Clinical Features of COVID-19 in Uzbekistan

Background@#As of April 30, 2020, a total of 2,039 cases of the novel coronavirus disease 2019 (COVID-19) were confirmed in the Republic of Uzbekistan after the first detection on March 15. Reports on symptoms of COVID-19 are non-specific and known to vary from asymptomatic, mild to severe, or fatal. This study aimed to analyze the symptomatic and clinical characteristics of study participants based on the medical records of participants hospitalized with COVID-19 in Uzbekistan. @*Methods@#We collected all data from medical records of COVID-19 confirmed patients in 19 hospitals from 13 regions of Uzbekistan between March 15 and April 30. We selected 1,030 patients discharged from the hospitals after COVID-19 treatment as study participants, excluding those with missing data. Further, we collected demographics, symptoms, clinical outcomes, and treatment data through medical records. @*Results@#More than half (57.6%) of confirmed cases of COVID-19 were males, and the median age was 36.0 years. The most frequent symptoms at the first inspection on hospital admission of all patients were fatigue (59.7%), dry cough (54.1%), pharyngalgia (31.6%), headache (20.6%), and anorexia (12.5%). Compared to the oldest group, the youngest group showed a lower frequency of symptoms. About half of the group aged 18–49 years reported that they came from abroad. One-fifth of patients in group 50–84 received oxygen support, while no patients in group aged 0–17 years received oxygen support. About two-thirds of the participants from intensive care unit (ICU) came from abroad, whereas 42.1% of the non-ICU group returned from other countries. Regarding symptoms, 16.9% of the patients in the ICU group were asymptomatic, while 5.8% in the non-ICU group were asymptomatic. @*Conclusion@#This study suggests that the medical delivery system and resource distribution need to be implemented based on clinical characteristics by age and severity to delay and effectively respond to the spread of infections in the future. This study analyzed symptoms of COVID-19 patients across Uzbekistan, which is useful as primary data for policies on COVID-19 in Uzbekistan.

Social Network Analysis for Research of Cancer Patients’ Health-Related Quality of Life

Purpose@#The purpose of this study was to identify the knowledge structure of articles related to the Health-Related Quality of Life (HRQoL) of patients with five different types of cancer. @*Methods@#Author keywords from the articles related to breast (508), prostate (319), cervical (45), colorectal (123), and gastric cancer (37) on Web of Science (1990~2013) were extracted and classified into seven domains of HRQoL. Social network analysis was performed using the NetMiner program. @*Results@#Core keywords with the highest degree centrality were ‘depression’ (breast), ‘radiotherapy’ (prostate), ‘sexual dysfunction’ (cervical), ‘colorectal cancer surgery’ (colorectal), and ‘gastrectomy’ (gastric). Core keywords with the highest betweenness centrality were ‘chemotherapy’ (breast), ‘radiotherapy’ (prostate), ‘sexual dysfunction’ (cervical), ‘fatigue’ (colorectal), and ‘gastrectomy’ (gastric). In addition, the five types of roles of the core keywords in the seven domains of HRQoL, verified through brokerage analysis, are coordinator, consultant, gatekeeper, representative, and liaison. @*Conclusion@#This study examined the HRQoL trends of patients with five different types of cancer. The findings of this study can be helpful for nursing intervention development to improve patients’ HRQoL according to the five different types of cancer.

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 follow-up study of the association between mobile phone use and symptoms of ill health

Objectives: The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects.Methods: The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed.Results: The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys) had no statistically significant reduction in HIT-6 scores.Conclusions: This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

A follow-up study of the association between mobile phone use and symptoms of ill health

Objectives: The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. Methods: The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed. Results: The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys) had no statistically significant reduction in HIT-6 scores. Conclusions: This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.

