Clinical characteristics of intentional self-harm inpatient with lethal methods

OBJECTIVE: The aim of this study was to identify the latent class, according to the risk factors, of the patients hospitalized due to intentional self-harm by lethal means. METHODS: The risk factors were derived by categorizing the intentional self-harming measures by lethal (hanging, pesticide poisoning, jumping, and drowning) and non-lethal (drug poisoning and stab) measures and comparing the demographics, diseased state, and suicide-related characteristics. Latent class analysis was performed to identify the type of intentional self-harm. RESULTS: Male (sex), elderly (age), rural (residing location), and comorbid diseases were found to be the risk factors for fatal injuries. For this, four latent classes were modeled. Factors, such as the age group between 20 to 40 years, women, and family conflict were included in the first class. The second class included the age group between 30 to 50 years, men, and financial problems. The third class covered the age group between 60 to 70 years and comorbidity. The fourth class contained the age group of 10 to 50 years, women, and mental problems. The rate of suicide and choice of fatal suicide was ranked in the order of 3 (62.7%, 21.5%), 2 (59.8%, 13.9%), 4 (36.8%, 5.7%), and 1 (29.5%, 5.9%). CONCLUSION: A lethal mean access control policy needs to be established for the high-risk group of self-harm. Moreover, establishing an emergency room-community link prevention policy could help reduce the re-suicide attempt among suffering patients.

A Study on the Mediating Effect of Emotional Intelligence between Perfectionism and Burnout in Advanced Practice Nurses (APN) / 간호행정학회지

PURPOSE: The aim of this study was to analyze relationships between perfectionism, burnout, and emotional intelligence in APN and to identify the mediating effect of emotional intelligence on the relationship between perfectionism and burnout. METHODS: A structured self-report questionnaire was used to measure perfectionism, burnout, and emotional intelligence. Data were collected from 121 APN working in five advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, Independent t-test, One-way ANOVA, Mann-Whitney U test, Pearson correlation and Hierarchical multiple regression with the SPSS/WIN 22.0 program. RESULTS: Mean scores for each variable were: perfectionism 3.57 (on a 5-point scale), burnout 3.32 (on a 7-point scale), and emotional intelligence 5.00 (on a 7-point scale). Self-oriented perfectionism had a positive correlation with burnout, as did socially prescribed perfectionism. Emotional intelligence was a significant variable reducing burnout, as it also had a reverse buffering effect on the relationship between self-oriented perfectionism and burnout. Explanatory power of the final model based on variables was 34%. CONCLUSION: The results of this study suggest a mediating direction regarding burnout by demonstrating that emotional intelligence plays a direct and reverse buffering role to self-oriented perfectionism, which can be used to reduce burnout in APN.

Association between Vitamin D Deficiency and Anemia in Patients with End-Stage Renal Disease: A Cross-Sectional Study

PURPOSE: Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease (ESRD). We investigated whether 25-hydroxyvitamin D [25(OH)D3] deficiency was associated with anemia in ESRD patients. MATERIALS AND METHODS: We reviewed the medical records of 410 ESRD patients who had undergone renal transplantation (RTx) at Yonsei University Health System and who had 25(OH)D3 levels measured at the time of RTx. Patients were divided into two groups based on baseline 25(OH)D3 concentrations: group 1, 25(OH)D3 levels <10 ng/mL; and group 2, 25(OH)D3 levels ≥10 ng/mL. RESULTS: Using multivariate regression models, 25(OH)D3, age, and erythrocyte-stimulating agent (ESA) dose were found to be significantly associated with hemoglobin (Hb) levels [25(OH)D3: β=0.263, p<0.001; age: β=0.122, p=0.010; ESA dose: β=-0.069, p=0.005]. In addition, logistic regression analysis revealed that patients in group 1 had a significantly higher risk for developing anemia (Hb level <10 g/dL) compared to group 2 patients, even after adjusting for potential risk factors for anemia (odds ratio=3.857; confidence interval=1.091-13.632; p=0.036). CONCLUSION: 25(OH)D3 deficiency was significantly associated with anemia in patients with ESRD. Randomized controlled trials are needed to determine whether vitamin D supplementation can improve anemia in these patients.

