Structural Equation Modeling of Nurses’ Turnover Intention Based on Affective Events Theory / 간호행정학회지

Purpose@#This study aimed to construct and test a hypothetical model of turnover intention for clinical nurses based on affective events theory. @*Methods@#Data were collected from 375 clinical nurses working in an advanced general hospital. The exogenous variable of the hypothetical model was emotional labor, and the endogenous variables were negative emotional events, emotional intelligence, positive affect, organizational commitment, and turnover intention. Data were analyzed using the SPSS/WIN 23.0, and AMOS 22.0. @*Results@#The final modified model demonstrated a good fit. This model explained 70.6% of the variance in the turnover intention of clinical nurses. The statistically significant explanatory factors for turnover intention were emotional labor, negative emotional events and organizational commitment. As for the significant pathway affecting nurses’ turnover intention, emotional labor showed a decreasing effect on turnover intention and was mediated by emotional intelligence, positive affect, and organizational commitment (B=-.33, p=.002). Emotional labor showed a decreasing effect on turnover intention through organizational commitment (B=-.40, p=.006). @*Conclusion@#Various opportunities for education and multiple-approach institutional support must be provided to nurses to increase their vocation about the profession, emotional intelligence, positive affect, and organizational commitment.

Comparison of Bleeding, Hematoma, Pain, and Discomfort After Bone Marrow Examination With or Without Sandbag Compression

Purpose@#A safe and effective hemostatic care is necessary after bone marrow examination to minimize bleeding, pain, and discomfort. However, a standardized hemostatic care protocol following bone marrow examination has not been established. The purpose of this study was to investigate the differences in bleeding, hematoma, pain, and discomfort by the hemostatic method used following bone marrow examination. @*Methods@#This study was carried out with a pre-test/post-test nonequivalent control group design. Sixty-four patients undergoing bone marrow examination at the hemato-oncology ward in a tertiary hospital in South Korea were assigned to an intervention (n = 30) and comparison group (n = 34). The intervention group was treated using a compression dressing alone, while the comparison group received a compression dressing followed by sandbag compression. Both groups received two hours of bedrest. Bleeding, hematoma, pain, and discomfort were measured at one and two hours after the biopsy. @*Results@#No significant differences in the occurrence of bleeding between the groups at one and two hours after bone marrow examination were observed, and no participant developed hematoma. The intervention group had significantly lower pain than the comparison group two hours after the bone marrow examination as well as lower discomfort one hour and two hours after the bone marrow examination (p < .05). @*Conclusion@#Applying only compression dressing after a bone marrow examination is effective in reducing pain and discomfort without measurable differences in bleeding and hematoma, suggesting that compression dressings alone could be effective in lowering pain and discomfort following bone marrow examination.

Comparison of Bleeding, Hematoma, Pain, and Discomfort After Bone Marrow Examination With or Without Sandbag Compression

Purpose@#A safe and effective hemostatic care is necessary after bone marrow examination to minimize bleeding, pain, and discomfort. However, a standardized hemostatic care protocol following bone marrow examination has not been established. The purpose of this study was to investigate the differences in bleeding, hematoma, pain, and discomfort by the hemostatic method used following bone marrow examination. @*Methods@#This study was carried out with a pre-test/post-test nonequivalent control group design. Sixty-four patients undergoing bone marrow examination at the hemato-oncology ward in a tertiary hospital in South Korea were assigned to an intervention (n = 30) and comparison group (n = 34). The intervention group was treated using a compression dressing alone, while the comparison group received a compression dressing followed by sandbag compression. Both groups received two hours of bedrest. Bleeding, hematoma, pain, and discomfort were measured at one and two hours after the biopsy. @*Results@#No significant differences in the occurrence of bleeding between the groups at one and two hours after bone marrow examination were observed, and no participant developed hematoma. The intervention group had significantly lower pain than the comparison group two hours after the bone marrow examination as well as lower discomfort one hour and two hours after the bone marrow examination (p < .05). @*Conclusion@#Applying only compression dressing after a bone marrow examination is effective in reducing pain and discomfort without measurable differences in bleeding and hematoma, suggesting that compression dressings alone could be effective in lowering pain and discomfort following bone marrow examination.

Study for Revision of the Korean Patient Classification System / 임상간호연구

PURPOSE: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. METHODS: The 47,711 KPCS-1 scores of 6,931 patients who discharged from 1st to 30th April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. RESULTS: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. CONCLUSION: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

Effects of the Educational Leadership of Nursing Unit Managers on Team Effectiveness: Mediating Effects of Organizational Communication

PURPOSE: This study identifies the effects of the educational leadership of nursing unit managers on team effectiveness and the mediating effects of organizational communication satisfaction; it highlights the importance of educational leadership and organizational communication and provides the data needed to enhance the education capacity of managers. METHODS: The participants were 216 nurses working at unit with nursing unit managers of staff nurses at a tertiary hospital located in Cheongju city, South Korea, and nurses who had worked for more than 6 months at the same unit. This study was conducted using questionnaires on educational leadership, team effectiveness, and organizational communication satisfaction. Data analysis was performed with a t test, analysis of variance, Scheffé test, Pearson's correlation coefficient, and simple and multiple regression analyses using SPSS, version 23.0. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test. RESULTS: The mean score for the educational leadership of nursing unit managers was 3.74 (±0.68); for organizational communication satisfaction, 3.14 (±0.51); and for team effectiveness, 3.52 (±0.49). Educational leadership was significantly positively correlated with team effectiveness and organizational communication satisfaction. Organizational communication satisfaction demonstrated a complete mediating effect on the relationship between educational leadership and team effectiveness (β = .61, p < .001) and was significant (Sobel test; Z = 7.40, p < .001). CONCLUSION: The results indicate that the educational leadership of nursing unit managers increases communication satisfaction among nurses; this supports the idea that educational leadership can contribute to team effectiveness. This suggests that the educational leadership and communication capacity of nursing unit managers must be improved to enhance the performance of nursing organizations.

