Collaborative Disaster Governance Recognized by Nurses during a Pandemic

Purpose@#We aimed to identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic. @*Methods@#We used a descriptive study design with an online survey technique for data collection. The survey questions were developed based on focus group interviews with nurses responding to COVID-19 and expert validity testing. A 42-question online survey focusing on disaster governance was sent to nurses working in COVID-19 designated hospitals, public health offices, and schools. A total of 630 nurses participated in the survey. Demand and supply analysis was used to identify the specific components of disaster governance during a pandemic situation and analyze priority areas in disaster governance, as reported by nurses. @*Results@#Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply quadrant, indicating a strong need in those areas of disaster governance among nurses. The nurses practicing at the public health offices and schools showed major components of disaster governance plotted in the second quadrant, indicating weak collaborative disaster governance. @*Conclusion@#These findings show that there is an unbalanced distribution among nurses, resulting in major challenges in collaborative disaster governance during COVID-19. In the future and current pandemic, collaborative disaster governance, through improved distribution, will be useful for helping nurses to access more required resources and achieve effective pandemic response.

Factors influencing quality of life in post-menopausal women

Purpose@#This study aimed to identify factors influencing quality of life in post-menopausal women. @*Methods@#The participants were 194 post-menopausal women who visited a women’s clinic in Changwon, Korea from July 1 to August 31, 2018, and completed questionnaires containing items on menopausal symptoms, marital intimacy, current menopausal hormone therapy (MHT), and quality of life. Collected data were analyzed by descriptive statistics, the independent t-test, Pearson correlation coefficients, and multiple regression using SPSS for Windows version 23.0. @*Results@#Quality of life had a significant negative correlation with menopausal symptoms (r=–.40, p<.001), and a significant positive correlation with marital intimacy (r=.54, p<.001). The factors influencing the quality of life of post-menopausal women were current MHT (t=6.32, p<.001), marital intimacy (t=4.94, p<.001), monthly family income (t=4.78, p<.001), menopausal symptoms (t=–4.37, p<.001), and education level (t=3.66, p<.001). These variables had an explanatory power of 59.2% for quality of life in post-menopausal women. @*Conclusion@#In order to improve the quality of life of post-menopausal women, nursing interventions are needed to help menopausal women choose appropriate MHT, alleviate menopausal symptoms, and increase marital intimacy. Interventions should also be prioritized for women of a low educational level and with a low income in consideration of their health problems.

Factors influencing quality of life in post-menopausal women

Purpose@#This study aimed to identify factors influencing quality of life in post-menopausal women. @*Methods@#The participants were 194 post-menopausal women who visited a women’s clinic in Changwon, Korea from July 1 to August 31, 2018, and completed questionnaires containing items on menopausal symptoms, marital intimacy, current menopausal hormone therapy (MHT), and quality of life. Collected data were analyzed by descriptive statistics, the independent t-test, Pearson correlation coefficients, and multiple regression using SPSS for Windows version 23.0. @*Results@#Quality of life had a significant negative correlation with menopausal symptoms (r=–.40, p<.001), and a significant positive correlation with marital intimacy (r=.54, p<.001). The factors influencing the quality of life of post-menopausal women were current MHT (t=6.32, p<.001), marital intimacy (t=4.94, p<.001), monthly family income (t=4.78, p<.001), menopausal symptoms (t=–4.37, p<.001), and education level (t=3.66, p<.001). These variables had an explanatory power of 59.2% for quality of life in post-menopausal women. @*Conclusion@#In order to improve the quality of life of post-menopausal women, nursing interventions are needed to help menopausal women choose appropriate MHT, alleviate menopausal symptoms, and increase marital intimacy. Interventions should also be prioritized for women of a low educational level and with a low income in consideration of their health problems.

