Critical Review III to Standardize the Textbooks of Fundamentals of Nursing: Nutrition, Urinary and Bowel Elimination Needs / 기본간호학회지

Purpose@#To identify the discrepancies in the textbook of fundamentals of nursing in nutrition and elimination needs in terms of number, range, definition and etc. @*Methods@#The 10 textbooks which are the most frequently used were selected and reviewed. After then compared it with the protocols of essential nursing skills of Korean Accreditation Board of Nursing Education and evidence-based clinical nursing practice guidelines of Korean Hospital Nurses’ Association. @*Results@#The most significant discrepancies in nutrition domain were criteria of obesity, confirmation of nasogastric tube placement. In elimination domain, there were several mixed or miss uses of French and number unit in catheter size. And appropriate catheter size for urinary catheterization and enema is different to books and guidelines. @*Conclusion@#In order to conduct an effective resource in education of nursing, textbooks need to be revised constantly and contain the recent researches and guidelines.

A Survey on Undergraduate Nursing Students Safety during Fundamentals of Nursing Practicum / 기본간호학회지

Purpose@#This study was done to investigate the experience of physical and emotional safety in nursing students during fundamentals of nursing practicum. @*Methods@#A descriptive cross-sectional study was conducted from March to September 2019. A total of 553 nursing students, who had completed fundamental nursing laboratories, participated in this study. Data were collected using self-report questionnaires which included questions about general characteristics, physical and emotional safety during fundamental nursing laboratories along with an informed consent given prior to the practicum. @*Results@#Of the students, 26 experienced physical safety accidents, and 18 reported emotional safety accidents. Students' mean stress score for physical safety was 1.95, and the mean score for emotional safety was 1.92. Of the students, more than 59.1% agreed to volunteer as practice models in certain nursing procedures’ training. Of the students, 55.8% were satisfied with using their bodies to train fundamental nursing skills. 61.8% of students reported that informed consent was obtained during the nursing laboratory, and 88.6% of students thought that informed consent needs to be obtained. @*Conclusion@#To prevent safety accidents during the fundamentals of nursing practicum and systematically manage accidents, standardized safety guidelines for nursing practicum should be developed. Establishing various training strategies using advanced models or simulators to increase education efficiency and satisfaction is necessary.

Relationship among Cognition, Sleep Patterns, Salivary Melatonin Level and Sleep Disorder Inventory of Older Adults in Nursing Homes

Purpose@#The purpose of this study was to investigate sleep quality in older adults in nursing home with objective data collection. @*Methods@#Participants included 74 older adults in nursing homes in Korea aged 65 years or above. Data were collected using a wearable device (Fitbit), salivary melatonin level and Sleep Disorder Inventory (SDI). The Pearson correlation coefficient was calculated to examine whether there was any correlation between sleep-related variables such as Total Sleep Time (TST), Rapid Eye Movement (REM) sleep, shallow sleep, deep sleep, salivary melatonin level and SDI. @*Results@#There were distortion of sleep structure, as TST comprised short REM sleep (15.93 ± 5.47%), long shallow sleep (74.18 ± 8.08%) and short deep sleep (9.89 ± 5.03%). Also, salivary melatonin levels were low (15.06 ± 7.77 pg/mL). Moreover, we found than melatonin was significantly associated with TST (r = .251, p = .044), REM sleep (r = .294, p = .020) and deep sleep (r = .391, p = .002). But there was no correlation between SDI and other sleeprelated variables. @*Conclusion@#These findings highlight that insufficient sleep structure is associated with the salivary melatonin level among older adults in nursing home. We suggest developing programs to promote sleep quality of older adults in nursing homes.