The Effects of Moxibustion on Chronic Back Pain and Activities of Daily Living in Aged / 재활간호학회지

PURPOSE: This study was attempted in order to verify the effects of moxibustion on aged back pain and activities of daily living. METHODS: A research design is quasi-experiment with pre-post test design in nonequivalent control group. As for data collection and experimental treatment, it accidentally sampled totally 50 people with 24 people for the experimental group and 26 people for the control group who appeal for chronic back pain aged over 60 who visited 4 senior centers where are located in N city from November 7, 2012 to December 3, 2012. Experimental treatment was carried out moxibustion totally 12 times by 3 times for 4 weeks in the experimental group. Data analysis was made by using SPSS program. As an analytical technique, the experimental group and the control group were analyzed the homogeneity verification with t-test, Fisher's exact test and chi2 test and the hypothesis verification with t-test. RESULTS: The back pain level was reduced in the experimental group than the control group. The disability of daily living activities was reduced in the experimental group than in the control group. CONCLUSION: Moxibustion was considered to be likely useful therapeutic method for effects of chronic back pain and disability of daily living activities in aged.

Effect of Auricular Acupressure Therapy on Decreasing Smoking rates, Desire for Smoking, and Exhaled Carbon Monoxide in Male College Students / 재활간호학회지

PURPOSE: This study was conducted to investigate the effect of auricular acupressure therapy on decreasing smoking rates, desire for smoking, and exhaled carbon monoxide in male college students. METHODS: The quasi-experimental, nonequivalent control group pretest-posttest design was used in this study. The participants (n=56) were assigned to the experimental group (n=29) that received auricular acupressure therapy or the control group (n=27) that received placebo therapy. The therapy was applied for 5 days followed by 1 or 2 days of rest. The therapy was repeated 2 times. To identify the effect of the experimental treatments, assessments of smoking rates, desire for smoking and exhaled carbon monoxide were measured. Data were analyzed using chi2 test, Fisher's exact test, t-test and Repeated measure ANOVA with the SPSS version 21.0 program. RESULTS: The experimental group showed significantly lower smoking rates (t=6.60, p<.001), desire for smoking (t=3.37, p=.002) and exhaled carbon monoxide levels (t=6.22, p<.001) after application of the therapy. Significant groupxtime interaction effect was found in exhaled carbon monoxide levels between the experimental group and the control group (F=8.73, p=.001). CONCLUSION: Auricular acupressure therapy was considered to likely be useful as a therapeutic intervention for smoking cessation in male young adults.

Effects of Auricular Acupressure Therapy on Nocturia and Insomnia in the Elderly / 재활간호학회지

PURPOSE: The purpose of this study was to confirm the effects of auricular acupressure therapy on insomnia and nocturia in the elderly. METHODS: This study was a nonequivalent control group pre-post test design. Data collection was conducted from July 1 to August 31, 2013. Subjects were set for totally 36 people with 18 people in the experimental group and 18 people in the control group among the elderly over the age of 60 in silver town, welfare center, and senior citizen center where are located in Seoul area. For the experimental group, auricular acupressure therapy was applied two times during 5 days by fixing it to auricular reaction site with tape using Sinapis alba L. seeds. With SPSS/WIN 19.0 program, the collected data were analyzed. RESULTS: Compared to the control group, the sleeping score and sleeping satisfaction were improved and nocturia frequency was lowered in the experimental group who applied auricular acupressure therapy. CONCLUSION: Auricular acupressure therapy was considered to be likely useful therapeutic method for the effects of relieving nocturia and insomnia in elderly.

Awareness and Ethical Attitudes Toward 'Do-Not-Resuscitate (DNR)' for Cancer Patients

PURPOSE: This descriptive study was conducted to investigate awareness and attitudes toward 'Do-Not-Resuscitate (DNR)'. METHODS: Study data were collected from July 24 to September 30, 2011 using structured questionnaires. Study subjects were 209 patients suffering from cancer at "C" Univ. hospital located in Seoul and Cancer Patient Coalition in Seoul. The purpose of the study was explained directly to them. All the data of 209 questionnaires were collected and analyzed without dropping out. RESULTS: In terms of awareness toward DNR, 61.5% said DNR is "necessary" because "their recoveries are impossible" (51.7%) and "they want dignified deaths" (41.1%). When it comes to ethical attitudes toward DNR according to demographic characteristics, there were significant differences both between genders (p<.032) on "Medical staff should tell hopeless patients their conditions openly" and between level of education and monthly income (p<.013) on "DNR decision should be made according to the guideline, if needed". CONCLUSION: The result of this study suggests that decisions on DNR should be made not by only families and doctors but by patients themselves as well. For this, sufficient explanations and education programs for DNR need to be developed and DNR decision including both patient's and family's demand should be standardized.

