Differences in the perceptions of partnership between nurses and mothers of children in a pediatric intensive care unit in South Korea: a qualitative study

Purpose@#The purpose of this study was to investigate how pediatric intensive care unit (PICU) nurses and the mothers of hospitalized children perceived their partnership and identify the detailed differences in the common domains of partnership between them. @*Methods@#A qualitative descriptive design with semi-structured and open-ended interviews was used. Interviews with mothers of hospitalized children and nurses in the PICU were conducted at a national university hospital in South Korea. @*Results@#Five integrated categories were identified concerning nurses' and mothers' perceptions of partnership. Five common domains were derived by merging the partnership categories perceived by each PICU mother and nurse: expectation of trust, sharing and communication, participation in care, equality in the relationship, and coordination of opinion However, there were significant differences in the composition of the categories of these common domains. @*Conclusion@#These results may facilitate more effective partnerships between parents and PICU nurses. Efforts should be taken to promote the formation of trust between nurses and parents and create an environment that is conductive to regular open communication in particular, steps should be taken to reduce gaps in awareness concerning this partnership and information sharing, nursing methods, and decision-making.

Mediating and Moderating Effects of Multicultural Efficacy in the Relationship between Cultural Empathy and Cultural Competence in Child Care Teachers

PURPOSE: This study examined the mediating and moderating effects of multicultural efficacy in the relationship between cultural empathy and cultural competence in child care teachers. METHODS: A cross-sectional descriptive survey design was used. The participants were 277 child care teachers at private and public daycare centers in G and S districts of Seoul. The survey instruments included a cultural empathy questionnaire, a multicultural efficacy scale, and a cultural competence scale. Data were analyzed using the SPSS and AMOS programs. For data analysis, descriptive statistics, correlation, and mediating and moderating effect analyses were performed. Bootstrapping was implemented to verify the mediating effect of the model developed herein. RESULTS: Positive correlations among cultural empathy, multicultural efficacy, and cultural competence were noted. Multicultural efficacy showed a significant mediating effect on the relationships between cultural empathy and cultural competence. However, there was no moderating effect. CONCLUSION: In order to enhance the cultural competence of child care teachers, it is necessary to develop a strategy that can promote their cultural empathy and multicultural efficacy. Furthermore, these results will ultimately enhance the role of child care teachers, thus contributing to the normal growth and development of multicultural children.

Development of Educational Content for Nurses to Prevent Safety Accidents of Hospitalized Children: Delphi Approach

PURPOSE: The purpose of this study was to develop content for safety education to prevent hospital safety accidents among hospitalized children and to investigate the status of safety education performed by nurses. METHODS: First, the Delphi method was used, with 18 experts, to develop educational contents for preventing safety accidents. Second, an exploratory survey was performed of the actual status of safety education for preventing safety accidents among hospitalized children using a questionnaire developed based on the Delphi method. The participants of this study were 159 nurses with at least 6 months of work experience. RESULTS: The educational content developed through the Delphi method for preventing safety accidents among hospitalized children contained seven domains (falls, injury, electric shocks/burns, suffocation/aspiration, poisoning/abuse, kidnapping, medical devices) with 44 topics. The item mean of nurses'perceptions of the importance of child safety education was 4.18, and the actual performance score was 3.72, which was a statistically significant difference (t=11.58, p < .001). CONCLUSION: These seven comprehensive domains of accident prevention education for hospitalized children are expected to be useful for interventions to support the safety of hospitalized children.

Mediating Effects of Sleep Quality on the Relationship between Job Stress and Stress Response of Shift-Working Nurses

PURPOSE: The aim of this research was to identify the mediating effect of sleep quality on the relationship between job stress and stress response of shift-working nurses.METHODS: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires. The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses.RESULTS: In the first and second steps, job stress was identified as a significant predictor of sleep quality (β=.29, p=.001) and stress response (β=.24, p=.004). In the third step, sleep (β=.55, p < .001) was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant (β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response.CONCLUSION: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.