Relationship among Cognition, Sleep Patterns, Salivary Melatonin Level and Sleep Disorder Inventory of Older Adults in Nursing Homes

Purpose@#The purpose of this study was to investigate sleep quality in older adults in nursing home with objective data collection. @*Methods@#Participants included 74 older adults in nursing homes in Korea aged 65 years or above. Data were collected using a wearable device (Fitbit), salivary melatonin level and Sleep Disorder Inventory (SDI). The Pearson correlation coefficient was calculated to examine whether there was any correlation between sleep-related variables such as Total Sleep Time (TST), Rapid Eye Movement (REM) sleep, shallow sleep, deep sleep, salivary melatonin level and SDI. @*Results@#There were distortion of sleep structure, as TST comprised short REM sleep (15.93 ± 5.47%), long shallow sleep (74.18 ± 8.08%) and short deep sleep (9.89 ± 5.03%). Also, salivary melatonin levels were low (15.06 ± 7.77 pg/mL). Moreover, we found than melatonin was significantly associated with TST (r = .251, p = .044), REM sleep (r = .294, p = .020) and deep sleep (r = .391, p = .002). But there was no correlation between SDI and other sleeprelated variables. @*Conclusion@#These findings highlight that insufficient sleep structure is associated with the salivary melatonin level among older adults in nursing home. We suggest developing programs to promote sleep quality of older adults in nursing homes.

Validation of Korean version of scrub nurses’ intra-operative non-technical skills evaluation system / 의료커뮤니케이션

Background@#: This is a methodological study for validation of the Korean version of scrub practitioners’ list of intra-operative nontechnical skills system, K-SPLINTS.Method : Data were collected from multidisciplinary expert panel (n=6) and a group of scrub nurses (n=40) with minimum two years of operative theatre experience in two university hospitals in Seoul. Contents validity was calculated from expert panel and reliability, completeness, observability and usability were analyzed from scrub nurses group.Result : K-SPLINTS is deemed to be adequate for assessing and training scrub nurses’ intraoperative behaviours. @*Conclusion@#: K-SPLINTS could be useful to inspire scrub nurses non-technical skills in the operating theatre.

Effects of a Customized Health Promotion Program on Depression, Cognitive Functioning, and Physical Health of Elderly Women Living Alone in Community: A Cluster Randomized Controlled Trial / 간호학회지

PURPOSE: This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community. METHODS: A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes. RESULTS: Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups. CONCLUSION: The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.

Exploring How to Conduct Infection Prevention and Control Education in Undergraduate Nursing Programs in Korea: Focus Group Interview Analysis / 기본간호학회지

PURPOSE: In the nursing profession, it is imperative that students are able to transfer their undergraduate knowledge and skills into practice to become competent nurses. The aim of this study was to illuminate how infection prevention and control (IPC) education would be conducted in undergraduate nursing programs. METHODS: A qualitative design utilizing focus group interviews as its data collection method was employed. Twelve professors from twelve South Korean universities that have undergraduate nursing programs were recruited as research participants and divided into two focus groups. RESULTS: Focus group interview analysis showed that IPC education in undergraduate nursing programs for fostering IPC competency was composed of two categories: a pre-clinical course and a clinical course. Each included three subcategories-education contents, education strategies, and considerations of how infection control is taught to students as they continue from beginning to advanced-and the themes of each subcategory were derived. CONCLUSIONS: The findings of this study can provide an overview of how nursing professors should teach IPC education to undergraduates. As IPC education for nurses is very important, more in-depth discussions that include educators, clinical mentors, and nursing students regarding IPC education are needed to ensure patients' safety in clinical settings.

A Survey on Safety of Fundamentals of Nursing Practicum in Korea / 기본간호학회지

PURPOSE: The purpose of this study is to investigate the safety of nursing students during fundamentals of nursing practicum in Korea. METHODS: This study used a descriptive design. A total of 106 nursing instructors teaching fundamentals of nursing longer than one year participated in this study. Data were collected using self-report questionnaires from July 24 to August 28, 2018. The questionnaires consisted of general characteristics, characteristics of fundamentals of nursing course, physical and emotional safety issues during fundamentals of nursing practicum, and obtaining an informed consent prior to practicum. RESULTS: The average number of physical safety accidents during practicum of fundamentals of nursing in the past 5 years was 1.12±2.44. The most common safety accident was punctured wound. The mean score of the participants' stress on physical safety accidents was 3.53±1.12 out of 5. The average number of emotional safety accidents of fundamentals of nursing practicum in the past 5 years was 1.05±2.72. The mean score of stress on emotional safety accident was 3.00±1.09 out of 5. We found that 47.2% of the participants obtained an oral consent or a written consent for safety of fundamentals of nursing practicum. CONCLUSION: The results of this study indicate that it is necessary to establish safety strategies for fundamentals of nursing practicum for nursing students.

