Development of Health Assessment Tool for Middle-aged Adults in Long-term Care Settings / 재활간호학회지

PURPOSE: This was a methodological study to develop a valid and reliable health assessment tool for middle-aged adults in long-term care settings (HATMAL). METHODS: At the first stage of this study, initial 56-items HATMAL were derived via literature review, survey for needs assessment, and focus group interviews with experts. At the second stage, 54 items HATMAL were finalized via content validity test with 5 experts and a pilot study with 30 nurses. At the third stage, validity and reliability tests were conducted with 100 middle-aged patients in a long-term care hospital. Data were analyzed by factor analysis using SPSS 18.0 program. RESULTS: Exploratory factor analysis resulted in 3 factors; functional assessment, symptom assessment, and comfort assessment. These 3 factors explained 83.8% of total variance and construct validity was confirmed. Test-retest reliability was .67 for appetite changes, .76 for regulating for behavior problems, and 1.0 for other items. CONCLUSION: Results indicate that HATMAL is valid and reliable to assess the health for middle-aged patients in long-term care settings. This study would contribute to provide more effective personalized treatment and care for middle-aged patients in long-term care settings considering their own characteristics.

Grit, Academic Resilience, and Psychological Well-being in Nursing Students / 한국간호교육학회지

PURPOSE: This study was conducted to investigate the relationship among grit, academic resilience, and psychological well-being among nursing students. METHODS: The participants were 271 nursing students, enrolled in C university. Data were collected from September 5 to 30, 2016 and analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression with the SPSS/WIN 21.0 program. RESULTS: The mean scores for academic resilience were above average. The mean score for grit and psychological well-being presented an appropriate level. Psychological well-being in nursing students was significantly correlated with academic resilience (r=.65, p<.001) and grit (r=.52, p<.001). The significant predictors of psychological well-being for nursing students were academic resilience (β=.47, p<.001), grit (β=.26, p<.001), and major satisfaction (β=.20, p<.001) which explained 53.1% of the variance in psychological well-being. CONCLUSION: The results indicate that it is necessary to develop grit and academic resilience enhancement programs to improve the psychological well-being of nursing students.

Effects of Birth Control Empowerment Program for Married Immigrant Vietnamese Women in South Korea

PURPOSE: Aims of the researchers were to develop an birth control empowerment program (BCEP) designed to help married immigrant women in Korea to plan their pregnancies. METHODS: This study was as a randomized controlled trial to verify the effects of the BCEP. The BCEP was developed based on Falk-Rafael (2001)'s Empowerment caring model. The program was offered once a week, for 90 minutes per session, for a total of 10 weeks. The BCEP incorporated group instruction, group discussion, and counseling. The eligible participants were randomly assigned to either experimental group (n=23) or control group (n=23). RESULTS: Participants in the intervention group had significantly better outcomes in contraceptive knowledge (p<.001), contraceptive self-efficacy (p=.014), perceived contraceptive control (p<.001), sex-related spousal communication (p<.001), and sexual autonomy (p=.009). CONCLUSION: The BCEP was effective intervention method, which can promote family planning practices among married immigrant women.

Core Temperature Evaluation in Different Body Parts in Patients Undergoing Laparoscope Surgery under Total Intravenous Anesthesia / 기본간호학회지

PURPOSE: The trend of body temperature change during laparoscopic surgery and the most adequate site for monitoring temperature measurements have not been investigated thoroughly. In this study body temperature change during laparoscopic surgery was measured and measurements of the tympanic, esophageal, and nasopharyngeal core temperatures in surgical patients with total intravenous anesthesia were compared. METHODS: From February to October 2013, 28 laparoscopic surgical patients were recruited from a tertiary hospital in Seoul. The patients' core temperature was measured 12 times at ten minute intervals from ten minutes after the beginning of endotracheal intubation. RESULTS: Repeated measure of core temperatures indicated a significant difference according to body part (p=.033), time of measure (p<.001) and the reciprocal interaction between body part and time of measure (p<.027). The core temperatures were highest at tympany location, lowest at nasopharynx. The amount of temperature change was least for the esophagus (36.10~36.33degrees C), followed by nasopharynx and tympany. CONCLUSION: The esophageal core temperature showed the highest stability followed by nasopharyngeal and tympanic temperature. Therefore, close observations are required between 10~20minutes after the beginning of the operation.