Development of Parent Coaching Domains for the Health Management of Childhood Leukemia Survivors

PURPOSE: The purpose of this study was to develop parent coaching domains for the health management of childhood leukemia survivors. METHODS: In this study, we conducted a literature review and in-depth interviews with 6 parents of childhood leukemia survivors who were identified using convenience sampling. We identified areas of parent coaching through the 4 stages of the GROW model, which are: goal setting, realistic grasp, confirmation of realization, and search for alternatives. RESULTS: Nine domains and 27 subcategories emerged from the study. The 9 parent coaching domains for the health management of childhood leukemia survivors were routine life management, education and information provision, emotional support for the surviving children, social support for the surviving children, follow-up management, family support, school life management, symptom management, and improvement of growth and development. CONCLUSION: This research developed 9 parent coaching domains for the health management of children surviving leukemia. The results of this study are expected to contribute to the efficient health management of childhood leukemia survivors by enabling practitioners to continuously identify new coaching domains as needed for their health management. Researchers should improve the health management of childhood leukemia survivors by developing nursing interventions for these new coaching areas.

Effects of a First Aid Coaching Program on First Aid Knowledge, Confidence, and Performance of Child Care Teachers

PURPOSE: The purpose of this study was to develop a first aid coaching program (FACP) and to investigate its effects on the first aid knowledge, confidence, and performance of childcare teachers. METHODS: A Delphi survey that included 16 experts was used to develop the FACP. A total of 60 participants were included to test the effectiveness of the program. The FACP developed using the survey results focused on improving first aid knowledge, confidence, and performance using a coaching-based method. First aid and cardiopulmonary resuscitation (CPR) performance was assessed using 39 items from the program content. RESULTS: Using a 3-round Delphi survey, 6 areas and 42 detailed topics for group and individual coaching programs were developed. The knowledge scores were significantly higher in the experimental group than in the control group (t=4.24, p=.001). The confidence scores were significantly higher in the experimental group than in the control group (F=3.89, p < .001). The performance scores were significantly higher in the experimental group than in the control group (t=12.40, p < .001). CONCLUSION: Continuous application of the FACP among child care teachers is expected to minimize the harm caused by minor accidents at child care facilities. This program should be formally implemented on a consistent basis.

Factors Affecting Nursing Students' Perception on Pediatric Patient Safety Culture and Nursing Activity

PURPOSE: The purpose of this study was to identify the factors that affect nursing students' perception of pediatric safety nursing activities for children during hospitalization. METHODS: The study sample included 304 nursing students who had participated in pediatric nursing practice. Data were analyzed using SAS 9.3 program. RESULTS: Regression analysis showed that the model's explanatory power was 37%. Safety policy and procedure, safety priority, disaster experience, and knowing a place of refuge were factors affecting the perception of safety nursing activities for children during hospitalization. CONCLUSION: Findings show that safety policy and procedures and safety priority are major factors that affect the perception of safety nursing activities and indicate that effective education programs on safety policy and procedure and safety priority are necessary to improve the perception of safety nursing activities.

CORRIGENDUM: Correction of the affiliation name. Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

In the original publication, The authors found a mistake in funding statement. Also in the title page (1st affiliation) and main text, the authots would like to revise the affiliation name.

Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

PURPOSE: This study compared the effects of robotic single-port cholecystectomy (RC) and 3-port laparoscopic cholecystectomy (LC) on patients' surgical pain, postoperative complications, and satisfaction. METHODS: One hundred twenty patients with gallbladder disease scheduled for either LC or RC were recruited. Each patient was followed up for 1 week after hospital discharge. RESULTS: Time stayed in operating room was longer in patients with RC, however their hospital stay was shorter than those with LC (t = 3.01, P = 0.003). Since patients with RC received more analgesics during the surgery (t = 3.98, P < 0.001), all participants' surgical pain level were analyzed by using analysis of covariance. Patients who underwent RC reported less surgical pain consistently at 6 hours and first day after surgery and 2 days and 1 week later than patients in the LC. Repeated measure analysis of variance also demonstrated that the RC with single-port might cause less pain throughout the postoperative period (F = 25.68, P < 0.001). Participants' conditions appeared stable without complications such as infection or bleeding regardless of the surgical type however, overall satisfaction with RC showed significantly higher than those with LC except for one item, “the cost of surgery.” CONCLUSION: These results suggested that the RC might be a better choice for people who concern about surgical pain and early hospital discharge. Since there were no differences in postoperative health status between the 2 groups, health care providers as an advocate can provide more reliable information to their patients.

