participation, mother's parenting hours, self-esteem and social support were significant predictors of parenting stress, significantly accounting for the 33.3% variance (F=16.118, p<.001). CONCLUSION: It is essential for health professionals to consider the aforementioned four factors when developing interventions to reduce parenting stress for mothers of children with cerebral palsy.

Evaluation of the Korean Formal Educational Program for Training Care Workers for Frail Elderly

PURPOSE: This study was done to evaluate the formal education program provided by the Korean government for care workers for frail elderly people. METHODS: This study was a cross-sectional survey in which 438 certified care workers who had completed the education program participated. Data were collected from June to October 2009, using a self-report questionnaire consisting of satisfaction with, and understanding of the education program. RESULTS: The participants had a mean age of 46.7 yr, 87.9% were female and 58.2% were high school graduates. For the theory part of the education, the highest score for understanding was for 'supporting household & activities of daily living' while the lowest score for understanding was for 'care for death and dying'. For the practical education, the highest score for understanding was for 'talking with the client' and the lowest score was for 'first aid & basic life support'. There was a significant difference in satisfaction and understanding of the theoretical and practical parts according to educational level. CONCLUSION: Continuing education programs are needed for care workers for elders, both in the theoretical and practical areas. Also the content of programs should address the weak points of this formal education program.

Cognitive Function, Mood, Problematic Behavior and Response to Interaction with Robot Pet by Elders with Dementia / 기본간호학회지

PURPOSE: The purpose of this study was to identify the effects on cognitive function, mood, problematic behaviors and response to interaction with robot pet by elderly people with dementia. METHOD: A methodological triangulation design with quantitative and qualitative methods was used. The participants were 9 elderly people with dementia. The intervention was conducted twice a week for 4 weeks. Qualitative data were collected by interviews and video-taping for analysis of the responses of participants. RESULTS: 1) Cognitive function, mood and problematic behaviors did not show any significantly differences after the program. 2) Analysis of the responses showed increases in verbal communication and positive action. CONCLUSION: The robot pet program had positive effects such as increasing communication and interaction. Therefore, this program could be considered as an effective program for emotional support for elderly people with dementia. However further repetitive study is need to validate the result

Development of a Multimedia Learning DM Diet Education Program using Standardized Patients and Analysis of Its Effects on Clinical Competency and Learning Satisfaction for Nursing Students

PURPOSE: The purpose of this study was to develop a multimedia learning program for patients with diabetes mellitus (DM) diet education using standardized patients and to examine the effects of the program on educational skills, communication skills, DM diet knowledge and learning satisfaction. METHODS: The study employed a randomized control posttest non-synchronized design. The participants were 108 third year nursing students (52 experimental group, 56 control group) at K university in Seoul, Korea. The experimental group had regular lectures and the multimedia learning program for DM diet education using standardized patients while the control group had regular lectures only. The DM educational skills were measured by trained research assistants. RESULTS: The students who received the multimedia learning program scored higher for DM diet educational skills, communication skills and DM diet knowledge compared to the control group. Learning satisfaction of the experimental group was higher than the control group, but statistically insignificant. CONCLUSION: Clinical competency was improved for students receiving the multimedia learning program for DM diet education using standardized patients, but there was no statistically significant effect on learning satisfaction. In the nursing education system there is a need to develop and apply more multimedia materials for education and to use standardized patients effectively.

Experiences of Interpersonal Relationships among Head Nurses in General Hospital Settings / 성인간호학회지

PURPOSE: The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. METHODS: The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. RESULTS: Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. CONCLUSION: The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.

Effects and Development of Clinical Competency Evaluation using Standardized Patients among Nursing Students: Based on Abdominal Surgical Patients / 성인간호학회지

PURPOSE: This study was to develop the clinical competency evaluation, and to examine the effects of the developed evaluation by comparing it with existing evaluation on clinical competency, communication skill, and self-efficacy of nursing students. METHODS: Design was a randomized control group post-test design. The subjects were 102 senior nursing students(Experimental group: 48, Control group: 54) at K university in seoul, Korea. The experimental group took the clinical competency evaluation using standardized patients and the control group took the existing evaluation using a doll. The clinical competency and communication skills were measured by evaluators, and self-efficacy was self reported by the nursing students. RESULTS: The experimental group had higher scores in clinical competency, communication skills, and self-efficacy than those in the control group. CONCLUSION: Through these results, practice education of nursing education programs need to activate the clinical competency evaluation using standardized patients.

The Levels of Impacts of Events, Depression and Anxiety among Injured Workers

PURPOSE: The aim of this study was to investigate the impact of accidental events, depression, and anxiety among workers with industrial accidents in South Korea. METHODS: The participants were 510 workers with industrial accidents. Data were collected by personal interviews with structured questionnaires for three months from August to October in 2005. For analyses, frequencies and means were utilized. RESULTS: The participants' average age was 44.9 years, and about 91% of them were male. Also, they had a greater risk of poverty after being injured. The most frequent cause of accidents was fall (32.2%), and the most frequent injured body area was extremities (73.9%). For around a half of the participants, the treatment period was 12 months or shorter. The participants were at great risk of experiencing a negative impact due to events, depression, and anxiety. CONCLUSION: It is necessary to develop: (a) strategies for injured workers to be financially stable during recuperation; and (b) supporting systems for them not to suffer and exacerbate mental health problems after being injured.