Erratum: Effects of Individual Education Using a Treating-to-target Strategy in Patients with Rheumatoid Arthritis

The original version of this article contained an error of the ORCID identifier of corresponding author (Ji Hyeon Ju).

Effects of a Customized Health Promotion Program on Depression, Cognitive Functioning, and Physical Health of Elderly Women Living Alone in Community: A Cluster Randomized Controlled Trial

PURPOSE@#This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community.@*METHODS@#A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes.@*RESULTS@#Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups.@*CONCLUSION@#The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.

The Effect of the Intergenerational Exchange Program for Older Adults and Young Children in the Community Using the Traditional Play

PURPOSE: This study aimed to explore the effects of a community-based first and third Intergenerational Exchange Program (IGEP) on older adults' health-related quality of life (HRQoL), loneliness, depression, and walking speed, and on 4~5-year-old preschool children's learning-related social skills. METHODS: This study employed a non-equivalent control group pre-post-test design. The experimental group included 42 older adults and 42 children who participated in the IGEP for 8 weeks, and the control group included 39 older adults. The experimental group participated in the IGEP once a week for 8 weeks. It comprised a traditional play program based on the intergroup contact theory. RESULTS: Compared to the control group, there was a significant increase in scores on the HRQoL-Visual analogue scale (VAS) and a decrease in loneliness and depression in older adults in the experimental group (p < .05). Children who participated in the IGEP showed an improvement in their learning-related social skills (p < .001). CONCLUSION: These results confirm that the IGEP is an effective intervention to improve HRQoL-VAS, loneliness, and depression among older adults and learning-related social skills among preschool children in the community.

Exposure to Needlestick and Sharp Injuries, Anxiety during Injection Practice and Experience of Injecting Human Beings in Fundamental Injection Practice / 기본간호학회지

PURPOSE: This study was done to understand nursing students' exposure of needlestick and sharp injuries (NSSI), level of anxiety as well as experience of practicing injection with human beings during Fundamentals of Nursing (FN) practice. METHODS: Data consisted of self-report questionnaires completed by 571 nursing students who had completed an injection practice in FN. The questionnaire included questions on general characteristics, exposure to NSSI, experience of practicing injections with human beings, level of anxiety and other experiences. Data were analyzed using descriptive statistics and content analysis. RESULTS: Of the students, 17.5% experienced NSSI and 83.2% performed invasive injection procedures in the FN practice. The level of anxiety was 4.62–6.46/10 points when injecting a classmate and 1.27–1.93/10 points when using manikins. The feeling most often reported was worried about making a mistake that could hurt my classmate (57.2%). CONCLUSION: Nursing students are exposed to NSSI and experience a high degree of anxiety in invasive injection practice. These results indicate that it is necessary to develop and implement standardized NSSI prevention and anxiety reduction programs in FN.

Effects of Individual Education Using a Treating-to-target Strategy in Patients with Rheumatoid Arthritis

OBJECTIVE: To examine effects of an individual education program using the treating rheumatoid arthritis to target (RA T2T) strategy in patients with moderate-severe rheumatoid arthritis. METHODS: Patients were assigned randomly to an educational intervention (n=33) or conventional care group (n=33). The intervention was a nurse-delivered 9-month educational program consisting of 3 monthly sessions and monthly telephone counseling. The assessments occurred at the baseline and every 3 months in both groups, but only the intervention group completed the 9-month education follow-up. The outcome variables included the disease activity (DAS28), functional disability (KHAQ), fatigue (FACIT-Fatigue), and quality of life (SF-36). Repeated measures ANOVA and a Bonferroni multiple comparison were used to evaluate the outcome variables comparing the groups and follow-up times. RESULTS: Significant interactions were observed between the groups and follow-up times in the disease activity (p=0.041), fatigue (p=0.042), and physical (p=0.006) and mental (p=0.031) health-related quality of life, but there was no significant interaction in the functional disability (p=0.110). Significant differences were noted between the groups at the 9-month period (p=0.048) in disease activity and fatigue, and at the 6-month (p=0.023) and 9-month periods (p=0.027) in the physical health-related quality of life. CONCLUSION: This education program using the RA T2T strategy had significant benefits on the disease activity, fatigue, and quality of life in patients with moderate to severe rheumatoid arthritis, and the results suggested that this contributed to positive clinical outcomes as a good practical nursing intervention.