Adolescent Health Behaviors according to Body Mass Index

PURPOSE: The purpose of this study was to analyze differences in health behaviors among adolescents in order to provide fundamental data to develop an effective body weight control program. METHODS: Secondary analysis was done using data from the 9th (2013) Online Survey on Ado-lescents' Health Behaviors by the Korea Centers for Disease Control and Prevention. The adolescents were divided into low weight, normal weight, overweight, and obesity groups according to body mass index (BMI). Differences in health behaviors were analyzed. RESULTS: Gender, grade, socioeconomic status, perceived-health status, exercise, breakfast, fast food, ramen noodles, snacks, carbonated soft drinks, fruits and vegetables, satisfaction with sleep, stress, smoking, and alcohol consumption were significantly different among the groups. Ingestion of carbonated soft drinks and snacks was significantly higher in the low weight group compared to the normal weight group. Eating fast foods, ramen noodles, and snacks was significantly lower in the overweight and obesity groups compared to the normal weight group. CONCLUSION: Findings indicate that health behaviors among the groups differ from traditional knowledge about obesity. To develop optimal programs and improve efficacy, prior knowledge should be used to think differently and individualized programs should be based on an understanding health behaviors of adolescents.

Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses

PURPOSE: This methodological study was conducted to develop and psychometrically test the Transcultural Self-efficacy scale (TCSEscale) for nurses. METHODS: Initial 41 items for the TCSE-scale were generated based on extensive literature reviews and in-depth interviews with 18 nurses who had experience in caring for foreign patients. Cultural Competence and Confidence model was used as a conceptual framework. Content validity was evaluated by an expert panel. Psychometric testing was performed with a convenience sample of 242 nurses recruited from four general hospitals in the Seoul metropolitan area and Gyeonggi-do province of South Korea. To evaluate the reliability of TCSE-scale, a test-retest reliability and an internal consistency reliability were analyzed. Construct validity, concurrent validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. RESULTS: The 25-item TCSE-scale was found to have three subscales-Cognitive, Practical, and Affective domain-explaining 91.5% of the total variance. TCSE-scale also demonstrated a concurrent validity with the Cultural Competence Scale. Criterion-related validity was supported by known-group comparison. Reliability analysis showed an acceptable-to-high Cronbach's alpha-.88 in total, and subscales ranged from .76 to .87. The ICC was .90, indicating that the TCSE-scale has internal consistency and stability of reliability. CONCLUSION: This preliminary evaluation of the psychometric scale properties demonstrated an acceptable validity and reliability. The TCSE-scale is able to contribute to building up empirical and evidence based on data collection regarding the transcultural self-efficacy of clinical nurses. We suggest further testing of the applicability of TCSE-scale in different settings and community contexts.

Parenting Experience of Parents with Chronically Ill Children

PURPOSE: The purpose of the study was to describe the parenting experience of parents of children with chronic illness in Korea. METHODS: A conventional contents analysis was used for the study. Twelve mothers of chronically ill children participated in the study. Qualitative data were analyzed using the Morse and Field method. RESULTS: Four categories, 10 subcategories and 42 codes emerged from the data on the parenting experience of parents of children with chronic illness. The four categories were 'Sacrifice and full-engagement within self-mortification', 'Renormalization of collapsed daily life', 'Paving a new way for independence' and 'Growing together of myself and the family'. CONCLUSION: Parents of children with chronic illness experienced not only negative aspects such as a confusion but also re-normalization and growing together. Based on the results, health professionals need to develop effective nursing interventions toward positive parenting for these parents and their children with chronic illnesses.