Development of a Play Toolkit for Supporting Infant and Toddler Development in Kyrgyzstan with a Focus on the Symbolic Functioning and Fine Motor Development of Infants 6 to 36 Months Old

PURPOSE: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. METHODS: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. RESULTS: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. CONCLUSION: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.

The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns

PURPOSE: This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS: The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS: The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION: The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.

Evaluation of a Community-based Child (Infants and Toddlers) Health Promotion Pilot Project in a Migrant Village in Kyrgyzstan

PURPOSE: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation.METHODS: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed.RESULTS: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care.CONCLUSION: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

Analysis of the Contents and Importance of Clinical Practicum Education in Adult Health Nursing According to Nursing Intervention Classification (NIC) System / 의료커뮤니케이션

BACKGROUND: The purpose of the study was to analyze the contents and importance of clinical practicum education in adult health nursing.METHODS: This is a descriptive study using content analysis for identifying the items of clinical nursing checklists gathered from 13 university nursing programs accredited by Korean Accreditation Board of Nursing Education. Items in the checklist were standardized in accordance with the Nursing Intervention Classification (NIC) and categorized into simple-technical skill, complex-technical skill, and disease-specific care. The perceived significance of each item was examined by surveying nurses who in charge of nurse education from various clinical setting.RESULTS: A total of 182 items in the clinical practicum contents were analyzed, and the terminologies of each item were variously described among nursing schools. Fifty percent of the total items were categorized into simple-technical skill. In terms of clinical importance, expert validity results showed that nurses considered infection control, infection protection, and fall prevention as the most significant items, which was not the same as the most common items in the clinical nursing checklist.CONCLUSION: These findings suggest that standardized nursing terminologies are needed to describe a nursing practicum checklist. Clinical importance of each item in the checklist should be taken into consideration in developing a clinical nursing checklist to assist the students in achieving the competencies as a clinical nurse.

Effect of Breathing Exercise Using Panflutes on the Postoperative Compliance, Pulmonary Infections and Life Satisfaction in Elderly Patients Undergoing Spinal Surgery

PURPOSE: The purpose of this study was to examine the effects of breathing exercises performed using panflutes in elderly patients undergoing spinal surgery. METHODS: The study design was a nonequivalent control group non-synchronized pre-post test. The study included 24 patients in both the experimental group and the control group. The experimental group completed a daily breathing exercise regimen using panflutes for 30minutes after meals, whereas the control group was provided standard preoperative education, including breathing exercises using incentive spirometers. After the exercise regimen, breathing exercise compliance, pulmonary infections, and life satisfaction were measured in both groups, and the data were analyzed using the SPSS/WIN program. RESULTS: The compliance rate of breathing exercises was significantly higher in the experimental group. The experimental group presented no pulmonary infections in the later period, whereas the control group presented higher pulmonary infection rates in the same period. In addition, the life satisfaction score in the experimental group significantly increased. CONCLUSION: The breathing exercise program using panflutes for elderly patients undergoing spinal surgery enhanced their breathing exercise compliance and their daily life satisfaction in addition to reducing their pulmonary infection rates.

Analysis of Nurses' Soothing Behaviors in Neonatal Intensive Care Unit: Focused on Babies with Bronchopulmonary Dysplasia

PURPOSE: The aim of this study was to analyze Neonatal Intensive Care Unit nurses' behaviors while soothing newborns with bronchopulmonary dysplasia. METHODS: An observational study was used to assess nurses'soothing behaviors. Data were collected from September, 2012 to March, 2013 using an audio-video recording system. Participants were eight babies and 12 nurses caring for those babies. After obtaining parental permission, the overall process of each episode from nurses'engagement in soothing to the end of soothing was recorded. Then a researcher interviewed each participating nurse. Data from 18 episodes were transcribed as verbal and nonverbal nursing behaviors and then categorized by two researchers. RESULTS: There were 177 observed soothing behaviors which were classified with the five sensory-based categories (tactile, oral, visual, auditory, vestibular). Most frequently observed soothing behavior was ‘Gently talking’ followed by ‘Removing irritant’, and ‘Providing non-nutritive sucking’. Nurses' perceived soothing behaviors were similar to the observed soothing behaviors except for ‘Gently talking’. CONCLUSION: Nurses used diverse and mixed soothing behaviors as well as recognizing those behaviors as essential nursing skills. Nurses' soothing behaviors identified in this study can be used to comfort babies and to enhance their developmental potential in accordance with individual characterstics or cues.