Core nursing practice and educational requirements according to nursing unit and clinical career in tertiary hospital / 기본간호학회지

PURPOSE: The purpose of this study was to provide fundamental data to develop an educational program for the development of nurses' core competences, and to improve the curriculum in nursing education institutions. METHODS: This study, based on a descriptive survey, was conducted with 1,019 nurses working in a tertiary hospital in Seoul. Among 47 core nursing practice items, core nursing practices as perceived by the participants and relevant educational requirements were measured on a four-point scale. The collected data were analyzed using descriptive statistics for the mean and standard deviation, one way ANOVA, and Duncan test as post-hoc test. RESULTS: Regarding the core nursing practice perceived as by the nurses, there were statistically significant differences in 43 out of 47 items according to nursing unit, and in 15 items according to clinical career. Regarding the educational requirements for core nursing practice, there were also statistically significant difference for the same items as perception differences according to nursing unit and clinical career. CONCLUSION: The results of this study suggest further study on the development of educational programs to advance the clinical expertise of nurses and for the development of curriculum reflecting the actual conditions and requirements in clinical nursing practice fields.

Professional Quality of Life and Clinical Competencies among Korean Nurses

PURPOSE: Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type. METHODS: A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters. RESULTS: There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence. CONCLUSIONS: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.

Factors that Influence Korean Breast Cancer Patients to Undergo Cancer Rehabilitation Therapy

PURPOSE: This study was to identify factors that affect breast cancer patients' intentions to participate in cancer rehabilitation therapy. Such findings could be utilized early in the rehabilitation process to improve treatment outcomes and quality of life. METHODS: A cross-sectional study of 300 breast cancer patients (> or =20 years old) receiving post-surgery outpatient care was used. A self-administrated survey was conducted from June 15 to July 25, 2012. The questionnaire included basic subject data, physical symptoms, optimism, and social support. RESULTS: A binary logistic regression analysis revealed that a short post-surgery period (<12 months), having undergone an axillary lymph node dissection, and high physical symptoms were factors that significantly affected participants' intentions to undergo rehabilitation. CONCLUSION: By accurately assessing the factors associated with each patient's decisions regarding cancer rehabilitation therapy at an early stage of treatment and then implementing such individualized rehabilitation, the quality of life for breast cancer patients can be substantially improved.

Effects of Family Presence Intervention on Anxiety, Delirium, Pain and Length of Time in Recovery Room of Post-operative Elderly Patients in Post-anesthesia Care Units / 기본간호학회지

PURPOSE: The objectives of this study were to assess the influence of family presence in the PACU (Post Anesthesia Care Unit) on anxiety, emergency delirium, pain and length of stay in the recovery room for elderly patients undergoing surgery for which general anesthesia has been used. METHODS: The study was a nonequivalent control group pre-post test design. Eighty elderly patients over 65 years who underwent surgery under general anesthesia were recruited. Forty were assigned to the experiment group, patients together with a family member and 40 to the control group, with no family member present. Patients' anxiety, emergency delirium, pain and length of time in the recovery room were evaluated at 10 minute and 30 minute after arrival in the PACU. RESULTS: Patients with family members in the PACU showed significantly decreased levels of anxiety at 10 and 30 minutes and significantly lower levels of emergency delirium and pain at 30 minutes. However there was no difference between the 2 groups for length of time in the recovery room. CONCLUSION: The results of this study indicate that being with family members in the PACU after surgery under general anesthesia is effective for reducing elderly patients' anxiety, delirium and pain during time in the recovery room.

Factors affecting the Fatigue of Hospitalized Women Cancer Patients Receiving Chemotherapy

PURPOSE: The purpose of this study was to identify factors that influence fatigue in hospitalized women cancer patients receiving chemotherapy. METHODS: The participants were 117 women cancer patients receiving chemotherapy. The instruments used in this study were physical symptoms, mood state, family support, and fatigue scales for patients with cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the IBM SPSS 19.0 program. RESULTS: Fatigue showed significant correlation with physical symptoms such as side effects as well as sub-elements of mood status such as anxiety-depression, vitality, anger and family support. Fatigue-anticipating variables were found to be some sub-elements of mood state such as anxiety-depression (beta=.61, t=10.40, p<.001), digestion organ factor (beta=.78, t=2.54, p=.013) and pain/fatigue factor (beta=.86, t=0.43, p=.045). The total variance explained was 69.7%. CONCLUSION: These results showed that the factors affecting fatigue were physical symptoms, and the mood state of hospitalized women cancer patients receiving chemotherapy. The results of this study provided basic materials for a nursing intervention program to reduce fatigue.