Family Stigma: A Concept Analysis

PURPOSE: Stigma negatively affects individuals as well as entire families; therefore, it is necessary to understand "family stigma" in order to reduce the social and emotional distress of families suffering from stigma and prevent the resulting avoidance of social support and treatment. Thus, this study clarifies the concept of "family stigma" by using concept analysis method. METHODS: In order to analyze the concept, we reviewed the relevant literatures. Characteristics that appeared repeatedly throughout the literature were noted and categorized. RESULTS: Three key defining attributes were identified: (a) others' negative perceptions, attitudes, emotions, and avoidant behaviors toward a family, because of the unusualness of the family, including the negative situations, events, behaviors, problems or diseases associated with that family, or because of the unordinary characteristics or structures of that family; (b) others' belief that the unusualness of the family is somehow harmful, dangerous, unhealthy, capable of affecting them negatively, or different from general social norms; and (c) others' belief that the family members are directly or indirectly contaminated by the problematic family member, so that every family member is also considered as harmful, dangerous, unhealthy, capable of having a negative effect on others, or different from general social norms. CONCLUSION: The results of this study are expected not only to guide future research but also to enhance family care in nursing practice.

Trends in Nursing Research in Korea: Research Trends for Studies Published from the Inaugural Issue to 2010 in the Journal of Korean Academy of Nursing and the Journals Published by Member Societies under Korean Academy of Nursing Science

PURPOSE: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS: A total of 6890 studies were analyzed using descriptive statistics. RESULTS: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9% ) as dependent variables. CONCLUSION: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Effects of Aroma Inhalation Method on Test Anxiety, Stress Response and Serum Cortisol in Nursing Students / 기본간호학회지

PURPOSE: This study was done to examine the effects of Aroma inhalation therapy on test anxiety, stress and serum cortisol in nursing students. METHODS: The study design was a pre posttest randomized design with a pre-survey, a 5-day experimental treatment (2012.11.17-21) and a post survey. Participants were 65 students - 31 in the aromatic inhalation group and 34 in the control group. The pre-survey included general demographic characteristics and test anxiety, stress and serum cortisol levels for all students. The experimental group received the aromatic inhalation using aroma oil (mixed Maychang, lavender, rosewood essence - ratio of 3:5:2). RESULTS: The experimental group treated with aromatic inhalation scored significantly lower for test anxiety (t=-2.330 p=.023), physical stress (t=-2.910 p=.005) and psychological stress (t=-3.285 p=.002) compared to the control group. However, there were no differences in serum cortisol levels (t=0.228 p=.820). CONCLUSION: Results indicate that Aromatic inhalation, using maychang, lavender and rosewood essential oils, contributes significantly to reducing anxiety and stress among nursing students, and can therefore be an effective intervention for anxiety and stress.

A Study on Health Behavior and Quality of Life of Married Immigrant Women / 대한폐경학회지

OBJECTIVES: The aim of this study was to investigate the factor influencing the quality of life of married immigrant women in Korea. METHODS: The subjects included 169 married immigrant women from 3 cities. Data collection was conducted by using 33 questionnaires. The SPSS/WIN 18.0 program was also used. Descriptive statistics, t-test, ANOVA, correlation analysis, stepwise multiple regression were all conducted. RESULTS: The results indicated that the general influencing factors related to the quality of life of married immigrant women are age, education career, nationality, family type, menopause, exercise, salt intake and social support. CONCLUSION: Based on the study results, nursing intervention and social - cultural, economical and social support network, including the consideration of a comprehensive approach, is needed in order to improved the quality of life.