Evidence-based Clinical Practice Protocol of Physical Restraints by Adaptation Process for Patients in a Geriatric Hospital / 재활간호학회지

PURPOSE: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. METHODS: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. RESULTS: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. CONCLUSION: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

Effects of a Standardized Patient Simulation Program for Nursing Students on Nursing Competence, Communication Skill, Self-efficacy and Critical Thinking Ability for Blood Transfusion / 기본간호학회지

PURPOSE: This study was conducted to identify the effects of a standardized patients (SP) simulation program for nursing students on nursing competence, communication skill, self-efficacy and critical thinking ability for blood transfusion. METHODS: A nonequivalent control group non-synchronized design study was used and included as participants 96 junior nursing students at C University. The SP group (n=48) participated in the teaching class using a SP, while the control group (n=48) received conventional practice education. The outcome measurements were nursing competence, communication skill, self-efficacy, and critical thinking ability for transfusion. RESULTS: Nursing competence, communication skill, self-efficacy, and critical thinking ability improved for students in both groups after training (2.01< or =t< or =13.03, p<.05). Self-efficacy showed greater improvement in students in the SP group compared to the control group (t=3.36, p<.001). CONCLUSION: SP simulation practice may be more effective in enhancing self-efficacy than that of conventional practice education. Whether self-efficacy will contribute to enhancing learning motivation for nursing students needs further examination.

Time for Young Adults to Reach Resting Blood Pressure after Walking as measured by an Automatic and a Mercury Sphygmomanometer / 기본간호학회지

PURPOSE: The purpose of this study was to identify the time for young adults to reach resting blood pressure after walking as measured by an automatic and a mercury sphygmomanometer. METHODS: Participants were 33 nursing students in their 20s. Blood pressure after walking was measured every minute on both arms simultaneously for a total of 6 times after walking for 12 minutes on a treadmill at ratings of perceived exertion (RPE) of 11. Data were analyzed using paired t-test, Bland-Altman plots and repeated measures ANOVA. RESULTS: Systolic blood pressure after walking was the same as measurements corresponding to resting blood pressure after 3 minutes of resting if measured with the automatic sphygmomanometer and 4 minutes of resting if measured with the mercury sphygmomanometer. CONCLUSIONS: In order to measure the resting blood pressure for healthy young adults who performed low-density walking for 12 minutes on flat land, the measurement needs to be made after a resting time of at least 3 minutes in the case of an automatic sphygmomanometer and 4 minutes in the case of a mercury sphygmomanometer.

A Preliminary Study on the Standardization of Fundamental Nursing Practice Education / 기본간호학회지

PURPOSE: This study was undertaken to develop directions for research on nursing practice education and also for standardization of contents of Fundamental Nursing Practice (FNP) by identifying and analyzing the present content and inconsistency in FNP textbooks. METHOD: Eleven FNP textbooks published between 2007 and 2013 were selected and itemized nursing contents were compared and analyzed. Nursing professors and practicingnurses prioritized contents identified from an actual condition survey based on theoretical reason and clinical guides for each item. RESULTS: Inconsistencies were found for 34 domains with 219 sub items and of them, 21 domains and 84 items needed to be standardized. Number of items that showed consistency between professors and nurses (ICC > or = .800) was 29 (34.5%) and for complete consistency (ICC=1), 4 (4.8%). Number of items that showed inconsistency between the groups (ICC< .600) was 30 (35.7%) and very low consistency (ICC=0), 10 (11.9%). CONCLUSION: The results indicate a difference between understood validity of content by professors and by nurses and technical differences among FNP textbooks. Therefore confirmation of the items needing to be standardized and differences in understanding content by professors and by nurses shows a need for standardization of practice education between course and clinical practice. These results provide basic data for developing standardized form of FNP education.

