Agreement on Core Components of an E-Learning Cultural Competence Program for Public Health Workers in South Korea: A Delphi Study

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.

Metabolic Syndrome in South Korean Patients with Chronic Obstructive Pulmonary Disease: A Focus on Gender Differences

PURPOSE: This study investigated the relationship between chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS), focusing on gender differences and using large-scale data on the Korean general population. METHODS: The total sample included 9,079 eligible participants aged ≥ 40 years who participated in the fifth Korea National Health and Nutrition Examination Survey, conducted between 2010 and 2012. Complex sampling methods, including strata sampling, clustering, and sample weighting were used to allow generalization of the findings to the Korean population. For the bivariate analysis, chi-square tests were conducted to compare differences in general/behavioral characteristics, individual MetS components, the prevalence of COPD, and the number of MetS components according to the presence or absence of COPD and gender. Finally, a multiple logistic regression analysis adjusted for variables was conducted. RESULTS: The prevalence rates of COPD and MetS were 13.6% and 26.0%, respectively. The prevalence rate of MetS in the COPD group was 23.0% for the total sample, 18.5% for men, and 38.5% for women. After sample weighting and adjusting for covariates, there were no significant relationships among COPD, MetS, and the individual MetS components. CONCLUSION: Although MetS components were not significantly associated with COPD, the results indicate that health care professionals should recognize that two conditions, respiratory symptoms and MetS, may coexist in patients, women in particular, or healthy general populations encountered even if a patient has a normal body mass index and does not drink or smoke at all.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting

PURPOSE: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. METHODS: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. RESULTS: In the experimental group, the occurrence of vomiting (z=2.147) was significantly decreased, the maintenance PCA (χ²=4.212) and the satisfaction of patients (z=5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z=3.791), awareness (z=2.982) and self-efficacy (z=2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z=2.446) was significantly positive. CONCLUSION: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors

PURPOSE: The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. METHODS: For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. RESULTS: Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. CONCLUSION: The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services

PURPOSE: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. METHODS: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. RESULTS: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. CONCLUSION: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Career Attitude Maturity, Calling, and Work as Meaning Affecting Student Adjustment to College among Health College Students / 간호행정학회지

PURPOSE: The aim of this study was to identify factors affecting student adjustment to college among students in health colleges (Nursing, Clinical Pathology, Radiology, Dental Hygienics, Medicine). METHODS: The participants in this study were 261 students in Daejeon city. Data were collected from October 5 to October 14, 2014. A structured questionnaire was used for data collection and data was analyzed using the SPSS/WIN program. RESULTS: Career attitude maturity, calling and work as meaning positively correlated with student adjustment to college. The significant predictors of student adjustment to college were career attitude maturity, calling, always working part-time, major in medicine and average grade for the last semester. CONCLUSION: These findings suggest that adjustment to college for students in health colleges is linked to career attitude maturity, and calling. College organization should develop a curriculum fostering a calling which will promote student adjustment to college and graduate health care professionals with desirable attitudes.

The Relationship among Hesitation Factor of Questions, Critical Thinking Disposition, and Problem Solving: The University Student's Perspective / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the relationship among hesitation factor of questions, critical thinking disposition, and problem solving. METHODS: Data were collected from 370 students at a university in D city using a structured questionnaire from April 1 to April 15, 2015. It was analyzed with frequency analysis, descriptive statistics, t-tests, ANOVA, and correlation analysis. RESULTS: Subjects scored an average of 2.62+/-.52 for hesitation factor of questions, 3.53+/-0.42 for critical thinking disposition, and 3.44+/-0.44 for problem solving. There were significant differences in the three variables according to satisfaction with major, self-expression, and interpersonal relationships. In addition, hesitation factor of questions exhibited a significant difference between genders. Hesitation factor of questions had a negative relationship with critical thinking disposition (r=-.23, p<.001) and with problem solving (r=-.34, p<.001). In addition, there was a statistically significant positive correlation between critical thinking disposition and problem solving (r=.69, p<.001). CONCLUSION: In order to improve critical thinking disposition and problem solving, we need to generate a lot of questions to the student's inside. We also need to develop appropriate teaching methods so that this can be expressed by the actual question coming from the control hesitation factor of questions.