Comparative Study on Parenting Stress, Guilt, Parenting Attitude, and Parenting Satisfaction Between Mothers with a Hemophilic Child and a Healthy Child / 여성건강간호학회지

PURPOSE: Although Hemophilia is a relatively rare hereditary disease, and is treatable with blood products, the parenting stress and guilt of hemophilic patients and their mothers are always high. This study was done to assess the extent of parenting stress, guilt, parenting attitude and parenting satisfaction of mothers with a hemophilic child. METHOD: The participants in this study were 119 mothers with a hemophilic child who were registered members of the Korea Hemophilia Foundation, and 287 mothers with a healthy child. In order to measure the dimensions related to parenting stress, guilt, parenting attitude and parenting satisfaction, the Questionnaire on Parenting Stress Index, Maternal Guilt Scale, Parenting Attitude Scale & Parenting Satisfaction Scale were administered. We analysed the differences between mothers with a hemophilic child and a healthy child in the questionnaire scores using the SPSS program. RESULT: Parenting stress and guilt of mothers with a hemophilic child were higher than with a healthy child. Parenting attitude and parenting satisfaction of mothers with a hemophilic child were lower than with a healthy child. CONCLUSION: The results may help medical professionals understand mothers with a hemophilic child and give basic assistance to develop a nursing intervention by exploring possible ways to alleviate such parenting stress and guilt.

Job Description of the Nurses Who Work in Operating Room Using DACUM Technique / 기본간호학회지

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.

Factors Influencing Aquatic Exercise Adherence of Patients with Arthritis / 기본간호학회지

PURPOSE: The purpose of this study was to identify change in the exercise behavior and to identify factors influencing long-term adherence to aquatic exercise in patients with arthritis as a follow-up study after five years. METHOD: Baseline data had been collected using a structured interview 6 months after participants completed the aquatic exercise educational program. This second follow-up data collection included 133 participants from the original baseline study and was done 5 years after the original baseline study. Data was analyzed using SPSS 16 Win program. RESULTS: The stage of change for the participants was as follows: Precontemplation (44.3%), Contemplation (24.1%), Preparation (3.0%), Action (0%) and Maintenance (adherence, 28.6%). The adherers (N=38) had significantly higher scores than non-adherers (N=91) in self-efficacy, outcome expectancy, group coherence and self-evaluation, and significantly lower scores in barriers to exercise. In logistic regression analysis, self-efficacy, group cohesion, barriers to exercise and self-evaluation were associated with exercise adherence (Chi Square=17.14, p=.002). Group cohesion (OR=2.587l, 95% CI=1.094-6.113, p= .030) was the most important factor. CONCLUSION: Self-efficacy, group cohesion, barriers to exercise and self-evaluation need to be considered in planning exercise programs to improve exercise adherence.

Comparison of the Effects of Meridian Massage and Hand Massage on the Affected Upper Extremity of Stroke Patients / 기본간호학회지

PURPOSE: In this study, the effects of meridian massage and hand massage on the affected upper extremity of patients with a stroke were identified. METHOD: A nonequivalent control group non-synchronized design was used. Participants were 84 (Experimental. 1: 28, Experimental. 2: 28, Control.: 28) patients with a stroke who were hospitalized in K oriental medical center. Experimental treatment for patients in experimental group 1 was the meridian massage for 10 minutes daily for 2 weeks, and for those in experimental group 2, hand massage for 2 minutes, 30 seconds each, daily for 2 weeks. Outcome variables were upper extremity function (grip power, shoulder pain, edema, ROM), ADL, and depression. Data were analyzed using SPSS PC+ version. RESULTS: The score for upper extremity functions and ADL were significantly higher in experimental group 1 who had meridian massage than for experimental group 2 or the control group. Experimental group 1 showed less depression than experimental 2 or the control group. CONCLUSION: Meridian massage can be an effective nursing intervention to improve upper extremity function and ADL, and to decrease depression in patients stroke who have had a stroke.

A Comparative Study on Profession-specific Handwashing Practices of ICU Health Care Providers / 기본간호학회지

PURPOSE: The purpose of this study was to evaluate knowledge, attitude, and compliance regarding hand hygiene according to the profession of ICU health care providers. METHOD: Data were collected by questionnaires and by recording of direct observations of 143 health care providers in 4 intensive care units. Wth SPSS/WIN 12.0 t-test, ANOVA, and chi-square-test were used to analyze the data. RESULTS: The level of knowledge regarding handwashing among the nurses was higher and a more positive attitude was shown compared to physicians. Overall handwashing compliance was low among all ICU health care providers, but nurses had better compliance than any other health care providers and significantly higher frequency for handwashing before care and after care activities. All of professions had lower scores on the appropriate length of time for handwashing and areas that need to be scrubbed. The level for nurses was medium and for physicians, the lowest of all professions. The appropriate agent for handwashing and the method of drying for handwashing compliance was high in all professions. CONCLUSION: The results suggest that multidisciplinary interventions are needed to develop an environment for appropriate handwashing as well as to reinforce importance of handwashing compliance for health care providers.

Influencing Factors for Fatigue in Cancer Patients / 간호학회지

PURPOSE: The purpose of this study was to identify degrees of fatigue and influencing factors for fatigue in cancer patients. METHOD: Data was collected by questionnaires from 115 cancer patients at 3 hospitals in Seoul. The research instruments utilized in this study were fatigue, physical symptoms, depression, family support, and health promoting behaviors. Data was analyzed using the pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. RESULT: The mean score of fatigue for cancer patients was 12.90(range: 6-36). Fatigue for cancer patients according to age group and weight change showed a significant difference. Fatigue for cancer patients showed a significantly positive correlation to physical symptoms and depression. There was a negative correlation between family support and health promoting behaviors. The significant factors influencing fatigue for cancer patients were physical symptoms, health promoting behaviors, depression, and age group, which explained about 45.9%. CONCLUSION: The results suggest that symptoms and depression management, nursing interventions and practices for providing health promoting behaviors according to age are needed to manage the fatigue in cancer patients.