Mediating Effect of School Nurses' Self Efficacy between Multicultural Attitude and Cultural Sensitivity in Korean Elementary Schools

PURPOSE: This study examined the mediating effect of school nurses' self efficacy, which is one of the significant cognitive factors influencing cultural sensitivity, on the mutual relationships between multicultural attitude and cultural sensitivity in Korean elementary schools. METHODS: A cross-sectional descriptive survey design was used. Participants were 157 school nurses in elementary schools located in Gyeonggi-do, South Korea. The survey instruments included Teacher Multicultural Attitude Survey, Teacher Efficacy Scale, and Multicultural Sensitivity Scale. Data were analyzed using three regression equations to test the mediation model. RESULTS: The mean score of the school nurses' cultural sensitivity was relatively low. A positive correlation among multicultural attitude, self efficacy, and cultural sensitivity was noted. Self efficacy of school nurses showed a significant mediating effect on the relationships between multicultural attitude and cultural sensitivity. CONCLUSIONS: Given the meaningful influence of positive multicultural attitude on cultural sensitivity and significant mediator effect of self efficacy as a school nurse between the two variables, the strategies to cultivate a positive multicultural attitude and enhance school nurses' self efficacy in their unique role should be considered in a training program. School nurses' health care services will benefit from the improvement of cultural sensitivity toward young children from multicultural families.

Maternal Conflicts of Vietnamese Married Immigrant Women in Korea

PURPOSE: The purpose of the study was to identify and explain the essences and structures of maternal conflicts in Vietnamese married immigrant women in Korea. METHODS: A phenomenological methodology was used for the study. Eleven Vietnamese married immigrant women participated in the study. Verbatim transcripts were analyzed using Colaizzi's method. RESULTS: Four categories, 10 clusters and 26 themes emerged from the data for the experience in maternal conflicts of Vietnamese married immigrant women. The four categories were 'An unprepared young motherhood in another culture', 'Feeling left out of the mother's place along the bands of Nap tai tradition', 'My image is like not-being able to stand alone/be independent' and 'Finding hope in motherhood despite of conflicts and stigmas'. CONCLUSION: Vietnamese married immigrant women experienced not only the negative aspects but also sublimation of maternal conflicts. Based on the results, health professionals need to develop effective nursing interventions toward a positive maternal identity and approach with interculturalism for the Vietnamese married immigrant women in Korea.

Effects of Transglutaminase 2 Inhibition on Ventilator-Induced Lung Injury

This study was performed to examine the role of transglutaminase 2 (TG2) in ventilator-induced lung injury (VILI). C57BL/6 mice were divided into six experimental groups: 1) control group; 2) lipopolysaccharide (LPS) group; 3) lung protective ventilation (LPV) group; 4) VILI group; 5) VILI with cystamine, a TG2 inhibitor, pretreatment (Cyst+VILI) group; and 6) LPV with cystamine pretreatment (Cyst+LPV) group. Acute lung injury (ALI) score, TG2 activity and gene expression, inflammatory cytokines, and nuclear factor-kappaB (NF-kappaB) activity were measured. TG2 activity and gene expression were significantly increased in the VILI group (P < 0.05). Cystamine pretreatment significantly decreased TG2 activity and gene expression in the Cyst+VILI group (P < 0.05). Inflammatory cytokines were higher in the VILI group than in the LPS and LPV groups (P < 0.05), and significantly lower in the Cyst+VILI group than the VILI group (P < 0.05). NF-kappaB activity was increased in the VILI group compared with the LPS and LPV groups (P < 0.05), and significantly decreased in the Cyst+VILI group compared to the VILI group (P = 0.029). The ALI score of the Cyst+VILI group was lower than the VILI group, but the difference was not statistically significant (P = 0.105). These results suggest potential roles of TG2 in the pathogenesis of VILI.

Factors Influencing Ego-Integrity in Community Dwelling Elders / 기본간호학회지

PURPOSE: This study was done to identify the relationship of perceived health status, depression, meaning of life, and family function and to ego integrity, and to investigate the main factors influencing ego-integrity in community dwelling elders. METHOD: The research design for this study was a descriptive survey design using a convenience sampling. Data collection was done using self-report questionnaires with 157 community dwelling elders located in 3 cities, Seoul, Seosan and Gyungju. Data analysis was done using SPSS 15.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: There were significant differences between ego-integrity according to gender, religion, economic level and amount of spending money. Ego-integrity had significant positive correlations with perceived health status, meaning of life, family function and a negative correlations with depression. The major factors that affect ego-integrity in community dwelling elders were self-awareness and acceptance, contentedness with past and present, gender and family function, which explained 62.7% of ego-integrity. CONCLUSION: Findings from this study provide a comprehensive understanding of ego-integrity and related factors for community dwelling elders.