Validation of the Korean version of the 39-Item Parkinson's Disease Questionnaire (PDQ-39)

PURPOSE: To evaluate the reliability and validity of the Korean version of the 39-item Parkinson's disease questionnaire (PDQ-39). METHODS: Cross-cultural adaptation was performed according to the international guidelines: forward and backward translation, focus group meeting, and a field test. With Korean consensus translation produced, validation was assessed by evaluating reliability and validity. Ninety-three outpatients with Parkinson's disease (PD) and 89 healthy aged controls were recruited. Internal consistency reliability was assessed by Cronbach's alpha. Validity was assessed by Spearman correlation analysis, t test, factor analysis, and analysis of variance with Duncan's multiple range tests. RESULTS: In the PD group, mean age was 65.13 +/- 9.84 years, and mean duration of PD was 42.41 +/- 37.01 months. Ceiling and floor effects ranged 1.1%-2.2% and 1.1%-15.1%, respectively. Cronbach's alpha of eight dimensions ranged from .70 to .97. All dimensions were correlated with each other, except for the stigma dimension. PD patients had significantly lower quality of life than healthy aged controls did, except for the bodily discomfort dimension. Eight dimensions of Korean PDQ-39 loaded on one factor. PD patients with a Modified Hoehn and Yarh Staging score of 4 had the worst quality of life. The relationships among the eight dimensions of Koran PDQ-39 and the Modified Hoehn and Yarh Staging is fair to good, except for the stigma and social support dimension. CONCLUSION: The Korean PDQ-39 was proved to be reliable and valid. Our results suggest that Korean PDQ-39 could be used in clinical research to assess and evaluate the disease process and its impacts on health-related quality of life in Korean PD patients.

Effects of Progressive Resistance Training on Body Composition, Physical Fitness and Quality of Life of Patients on Hemodialysis

PURPOSE: To investigate the effect of progressive resistance training (PRT) on body composition, physical fitness, quality of life, lipid and nutritional profile of patients on hemodialysis (HD). METHODS: A non equivalent comparison group pretest and posttest design study was used with 40 participants who were randomly assigned to the exercise group (20 participants) and the comparison group (20 participants). The exercise group received PRT for 30 minutes per session, 3 sessions a week, for 12 weeks, while the comparison group received usual care. The PRT consisted of upper and lower body exercises using elastic bands and sandbags. Outcome measures evaluated were: body composition, physical fitness, quality of life, and lipid profile. RESULTS: Skeletal muscle mass, grip, leg muscle strength, and quality of life all improved significantly in the exercise group. Body fat rate, total cholesterol and triglyceride rate decreased significantly in the exercise group. CONCLUSION: These results suggest that PRT improves body composition, physical fitness, quality of life, and lipid profile of patients on HD. PRT using elastic bands and sandbags can be utilized as part of a regular care plan for these patients.

Accuracy, Precision, and Validity of Fever Detection using Non-invasive Temperature Measurement in Adult Coronary Care Unit Patients with Pulmonary Catheters

PURPOSE: To investigate the accuracy, precision and validity of fever detection of tympanic membrane (TM), temporal artery (TA) and axillary temperature (AT) compared with pulmonary artery temperature (PA). METHODS: Repeated-measures design was conducted for one year on 83 adult cardiac care unit patients with pulmonary artery catheters after open heart surgery. Sequential temperature measurements were taken three times at 20-minute intervals. Accuracy, precision, repeatability, and validity of fever detection were analyzed. RESULTS: Mean pulmonary artery temperature was 37.04degrees C (SD 0.70degrees C). The mean (SD) offsets from PA, with the mean reflecting accuracy and SD reflecting precision, were -1.31degrees C (0.75degrees C) for TA, -0.20degrees C (0.24degrees C) for TM, and -0.97degrees C (0.64degrees C) for AT. Percentage of pairs with differences within +/-0.5degrees C was 9.6% for TA, 19.7% for AT, and 91.6% for TM. Repeated measurements with all three methods had mean SD values within 0.04degrees C. Sensitivity, specificity, and positive and negative predictive values of tympanic measurements were 0.76, 1.0, and 1.0, and 0.90, respectively. CONCLUSION: Results show that TM best reflects PA, and is most consistent, accurate, and precise. AT tends to underestimate PA, and TA is least accurate and precise. Therefore tympanic membrane measurement is a reliable alternative to other non-invasive methods of measuring temperatures.