The Reliability and Validity of the Lasater Clinical Judgement Rubric in Korean Nursing Students

PURPOSE: This study was done to evaluate the Lasater Clinical Judgement Rubric for use with Korean nursing students. METHODS: A methodological study was used to validate the rubric developed by Lasater to assess clinical judgment during nursing simulation. Participants were 34 nursing students at K University in Seoul. Between February and May, 2012, analysis was done of 91 video clips recording performance during simulation. RESULTS: Findings showed reliability and validity of the rubric. For internal consistency, Cronbach's alpha score was .884 and intraclass correlation coefficient was .839, which established reliability. The rubric was validated using the exploratory factor analysis and content validity. The content validity score was 83%, establishing the appropriateness and readiness of the tool. Factor analysis showed that noticing, responding, and reflecting domains had Eigen values of 2.669, 1.991, and 2.912, respectively and were bound, but unlike the original tool in which four factors noticing, interpretation, responding, and reflecting domains were bound. CONCLUSION: Results of the study indicate that the rubric shows acceptable reliability and validity in Korean nursing students. This evaluation tool for nursing simulation allows nursing faculty to objectively evaluate students' clinical judgment as well as students to reflect on their clinical judgment process during simulation.

Evaluation of Algorithm-Based Simulation Scenario for Emergency Measures with High-Risk Newborns Presenting with Apnea

PURPOSE: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. METHODS: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. RESULTS: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. CONCLUSION: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.

Evaluation of Algorithm-Based Simulation Scenario for Emergency Measures with High-Risk Newborns Presenting with Apnea

PURPOSE: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. METHODS: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. RESULTS: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. CONCLUSION: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.

Validation of Yoon's Critical Thinking Disposition Instrument

PURPOSE: The lack of reliable and valid evaluation tools targeting Korean nursing students' critical thinking (CT) abilities has been reported as one of the barriers to instructing and evaluating students in undergraduate programs. Yoon's Critical Thinking Disposition (YCTD) instrument was developed for Korean nursing students, but few studies have assessed its validity. This study aimed to validate the YCTD. Specifically, the YCTD was assessed to identify its cross-sectional and longitudinal measurement invariance. METHODS: This was a validation study in which a cross-sectional and longitudinal (prenursing and postnursing practicum) survey was used to validate the YCTD using 345 nursing students at three universities in Seoul, Korea. The participants' CT abilities were assessed using the YCTD before and after completing an established pediatric nursing practicum. The validity of the YCTD was estimated and then group invariance test using multigroup confirmatory factor analysis was performed to confirm the measurement compatibility of multigroups. RESULTS: A test of the seven-factor model showed that the YCTD demonstrated good construct validity. Multigroup confirmatory factor analysis findings for the measurement invariance suggested that this model structure demonstrated strong invariance between groups (i.e., configural, factor loading, and intercept combined) but weak invariance within a group (i.e., configural and factor loading combined). CONCLUSIONS: In general, traditional methods for assessing instrument validity have been less than thorough. In this study, multigroup confirmatory factor analysis using cross-sectional and longitudinal measurement data allowed validation of the YCTD. This study concluded that the YCTD can be used for evaluating Korean nursing students' CT abilities.

Use of Physical Assessment Skills and Education Needs of Advanced Practice Nurses and Nurse Specialists

PURPOSE: The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. METHODS: A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. RESULTS: Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. CONCLUSION: More educational opportunities in physical assessment should be provided including education programs based on the nurses' skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.