Study of Nurses' Knowledge and Attitudes on Hormone Replacement Therapy / 대한폐경학회지

OBJECTIVES: This study was performed to identify nurses' knowledge and attitudes on hormone replacement therapy (HRT) of menopausal women. METHODS: Data were collected from 221 nurses who were working at maternity hospitals in the whole country using questionnaires consisting of 9 questions related to menopause-related knowledge and HRT-related attitudes and knowledge. RESULTS: According to the nurses's responses, the diseases of concern in menopausal women were osteoporosis (78%), and depression (69%). Most nurses replied that the most effective treatment of menopausal symptoms is HRT, and nurses were very knowledgeable about its strengths (59%) and weaknesses (44%). Cancer was regarded as the major complication of HRT (71%), and its side effects were breast pain (77%) and vaginal bleeding (77%). Forty-six percent of nurses thought that the appropriate treatment duration of HRT is not necessary to limit the period. The most important considerations when conducting HRT were drug stability (59%) and improving the quality of life (36%). Ninety-fi ve percent of nurses responded that they personally would use HRT for menopausal treatment or would recommend their family. HRT for menopausal symptoms was being utilized before seeking medical treatment (40%) and after drug prescription (42%). CONCLUSION: Nurses have very positive attitudes about HRT but appeared to lack critical knowledge about HRT. Therefore, more educational programs for nurses about HRT should be required.

Caregivers' Experience of Violence and Coping with It in Nursing Homes

PURPOSE: The purpose of this study is to investigate verbal, physical and sexual violence to caregivers in nursing home workplaces. METHODS: This cross-sectional study was done from October 17 to 31, 2011 at eight randomly selected nursing homes in Seoul and one nursing home in Gyeonggi, South Korea. This study explored their responses to violence and violent situations, and then investigated on how caregivers coped with workplace violence. RESULTS: The results of this study show that most caregivers in nursing homes experience some form of violence. Verbal violence was more frequent than physical or sexual violence. Verbal and physical violence occurred most often while they were changing the clothes of patients and sexual violence occurred most often while they were showering patients. After experiencing violence, caregivers most often dealt with the situation by informing their colleagues of what was happened. CONCLUSION: These results suggest that institutional and administrative measures must be implemented to increase the prevention of violence against caregivers and to improve effective measures to deal with violence once it has occurred. Violence in nursing homes can be reduced through the combination of appropriate responses by caregivers and proper education of both patients and caregivers.

Factors Influencing Run Away Impulse in Early Adolescents

PURPOSE: This study carried out a preliminary analysis of available literature and used the ecological approach to define a research hypothesis with focus on individual, family, and school variables related to early adolescents' urge to run away. This study also aimed to examine the influence of each of these variables in order to build a forecast model showing which variables have more influential on early adolescents' urge to run away. METHODS: Materials were collected from 433 male and female fifth- and sixth-grade students at two schools in Gyeonggi Province. Analysis was carried out using SPSS/WIN 18.0. Frequency analysis, chi2-test, t-test, correlation analysis and logistic regression analysis were conducted. RESULTS: The results indicate that personal factors related to runaway impulse are gender and previous runaway attempts, family-related factor family functionality, and school-related factor the area of stress from study. CONCLUSION: Based on the study results as above, individual, family, and school interventions need to be developed.

Factors Influencing Cognitive Impairment in Elders with Dementia Living at Home / 기본간호학회지

PURPOSE: The purpose of this study was to contribute data toward prevention from advancing dementia and also prevention of deterioration in cognitive impairment by constructing an optimal prediction model and verifying factors influencing cognitive impairment in elders with dementia who reside at home. METHODS: The participants in this study were 351 elders who were registered at dementia day care centers in 11 regions of Metropolitan Incheon. Collected data were analyzed using SPSS Statistics 17.0 and SAS 9.1. Bootstrap method using the Clementine program 12.0 was applied to build an optimum prediction model. RESULTS: Gender and education (general characteristics), alcohol, urinary/fecal incontinence, exercise, weight, and ADL (state of health), and depression (psychological state) were found to have an affect on cognitive impairment in these elders. CONCLUSION: Study results indicate nine key factors that affect cognitive impairment of elders with dementia who reside at home and that could be useful in prevention and management nursing plans. These factors could also be used to expand the role of nurses who are working in community day care centers, and can be applied in the development and provision of various programs to aid retention and improve cognitive function as well as preventing deterioration of cognition.