Factors Influencing Cultural Sensitivity among Nursing Students

PURPOSE: This study was conducted to determine the predictors of cultural sensitivity for nursing students in Korea. METHODS: The participants in this study were 332 nursing students. Data collection was conducted through the use of questionnaires which were constructed to include a Cultural Sensitivity Scale, Knowledge of Culture, Interpersonal Reaction Index, and Self-efficacy Scale. RESULTS: Results showed that cultural sensitivity of nursing students was middle range. Knowledge level of culture was very low. There was a significant positive correlation between cultural sensitivity and knowledge of culture, empathy, and self-efficacy. The significant factors influencing cultural sensitivity of nursing students were empathy, self-efficacy, experience of an overseas trip and awareness of cultural education. These four factors explained 23.8% of the variance in cultural sensitivity of nursing students. CONCLUSION: These results indicate that cultural sensitivity is an important link with empathy and self-efficacy in nursing students. For nursing students to enhance cultural sensitivity, a transcultural nursing curriculum needs to develop for appropriate and effective services in cross-cultural situations of the multicultural families in Korea.

Factors Influencing Health Conservation among Elders / 기본간호학회지

PURPOSE: This study was conducted to determine the predictors of health conservation for elders in Korea. METHOD: Random sampling method was used and data from 113 elders were used for final analysis. Data collection was conducted through the use of questionnaires which were constructed to include Health Conservation Scale, Purpose in Life Test and Self-efficacy Scale. RESULTS: Health conservation of the elders was in the middle range. The elders of this study had few goals towards meaning in life, and were in an existential vacuum state. There was a positive correlation between health conservation, meaning in life and self-efficacy. The significant factors influencing health conservation of elders were meaning in life, education level and gender. These 3 factors explained 30.6% of health conservation of elders. CONCLUSIONS: The results indicate that health conservation is an important link with meaning in life in elders. There should be a comprehensive study in the future for in-depth understanding of health conservation of elders.

Factors Influencing Vitality among Nurses / 간호학회지

PURPOSE: This study was conducted to understand the degree of vitality, meaning in life and self-efficacy and to elucidate the factors influencing this vitality in the nurses of Korea. METHOD: A cross-sectional survey of nurses from 4 hospitals was conducted by convenience sampling. Data collection was conducted through the use of questionnaires which were constructed to include a Vitality Self Test, Purpose in Life Test and Self-efficacy Scale. RESULTS: The degree of vitality in nurses was in the middle range. The nurses of this study had few goals towards meaning in life, and an existential vacuum state. A positive relationship was found between vitality and the research variables. The significant predictors influencing vitality in nurses were meaning in life, self-efficacy, and clinical career, and these variables accounted for 28.7% of the variance in vitality. CONCLUSIONS: This results support that vitality is an important link with meaning in life and self-efficacy. There should be a comprehensive study in the future for in-depth understanding of the vitality of nurses.

Parenting Experiences of Parents of Children with ADHD: Approaching the Normal / 간호학회지

PURPOSE: The purpose of this study was to explore the experiences of parenting from the parents of children with ADHD and to develop a grounded theory about their experiences. METHOD: This study was a qualitative research study that used a grounded theory to understand and discuss the parenting experiences of parents of children with ADHD in a greater depth. Grounded data was collected through an in-depth interview from twelve participants with ADHD children. The data was analyzed using the grounded theory method. RESULTS: "Approaching the normal" emerged as the core phenomenone. Parenting experiences for parents of children with ADHD referred to a process of bringing the children, back on track of normal growth development, and their functioning in the family at a normal level and establishing a new normalcy. The process of approaching the normal involved a basic social-psychological process, such as 'living a day in hell', 'accepting', 'confronting the conflicts', 'lowering expectations', and 'making a new normalcy'. CONCLUSION: The outcomes of this study, which observed the parenting process of parents of children with ADHD, could enhance nurses' understanding of ADHD and help nurses become major mental health service providers for the mental health of children with ADHD and their families.