Risk Factors Associated with Venous Thromboembolism in Cancer Patients

PURPOSE: This study aimed to investigate clinical characteristics of venous thromboembolism (VTE) in cancer patients. METHODS: We retrospectively analyzed clinical characteristics in patients with VTE confirmed with cancer. Multivariable logistic regression was used to identify differences associated with the development, between the pulmonary embolism (PE) and deep vein thrombosis (DVT) groups. RESULTS: From January 2009 to December 2014, a total of 103 patients with VTE were included in the final analysis: mean age, 70.6+/-11.8 years; female, 56.3%. Most of the patients had a solid cancer (95.1%), and half of all patients had distant metastasis (50.5%). Proportion of patients with VTE who received chemotherapy within a year was 64.1%. Central venous catheters were applied to 59 patients within 6 weeks before the diagnosis of VTE. The proportion of patients with DVT only among VTE patients was 21.4%. In logistic regression analysis, central venous catheter insertion (OR=2.66, 95% CI=1.09, 6.49; p=.032), as well as lung metastasis (OR=2.94; 95% CI=1.06, 8.18; p=.039) were significant predictors for PE rather than DVT only. CONCLUSION: VTE developed in patients with advanced stage cancer. Further studies analyzing the effects of prophylactic anticoagulation in patients with cancer in regards to development of VTE are recommended.

Effects of 4% Hypertonic Saline Solution Mouthwash on Oral Health of Elders in Long Term Care Facilities

PURPOSE: This study was done to examine the effects of 4% hypertonic saline solution mouthwash and tooth brushing education on the oral health of elders living in long term care facilities. METHODS: In this quasi-experimental study, the participants were assigned to a 2% experimental group (n=20), a 4% experimental group (n=20), and a control group (n=20). Data were analyzed using ANOVA, repeated measures ANOVA, Fisher exact test, Chi-square test, Kruskal-Wallis test and multiple response analysis with the SAS program. RESULTS: Regular tooth brushing and use of 4% hypertonic saline solution mouthwash by elders provided better oral health by decreasing xerostomia, oral tongue plaque, halitosis, and the number of oral bacteria. CONCLUSION: The results indicate that regular tooth brushing with continuous 4% hypertonic saline solution mouth washing education promotes oral health for elders in long term care facilities, thus the dental care described in this study is recommended for elders in long term facilities.

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.

Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation

PURPOSE: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. METHODS: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. RESULTS: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. CONCLUSION: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

Development of a Nursing Competence Measurement Scale according to Nurse's Clinical Ladder in General Wards / 간호행정학회지

PURPOSE: This methodological study was done to develop a Nursing Competency Measurement Scale based on the clinical ladders of nurses working in wards. METHODS: Thirty clinical experts and 501 ward nurses evaluated the content validity of the scale. A survey using the Nursing Competency Measurement Scale was conducted with 114 nurses to evaluate reliability and applicability of the instrument. Data were analyzed using SPSS/WIN 21.0. RESULTS: A review of the literature identified 13 components of nursing competencies and 30 core nursing competencies based on each of the 4 grade clinical ladders. Cronbach's alpha coefficient for the total was .92. Cronbach's alpha reliabilities of each clinical ladder grade were .83 for Grade I, .84 for Grade II, .81 for Grade III, and .84 for Grade IV. The Content Validity Index (CVI) of the scale with 120 individual items was 0.976~1.000 for Grade I scale, 0.986~1.000 for Grade II scale, 0.984~1.000 for Grade III scale, and 0.992~1.000 for Grade IV scale. The expert group nurses' average degree of nursing competence measured using the scale was 3.38~3.75 out of 4.0. CONCLUSION: Through this process, 120 final questions were confirmed to represent items of the Nursing Competency Measurement Scale based on clinical grade.

Development of Critical Thinking Skill Evaluation Scale for Nursing Students

PURPOSE: To develop a Critical Thinking Skill Test for Nursing Students. METHODS: The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed. RESULTS: Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001). CONCLUSION: The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.

Effects of Nordic Walking on Body Composition, Muscle Strength, and Lipid Profile in Elderly Women

PURPOSE: The purpose of this study was to investigate the effects of Nordic walking on body composition, muscle strength, and lipid profile in elderly women. METHOD: Sixty-seven women were assigned to the Nordic walking group (n = 21), the normal walking group (n = 21), and the control group (n = 25). Nordic walking and normal walking were performed three times a week for 12 weeks. Body weight, body mass index, total body water, skeletal muscle mass, percent body fat, grip strength, sit to stand, arm curl, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured before and after the program. A Chi-square test, one way analysis of variance, paired t test and repeated-measure two-factor analysis were used with the SAS program for data analysis. RESULTS: There was a significant difference in the weight (F = 8.07, p < .001), grip strength (F = 10.30, p < .001), sit to stand (F = 16.84, p < .001), arm curl (F = 41.16, p < .001), and total cholesterol (F = 5.14, p = .009) measurements between the groups. In addition, arm curl was significantly increased in the Nordic walking group compared to the normal walking group and the control group. CONCLUSION: The results indicate that Nordic walking was more effective than normal walking in improving upper extremity strength.

Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty

PURPOSE: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. METHODS: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. RESULTS: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). CONCLUSION: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

The Effects of Pre-operative Visual Information and Parental Presence Intervention on Anxiety, Delirium, and Pain of Post-Operative Pediatric Patients in PACU

PURPOSE: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. METHODS: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. RESULTS: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. CONCLUSION: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.