Quality of Life in Colorectal Cancer Patients according to the Severity of Symptom Clusters Classification

PURPOSE: The purpose of this study to verify the symptom clusters of colorectal cancer patients and also identify the influence of the symptom clusters upon colorectal patient symptom clusters identify acording exper. METHODS: 101 colorectal cancer patients were the subjects of this study. As for a research tool, the global health status/QOL was used including the sub-scales of QLQ-C30. In the functional scales and the symptom scales, the sub-scales of QLQ-C30 and QLQ-CR29 were used. Results: The result of this study shows us there are 7 kinds of symptom clusters. RESULTS: The result of this study shows us there are 7 kinds of symptom clusters, bowel movement problems, abdominal-pelvic problems, feces problems, urination problems, dry mouth-taste problems, side effect problems, and elimination problems. CONCLUSION: Based on the result, the symptom clusters in colorectal cancer patients were confirmed to be influencing the subjects' quality of life and functions. The efficient management of symptom clusters that subjects experience leads to promoting colorectal cancer patients' physical and emotional status, thereby contributing to an improvement in their quality of life.

Nursing Need and Satisfaction of Patients in Hospice Ward / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to explore the nursing needs and satisfaction of patients who are hospitalized at hospice palliative care institutions. METHODS: This study included 80 hospice patients who were in-patients of the hospice department of two general hospitals in S city. The collected data were analyzed by descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficients using the IBM SPSS 20.0 program. RESULTS: The mean score of nursing needs and satisfaction were 3.58 (+/-0.31) and 3.25 (+/-0.20) respectively. Significant differences in hospice nursing needs and satisfaction were observed in terms of general characteristics including gender, education level, occupation, religion, support for medical expense and functional status. Significant positive correlation was found between the overall nursing needs and nursing satisfaction. CONCLUSION: Based on the results of this study, in order to improve the quality of hospice service, further study is necessary in a comprehensive manner to develop nursing intervention to meet physical, psychological/social, spiritual, and educational/referral nursing needs of hospice in-patients.

Development and Evaluation of Learning Program for Oncology Unit-based Core Nursing Practice: Outcomes based Cancer Patients Pain Management Learning Program

PURPOSE: This study was conducted to develop a nurse-learning program for the pain management of cancer patients. METHODS: In this methodological study, a learning program was developed between January and June 2011, following the methodological procedure based on the ADDIE Instructional System Design. RESULTS: The learning program consists of 4 parts: learning goal, learning outcomes, learning method, and evaluation method. Learner-centered learning goal and learning outcomes were established, and lecture-based group learning and self-directed study were combined as the learning method. For the evaluation, we developed a written test, a nursing skill checklist, and a case report evaluation tool. After a pilot test, the learning program was assessed by an expert group for its construct validity and content-related conformance. Moreover, the effectiveness of the program was validated by the results of the learning outcomes evaluation and the achievement levels of 40 trainees who participated in the program. CONCLUSION: On the basis of the results of this study, we suggest that this unit-based core nursing practice learning program, comprising 202 nursing units developed by a research institute nursing department since 2010, be shared by all nurses in clinical nursing care settings to improve their practical performance and ensure necessary specialization.

Trends in Research Studies Published in Journal of Korean Academy of Fundamentals of Nursing: 2009-2011 / 기본간호학회지

PURPOSE: The purpose of this study was to identify the trends in research studies published in Journal of Korean Academy of Fundamentals of Nursing from 2009 to 2011. METHODS: A total of 156 studies published between 2009 and 2011 were reviewed using analysis criteria developed by the researchers. RESULTS: Quantitative studies accounted for 90.4% and qualitative studies, 8.3%. The research designs for the quantitative studies were experimental, 28.0% and survey, 63.8%. IRB approval was received for only 25.6% of the studies and 61.0% of studies presented participant criteria. Questionnaires were used for data collection in 90.8% of studies. Individual or group education was the most frequent intervention in the experimental studies. CONCLUSION: The results indicate that more randomized controlled trials with a low risk of bias are needed to support greater evidence-based nursing practice. Considering the low rate of ethical consideration, it is important that stricter application of research methods needs to be encouraged to improve the quality of Journal of Korean Academy of Fundamentals of Nursing.