Trends of Doctoral Dissertations in Nursing Science: Focused on Studies Submitted Since 2000 / 간호학회지

PURPOSE: The purpose of this study was to identify the characteristics of doctoral dissertations in nursing science submitted since 2000. METHOD: Three-hundred and five dissertations of six schools of nursing published from 2000 to 2006 in Korea were analyzed with the categories of philosophy, method, body of knowledge, research design, and nursing domain. RESULT: In philosophy, 82% of all dissertations were identified as scientific realism, 15% were relativism, and 3% were practicism. Two-hundred and fifty dissertations (82%) were divided into a quantitative methodology and 55 dissertations (18%) were qualitative methodology. Specifically, 45% were experimental, 23% methodological, 13% survey and 17% qualitative designed researches. Prescriptive knowledge was created in 47% of dissertations, explanatory knowledge in 29%, and descriptive knowledge in 24%. Over 50% of all research was studied with a community-based population. In the nursing domain, dissertations of the practice domain were highest (48.2%). CONCLUSION: Dissertations since 2000 were markedly different from the characteristics of the previous studies (1982-1999) in the increase of situation-related, prescriptive and community-based population studies. A picture of current nursing science identified in this study may provide a future guideline for the doctoral education for nursing.

Developmental Direction for Review System of the Journal of Korean Academy of Nursing / 간호학회지

PURPOSE: This study was performed to identify current characteristics of the Journal of Korean Academy of Nursing and to explore a way to elevate it to an international level and to critique the overall review process so as to delineate the advanced, objective paper appraisal in this journal. METHODS: Data was collected using self administered questionnaires to 75 journal reviewers belonging to the Korean academy of nursing and its division academy of nursing from August 15th to September 30th, 2006. RESULTS: The majority of reviewers pointed out a lack of discrimination between the Journal of Korean Academy of Nursing and other journals. Among the main answers of reviewers, Creativeness(52.3%) and excellence of nursing(38%) will be critical factors to develop in order to elevate to an the journal to an international level. In specific evaluation areas, reviewers preferred a subjective critique method(60%), and the condition of the decision making process regarding paper acceptance as a combination of checklist and subjective evaluation(84%). Subjective evaluation opinions with major categories will occur in the next revised evaluation format. 76% of reviewers agreed with the current objective evaluation form. CONCLUSIONS: The journal review process should be evaluated on a regular basis to elevate the journal level and a mutual agreement of the journal's scope, range, and purpose will be necessary. As a recommendation, an attempt at various approaches in journal reviews and reviewer training should be made.

Developmental Direction for Review System of the Journal of Korean Academy of Nursing / 간호학회지

PURPOSE: This study was performed to identify current characteristics of the Journal of Korean Academy of Nursing and to explore a way to elevate it to an international level and to critique the overall review process so as to delineate the advanced, objective paper appraisal in this journal. METHODS: Data was collected using self administered questionnaires to 75 journal reviewers belonging to the Korean academy of nursing and its division academy of nursing from August 15th to September 30th, 2006. RESULTS: The majority of reviewers pointed out a lack of discrimination between the Journal of Korean Academy of Nursing and other journals. Among the main answers of reviewers, Creativeness(52.3%) and excellence of nursing(38%) will be critical factors to develop in order to elevate to an the journal to an international level. In specific evaluation areas, reviewers preferred a subjective critique method(60%), and the condition of the decision making process regarding paper acceptance as a combination of checklist and subjective evaluation(84%). Subjective evaluation opinions with major categories will occur in the next revised evaluation format. 76% of reviewers agreed with the current objective evaluation form. CONCLUSIONS: The journal review process should be evaluated on a regular basis to elevate the journal level and a mutual agreement of the journal's scope, range, and purpose will be necessary. As a recommendation, an attempt at various approaches in journal reviews and reviewer training should be made.