The Effect of Ethanol Inhalation on Postoperative Nausea in Patients using Patient Controlled Analgesia / 성인간호학회지

PURPOSE: The study was done to investigate the effect of ethanol inhalation on postoperative nausea in patients using Patient Controlled Analgesia (PCA). METHODS: The data were collected from June 1st 2006 to September 30th, 2007. The subjects were 70 patients who had had orthopedic surgery under general anesthesia. The levels of the Visual Analogue Scale (VAS) was used to measure postoperative nausea. The experimental group was given ethanol inhalation using ethanol pads and the control group received normal saline pads. All participants were instructed to take two deep sniffs with the pad one inch from the nose. This was repeated every five minutes for three doses. The collected data were analyzed using SPSS/WIN 12.0 program. RESULTS: The study supported all hypotheses. "The experimental group given first dose of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -5.900, p = .000). "The experimental group given second doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -7.507, p = .000). "The experimental group given third doses of ethanol inhalation would have a lower level postoperative nausea compared to the control group"(t = -6.685, p = .000). CONCLUSION: According to these results, the ethanol inhalation can be considered an effective nursing intervention for relieving the postoperative nausea in patients using PCA.

A Comparison of the Opened Versus Closed-System of Suctioning : In Oxygen Saturation, Vital Signs and Suction Time / 성인간호학회지

PURPOSE: The purpose of this study was to compare the difference of change in oxygen saturation, vital signs and suction time taken for the suctioning during endotracheal suctioning performed with closed suction system and with opened suction system. METHODS: Data were collected from 31 adult patients with ventilator treatment who were admitted to a university hospital in Seoul and the collection period was from July 1 to November 15, 2005. Oxygen saturation, heart rate, respiration rate and mean arterial pressure were collected immediately prior to the suctioning intervention, during and 1 and 5 minutes after the suctioning from opened suction system and closed suction system. RESULTS: 1) The difference in oxygen saturation was statistically significant in recovery time for oxygen saturation to return to baseline values after suctioning was significantly rapid on closed suction system (p < .05). 2) The difference in heart rate, respiration rate and mean arterial pressure was statistically insignificant. 3) The suction time was shorter in closed suction system. CONCLUSION: Closed suction system is more efficient, as compared with the open suction system in the ventilator treatment.

Content Analysis of Experience of Nursing Students in Clinical Judgment during Nursing Practicum / 성인간호학회지

PURPOSE: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.

The Nursing Needs of Post-Surgical Colon Cancer Patients at Discharge / 기본간호학회지

PURPOSE: This study was a descriptive survey of nursing needs for post surgical colon cancer patients at discharge. METHOD: A survey was done utilizing questionnaires about the nursing needs a target sample of 61 patients who had colon cancer surgery during April May 2006 in a general hospital in Seoul. RESULTS: Levels for treatment & prognosis were the highest in all domain, high in order of psychological support & stability, complications & discomfort, diet, daily life style, recovery & health promotion, and support system. Patient factors affecting nursing needs were age, job, duration of colon cancer and handling of stoma. CONCLUSION: Using discharge education for colon cancer patients based on the results of this study, nurses should focus on the domains of treatment & prognosis, psychological support & stability and complication & discomfort, and should tailor teaching content to be specified for age, job, duration of colon cancer, and handling of stoma.

Expression of Macrophage Migration Inhibitory Factor in Behcet's Disease / 대한피부과학회지

BACKGROUND: Macrophage migration inhibitory factor (MIF) is a unique protein, participating in inflammation, immune response, and cell growth. Previous reports showed that MIF-polymorphisms are associated with an increased risk for various inflammatory diseases. OBJECTIVE: This study was designed to investigate the effect of MIF polymorphisms on Behcet's disease (BD). METHODS: A total of 362 patients with BD and 290 healthy controls were genotyped. We also performed RT-PCR analysis, ELISA, and immunohistochemical stain for MIF. RESULTS: We could not find statistically significant differences in the genotype frequencies of the MIF-794[CATT]5-8 repeat polymorphism or MIF-173 G>C polymorphism between BD patients and controls. Immunohistochemical analysis showed that MIF protein was diffusely distributed throughout epidermis and subcutaneous fat tissue from the skin lesions of patients with BD and erythema nodosum. CONCLUSION: Contrary to earlier reports, serum MIF levels were decreased in patients with BD, and the prescence of polymorphisms in the MIF promoter region was not associated with disease susceptibility. Nevertheless, MIF may play a role in cutaneous inflammation in BD.