Impact of Uncertainty on Resilience in Cancer Patients

PURPOSE: This study was designed to identify the impact of uncertainty degree and uncertainty appraisal on cancer patients resilience. METHODS: A sample of 181 patients with cancer was recruited from a hospital in Incheon. Data were collected from May 20 to August 25, 2011. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression with the SPSS/WIN 12.0 program. RESULTS: The resilience for cancer patients showed a significant relationship with uncertainty degree and uncertainty appraisal. The significant factors influencing resilience were uncertainty degree and uncertainty appraisal, they explained 26.5% of the variance. CONCLUSION: Patients with cancer were adversely affected by uncertaint which led to a negative effect on resilience. The result suggests that intervention programs to reduce the level of uncertainty among patients could improve the resilience of cancer patients.

Analysis of Trends and Contents of Nursing Doctoral Dissertations in Korea

PURPOSE: This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS: The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS: The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION: Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.

Effects of Symptom Severity and Symptom Interference on Sleep Disturbance in Cancer Patients

PURPOSE: The purpose of this study was conducted to identify the impact of Symptom Severity and Symptom Interference on Sleep Disturbance among cancer patients. METHODS: This study was conducted from October 8th to October 25th, 2012. One hundred eight cancer patients were recruited from S city in Korea. The instruments used in this study were the Symptom Severity, Symptom Interference and the Sleep Disturbance scales for patients with cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 20.0 program. RESULTS: The Sleep Disturbance for cancer patients showed a significant relationship with Symptom Interference and cancer stage. The significant factors influencing Sleep Disturbance were Symptom Severity and Symptom Interference. They explained 40.5% of the variance in stage IV. CONCLUSION: Patients with cancer experienced Symptom Severity and Symptom Interference which led to a negative effect on Sleep Disturbance. The results suggest that intervention programs to reduce Symptom Severity, Symptom Interference could improve Sleep Disturbance for cancer patients.

Diabetes-related Characteristics in Men with Diabetes for the Glucose Control Group and Noncontrol Group / 기본간호학회지

PURPOSE: This study was done to identify factors related to glycemic control in men with diabetes. METHODS: Data from the Korean National Health and Nutrition Examination Survey 2007, 2008 collected by the Korean Center for Disease Control were analyzed using chi-square test and t-test. RESULTS: There was a difference in glycemic control according to the individual factor of economic status. Differences in glycemic control according to health related factors were as follows: fasting blood sugar, cholesterol, triglyceride, sleep duration, experience of depression and suicidal thoughts. CONCLUSION: The results of this study will contribute to improvements in management for men with diabetes through comprehensive identification of factors related to glycemic control.

Content and Educational Needs for Fundamental Nursing Practice / 기본간호학회지

PURPOSE: The purpose of this study was to identify content of Fundamental Nursing Practice (FNP) and the educational needs for nursing practice items in schools of nursing. METHODS: Participants were 81 professors who were teaching FNP and 166 clinical nurses. The research questionnaire included 148 practice items, which were selected by content analysis of 7 FNP textbooks. Data were collected from May 20 to July 27, 2011 and analyzed using descriptive statistics and t-test with SPSS 17.0. RESULTS: The research findings showed that : 1) the seven items included in the education content of all schools of nursing were putting on sterile gloves, checking radial pulse, checking blood pressure in the arm, Foley catheterization, injection preparation with ampule, intramuscular injection in the buttocks, and mixing intravenous fluid. Fifty items were included in the content in more than 80% of the schools. 2) Educational domains needing emphasis were medication, infection control, health assessment, oxygenation, urinary elimination, activity/positioning, and nutrition. There were significant differences in reported educational needs between professors and clinical nurses for 62.8% of practice items. CONCLUSIONS: Results indicated that standardization of FNP education contents using the findings of this study should lead to improvement in quality of FNP education.