ABSTRACT
Purpose@#This study aimed to develop an emerging infectious disease (COVID-19) simulation module for nursing students and verify its effectiveness. @*Methods@#A one-group pretest–posttest quasi-experimental study was conducted with 78 under-graduate nursing students. A simulation module was developed based on the Jeffries simulation model. It consisted of pre-simulation lectures on disaster nursing including infectious disease pandemics, practice, and debriefings with serial tests. The scenarios contained pre-hospital settings, home visits, arrival to the emergency department, and follow-up home visits for rehabilitation. @*Results@#Disaster preparedness showed a statistically significant improvement, as did competencies in disaster nursing. Confidence in disaster nursing increased, as did willingness to participate in disaster response. However, critical thinking did not show significant differences between time points, and neither did triage scores. @*Conclusion@#The developed simulation program targeting an infectious disease disaster positively impacts disaster preparedness, disaster nursing competency, and confidence in disaster nursing, among nursing students. Further studies are required to develop a high-fidelity module for nursing students and medical personnel. Based on the current pandemic, we suggest developing more scenarios with virtual reality simulations, as disaster simulation nursing education is required now more than ever.
ABSTRACT
PURPOSE: Decitabine, a DNA hypomethylating agent, was recently approved for use in Korea for older adults with acute myeloid leukemia (AML) who are not candidates for standard chemotherapy. This study aimed to evaluate the role of decitabine as a first-line treatment for older adults with AML. MATERIALS AND METHODS: Twenty-four patients with AML who received at least one course of decitabine (20 mg/m²/d intravenously for 5 days every 4 weeks) as a first-line therapy at Severance Hospital were evaluated retrospectively. RESULTS: The median age of the patients was 73.5 years. The longest follow-up duration was 502 days. A total of 113 cycles of treatment were given to 24 patients, and the median number of cycles was four (range, 1–14). Thirteen patients dropped out because of death, no or loss of response, patient refusal, or transfer to another hospital. Twenty-one (87.5%) and 12 (50%) patients completed the second and fourth cycles, respectively, and responses to treatment were evaluated in 17. A complete response (CR) or CR with incomplete blood-count recovery was achieved in six (35.3%) patients, and the estimated median overall survival was 502 days. Ten patients developed grade >2 hematologic or non-hematologic toxicities. In univariate analysis, bone marrow blasts, lactate dehydrogenase, serum ferritin level, and bone marrow iron were significantly associated with response to decitabine. CONCLUSION: Five-day decitabine treatment showed acceptable efficacy in older patients with AML who are unfit for conventional chemotherapy, with a CR rate 35.3% and about a median overall survival of 18 months.