Critical Care Nursing Courses in Bachelor of Science in Nursing Programs: Present and Future Directions / 중환자간호학회지

PURPOSE: This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions.METHODS: The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi.RESULTS: Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing.CONCLUSION: The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients' health. It is necessary to develop a practical and integrative curriculum for critical care nursing education.

Teaching Effectiveness and Adequacy of Practical Training in Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the teaching effectiveness and adequacy of practical training in nursing students. METHODS: This descriptive research was conducted using a convenience sampling. The sample consisted of 619 nursing students with experience in practical training among five colleges, located in four cities. The data collection was performed using self-reported questionnaires. Research tools, developed by Kim (1996), were used to measure the effectiveness of clinical instructors and the adequacy of practical training developed by researchers. The data was analyzed using SPSS 20.0. RESULTS: The average of teaching effectiveness was 3.43 (out of 5) and adequacy of practical training was 3.33 (out of 5). Teaching effectiveness and adequacy of practical training showed a significant positive correlation (r=.74, p<.001). Teaching effectiveness and each sub-area: adequacy of practical training, practical contents (r=.59, p<.001), practical attitude (r=.45, p<.001), practical instructor (r=.62, p<.001), practical environment (r=.46, p<.001), and practical evaluation (r=.64, p<.001), revealed a significant positive correlation. CONCLUSION: Nursing students prefer the actual training from professors who are more professional and clinical experienced. Professors presenting the theory lectures should also be aware of clinical practice so that education can be more professional and effective in terms of clinical practice.

Analysis of the Adverse Effects Associated with Therapeutic Plasmapheresis / 대한수혈학회지

BACKGROUND: Although therapeutic plasmapheresis (TP) is a useful procedure in removing pathogenic antibodies and toxic substances from the patient, adverse reactions could arise from the use of replacement fluids and anticoagulants. Comprehensive analysis on those adverse effects had been rarely reported in Korea. METHODS: We retrospectively investigated the clinical records and the TP records from 3,962 TP sessions for 581 patients between January 1995 and October 2008 at Asan Medical Center, and we analyzed the adverse reactions related to TP. RESULTS: Adverse reactions were seen in 142 patients (24.4%) in 348 TP procedures (8.8%). Citrate toxicity was most frequently seen in 83 procedures (23.9%) followed by chills in 72 procedures (20.7%), allergic reactions in 69 procedures (19.8%) and hypotension in 60 procedures (17.2%). Citrate toxicity, chills and allergic reactions were seen more frequently in the TP procedures using FFP than in the TP procedures using albumin (P=0.001). The prevalence of citrate toxicity was significantly lower in the cases where calcium gluconate was administered (P<0.001), while it was significantly higher in the patients whose hematocrit was below 28.5% (P<0.001). In terms of severity, the mild, moderate and severe adverse reactions were 36.8%, 56.3% and 6.9%, respectively. CONCLUSION: TP is a relatively safe method of treatment, but it is important to predict and prevent adverse reactions and to respond appropriately to these adverse reactions.

Use of Physical Assessment Skills and Education Needs of Advanced Practice Nurses and Nurse Specialists

PURPOSE: The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. METHODS: A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. RESULTS: Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. CONCLUSION: More educational opportunities in physical assessment should be provided including education programs based on the nurses' skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.

Critical Thinking Disposition and Clinical Competence in General Hospital Nurses

PURPOSE: This study was done to investigate the relationship between critical thinking disposition and clinical competence among nurses in general hospitals. METHODS: This study was a descriptive-correlational study with a convenience sample of 560 nurses from 5 general hospitals. The data were collected by self-administered questionnaires. Critical thinking disposition was measured using the Critical Thinking Disposition Scale for Nursing Students. Clinical competence was measured using the Standardized Nurse Performance Appraisal Tool. RESULTS: The mean score for critical thinking disposition and clinical competence was 3.37 and 4.10 respectively on a 5 point scale. A statistically significant correlation was found between critical thinking disposition and clinical competence. A regression model explained 72.8% of clinical competence. Prudence is the most significant predictor of clinical competence (R2=.728). CONCLUSION: Study findings suggest that nurses with a higher level of critical thinking disposition would have a higher level of clinical competence. Furthermore, prudence might be the most important predictor of clinical competence. In order to strengthen clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the college level and nurses should be encouraged to make a clinical decision with greater prudence.

Subjective and Objective Caregiver Burden in Parkinson's Disease / 간호학회지

PURPOSE: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. METHODS: A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology outpatient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. RESULTS: The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion(47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). CONCLUSION: Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

Depression and Quality of Life among Family Caregivers of Patients with Parkinson's Disease in South Korea / 재활간호학회지

ression and quality of life of family caregivers of patients with Parkinson's disease(PD). METHODS: A cross-sectional descriptive study was conducted in one neurology outpatient clinic in Seoul, Korea from March to June, 2006. Sixty eight family caregivers of PD patients were participated to the study, using CES-D and SF-36. RESULTS: Mean scores of depression were 16.18+/-8.39 (range: 0-48) and it was a little lower than caregiver's who took care of Dementia patients and were higher than primary caregivers of the patients with Stroke. Time for caregiving, perceived severity, duration of PD were significantly related with depression respectively. Higher ADL scores which mean greater motor disabilities were related to higher caregiver depression. Lower income and greater medical expenditure were closely related with the depression of family caregivers respectively. The mean scores of total QOL were 435.5+/-96.5 and the mean scores of PF, SF, RE and MH were lower than general population. Time for caregiving, depression, patients' ADL scores were significantly associated with QOL respectively. People who were older and had lower educational background showed lower QOL scores respectively. CONCLUSION: Healthcare professionals should pay more attention to emotional aspects of caregivers who take care of PD patients, and develop comprehensive management strategies both for patients and their caregivers.

A Study on the Correlations between Social Support, Dependence of Activities of Daily Living and depression in Patients with parkinson's disease / 성인간호학회지

The purpose of this study was to investigate the correlations between social support, dependence of activities of daily living and depression among Parkinson's disease patients. Subjects were 122 patients with Parkinson's disease. Neurologic wards inpatients or neurology clinic out patients department in a tertiary-affiliated hospital in Seoul. Data were collected from April 1996 to March 1997. The results of this study were summarized as follows: 1. The lower the level of dependence of activities of daily living, the lower the level of depression. 2. The higher the level of perceived family support, the lower the level of depression. 3. The higher the level of perceived health personnel support, the lower the level of depression. 4. The rate of depression evaluated by Zung depression scale was 37.4%(mild to moderate:30.1%, moderate to severe:4.1%, severe:3.2%). 5. Socio-demographic characteristics sex, education, occupation, and the charge person of treatment cost, significantly influenced the level of depression. 6. There was no significant difference in level of depression, dependence of activities of daily living, stage of disease between user and nonuser of L-dopa. Suggestions were made for further studies: 1. To develop nursing intervention for decreasing the dependence of activities daily living is needed. 2. To identify the change pattern of depression by time.