Effects of Maximal Sterile Barrier Precaution on the Central Venous Catheter-related Infection and Cost / 성인간호학회지

PURPOSE: The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings. METHODS: Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care. RESULTS: Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons. CONCLUSION: The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.

Effects of Nei-Guan Acupressure on Nausea, Vomiting and Level of Satisfaction for Gynecological Surgery Patients Who Are Using a Patient-Controlled Analgesia

PURPOSE: This study was done to examine effects of Nei-Guan acupressure on nausea, vomiting and level of satisfaction for gynecological surgery patients who were using a patient-controlled analgesia (PCA). METHODS: For this study, 51 patients were assigned to one of three groups, a control group (17 patients), experimental group 1 (finger acupressure group) (17 patients), and experimental group 2 (relief band group) (17 patients). The data were collected for 24 hr in the recovery room of a university hospital located in Seoul. The 6 hr-intervals including the time of leaving the recovery room were taken into consideration. RESULTS: The occurrence of nausea between the experimental group with Nei-Guan acupressure treatment and the control group was different. However, there was no difference in nausea and vomiting control or level of patient satisfaction between the finger acupressure group and the relief band group. CONCLUSION: Nei-Guan acupressure is recommended for nursing practice as a way for alleviating the opioid-induced nausea and accelerating the recovery of patients who are using PCA after surgery.

Effects of Resistance Exercise Combined to Relax Therapy in Blood Pressure, Frequency of Exercise and Physical Fitness in elderly Women in Rural District / 성인간호학회지

PURPOSE: This study was object to the effects of a resistance exercise combined with relaxation therapy on blood pressure, frequency of exercise and physical fitness in elderly women. METHODS: Seventy three elderly women participated in an exercise program for 12 months. The exercise program consisted of stretching, massage and resistance training using thera-bands twice a week and 50 minutes in every sessions each week. Repeated measures ANOVA were performed using SAS. RESULTS: After the exercise program there was a significant difference in systolic blood pressure, frequency of exercise, body fat, sitting to standing, walking 2 minutes, sitting on a chair and reaching, and standing on one leg with eyes opened. After 6 months, there was a significant decrease in systolic blood pressure and significant increase in frequency of exercise, body fat, sitting to standing and standing on one leg with eyes opened. In 12 months, there was a significant increase in body fat, 2 minutes walking, and sitting in a chair and reaching. CONCLUSION: Resistance exercise combined with muscle relaxation therapy would have a positive effect on elderly women. We found that it was helpful for the elderly women in terms of physical fitness.

Effects of Infection Control Strategies for Vancomycin Resistant Enterococci in Intensive Care Units / 성인간호학회지

PURPOSE: This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU. METHODS: All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively. RESULTS: VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture. CONCLUSION: These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

Effect of Hand Massage on Fatigue, Sleep Satisfaction and Blood Pressure of the aged in a Long-term Care Facility / 성인간호학회지

PURPOSE: The purpose of this study was to examine the effects of hand massage on fatigue, sleep satisfaction and blood pressure of the aged in a long-term care facility. METHODS: The data were collected from June to August 2008. The subjects were randomly recruited from a long-term care facility in Junnam Providence and were randomly assigned to the experimental group (n = 22) or control group (n = 22). Hand massage was carried out every other day in the evening for two weeks. Massage was administered to each forearm and hand for 10 minutes. Descriptive statistics, x2-test and t-test were performed using SAS program. RESULTS: In the experimental group, the fatigue (p = .017) was significantly lower and the sleep satisfaction (p = .043) was significantly higher than for the control group. CONCLUSION: On the basis of the results of the study, hand massage can be recommended for the elderly with sleep disturbance to reduce fatigue.

Effects of Power Walking Exercise on Fatigue, Blood Lipids, and Body Composition in Overweight Korean College Students with Taeumin Constitution / 성인간호학회지

PURPOSE: To examine the effects of power walking exercise on fatigue and overweight in college students with Taeumin constitution. METHODS: According to results of the constitution diagnosis (QSCC II), 58 students who were identified as Taeumin, whose BMI was over 23 were assigned to one of three groups. The power walking group walked fast at a speed of 7,000 steps per hour using a pedometer, and the walking group walked at a speed of 5,000 steps per hour. There was no treatment with control group. Each group's fatigue level, blood lipids and body composition before and after the experiment were compared and analyzed. RESULTS: Total fatigue and total cholesterol decreased significantly in the power walking group compared to the walking group and the control group. Weight decreased significantly in the power walking group compared to the control group, and percentage of body fat decreased significantly in both the power walking group and the walking group compared to the control group. CONCLUSION: When power walking exercise was used with overweight Taeumin students, fatigue, blood lipid, weight and percentage of body fat decreased significantly.

A Study of Nurses' Knowledge Level and Assessment Experience of Delirium / 성인간호학회지

PURPOSE: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. METHODS: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. RESULTS: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. CONCLUSION: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.