Bone Health Knowledge, Self-Efficacy, and Behaviors in Middle-Aged Korean Women

BACKGROUND: With the rapid growth of the elderly population, osteoporosis has become a major health problem worldwide. Although health knowledge and self-efficacy are important assets to facilitate healthy behaviors and disease prevention, such information as it relates to individuals and their bone health is limited. The purpose of this study was to assess the levels of knowledge, self-efficacy, and health behaviors on promoting bone health in middle-aged Korean women. METHODS: This is a cross-sectional survey study. A convenience sampling of middle-aged women (> or =40 years) was done at a community health center in Korea. Bone mineral density was measured by dual energy X-ray absorptiometry with the DEXXUM T. The level of knowledge was measured with the Knowledge of Osteoporosis Scale, and self-efficacy with the Osteoporosis Self-efficacy Scale. A questionnaire for bone health behaviors was developed for this study. Collected data were analyzed through descriptive methods, independent t-test, analysis of variance, and Pearson's correlation analysis. RESULTS: A total of 150 middle-aged women whose mean age was 59.8+/-11.5 years participated in the study. Most (74%) were menopausal. Less than one-quarter of participants (22.7%) had osteoporosis and less than half (42%) had osteopenia based on the T-score at the left femur neck site. Level of knowledge (mean score, 10.35) and self-efficacy (mean score, 47.67) ranged from low to moderate. Intake of calcium and vitamin D-rich foods was insufficient in our subjects. Bone health behaviors had significant positive relationships with knowledge (r=0.22, P=0.008) and self-efficacy (r=0.29, P<0.001) on promoting bone health. CONCLUSIONS: These results indicate that educational interventions are needed to enhance knowledge and confidence and to encourage middle-aged women to engage in bone health behaviors.

Level of Beliefs, Knowledge and Performance for Evidence-Based Practice among Nurses Experienced in Preceptor Role / 간호행정학회지

PURPOSE: As Evidence-Based Practice (EBP) has increasingly been proven as a means of cost-effective and higher-quality healthcare, its successful implementing are challenging. This study done to identify EBP beliefs, knowledge and performance among nurses experienced as a preceptor. METHOD: A descriptive cross-sectional survey was conducted with a convenience sample of 249 preceptor nurses working in 9 general hospitals in Korea. Reliable and valid questionnaires (EBP beliefs scale, Evidence Based Practice Questionnaire, Research-related activities) were used and the data were analyzed using SPSS win 17.0. RESULT: Perceived beliefs on EBP were relatively positive (mean score 3.57 out of 5), and the level of knowledge was moderate (4.21 out of 7). However, performance of EBP was low (3.82 out of 7). Regularity in reading research journals and searching evidences using core web-database were rarely conducted. Statistically significant correlations were found between beliefs, knowledge and performance of EBP (all p<.05). CONCLUSIONS: This result indicates that education and training programs to facilitate EBP performance are needed among preceptor nurses.

Female College Students' Knowledge, Self-efficacy and Health Behaviors related to Bone Health / 여성건강간호학회지

PURPOSE: This study described female college students' knowledge, self-efficacy and health behaviors related to bone health. METHODS: A descriptive cross-sectional survey design was used. A total of 214 students were conveniently recruited from a school of nursing in Korea. Participants (mean age=21.2, SD=1.9 years) bone mineral density (BMD) was measured using dual energy x-ray absorptionmetry. Participants also completed a questionnaire consisting of knowledge test, self-efficacy scale and health behaviors related to bone health. Data were analyzed using SPSS/WIN 17.0 program. RESULTS: The mean BMD at left femoral neck site was 0.86 g/cm2 and 6.1~12.6%. Results showed that participants were below the expected range of BMD. Level of knowledge (correct rate=54%) and self-efficacy were moderate (mean 54.8 out of 84). More than 84% of subjects drank alcohol more than once a month and 58.4% did participate in regular exercise. Only 7.9% participants took calcium and vitamin-D rich foods every day. There were significant positive correlations between knowledge and self-efficacy (r=.17), health behaviors (r=.14) and self-efficacy and health behaviors (r=.28, all p<.05). CONCLUSION: These results suggest that health care professionals need to provide effective interventions for young women in order to enhance knowledge, self-efficacy and health behaviors related to bone health.