Harmless effects of argon plasma on caudal fin regeneration and embryogenesis of zebrafish: novel biological approaches for safe medical applications of bioplasma

The argon plasma jet (Ar-PJ) is widely used in medical fields such as dermatology and dentistry, and it is considered a promising tool for cancer therapy. However, the in vivo effects of Ar-PJ for medical uses have not yet been investigated, and there are no biological tools to determine the appropriate clinical dosages of Ar-PJ. In this study, we used the caudal fin and embryo of zebrafish as novel in vivo tools to evaluate the biosafety of Ar-PJ. Typically, Ar-PJ is known to induce cell death in two-dimensional (2D) cell culture systems. By contrast, no detrimental effects of Ar-PJ were shown in our 3D zebrafish systems composed of 2D cells. The Ar-PJ-treated caudal fins grew by an average length of 0.7 mm, similar to the length of the normally regenerating fins. Remarkably, Ar-PJ did not affect the expression patterns of Wnt8a and β-Catenin, which play important roles in fin regeneration. In the embryo system, 85% of the Ar-PJ-treated embryos hatched, and the lateral length of these embryos was ~3.3 mm, which are equivalent to the lengths of normal embryos. In particular, vasculogenesis, which is the main cellular process during tissue regeneration and embryogenesis, occurred normally under the Ar-PJ dose used in this study. Therefore, our biosafety evaluation tools that use living model systems can be used to provide an experimental guideline to determine the clinically safe dosage of Ar-PJ.

Effects of a New Nursing Delivery System on Nurses' Satisfaction, Self-efficacy, Job Stress, and Nursing Performance in a University Hospital / 간호행정학회지

PURPOSE: The purpose of this study was to identify effects of moving from a functional method of nursing care delivery to a modified team nursing delivery system. METHODS: A structured self-report questionnaire was used to measure satisfaction with the nursing delivery system, self-efficacy, job stress and nursing performance. Participants were 72 nurses working at a university hospital and data were collected three times; before, one month and three months after the modification to a modified team nursing delivery system. Data were analyzed using repeated measure ANOVA. RESULTS: Satisfaction with the nursing delivery system increased significantly after the change to the modified team nursing method. There were no significant differences in self-efficacy, job stress, or nursing performance. However, satisfaction with the nursing delivery system and nursing performance increased and job stress decreased significantly in new nurses with less than 1 year experience. CONCLUSION: Results indicate that a modified team nursing method has positive results on nurses' satisfaction, self-efficacy, job stress, and nursing performance compared to the functional method. Effect of changing the nursing delivery system in the hospital suggests possibilities and directions for a modified nursing delivery system that would be useful in hospitals presently using the functional method.

Anti-stress effects of ginseng via down-regulation of tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) gene expression in immobilization-stressed rats and PC12 cells

Catecholamines are among the first molecules that displayed a kind of response to prolonged or repeated stress. It is well established that long-term stress leads to the induction of catecholamine biosynthetic enzymes such as tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) in adrenal medulla. The aim of the present study was to evaluate the effects of ginseng on TH and DBH mRNA expression. Repeated (2 h daily, 14 days) immobilization stress resulted in a significant increase of TH and DBH mRNA levels in rat adrenal medulla. However, ginseng treatment reversed the stress-induced increase of TH and DBH mRNA expression in the immobilization-stressed rats. Nicotine as a ligand of the nicotinic acetylcholine receptor (nAChR) in adrenal medulla stimulates catecholamine secretion and activates TH and DBH gene expression. Nicotine treatment increased mRNA levels of TH and DBH by 3.3- and 3.1-fold in PC12 cells. The ginseng total saponin exhibited a significant reversal in the nicotine-induced increase of TH and DBH mRNA expression, decreasing the mRNA levels of TH and DBH by 57.2% and 48.9%, respectively in PC12 cells. In conclusion, immobilization stress induced catecholamine biosynthetic enzymes gene expression, while ginseng appeared to restore homeostasis via suppression of TH and DBH gene expression. In part, the regulatory activity in the TH and DBH gene expression of ginseng may account for the anti-stress action produced by ginseng.

Comparison of Professional Standardized and Amateur Standardized Patients in OSCE / 한국의학교육

PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.

Patient Severity Classification in a Medical ICU using APACHE III and Patient Severity Classification Tool / 간호학회지

The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE III and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE III developed by Knaus and thePatient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, X2, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing. 1) This paper was awarded the first prize at the Seoul National Hospital Nursing Department Research Contest.

A Case of Complete Response by Hormonal Therapy with Tamoxifen and Progesterone in Recurrent Endometrial Cancer to Metastasis to Lung / 대한산부인과학회잡지

Endometrial carcinoma has been the most common female pelvic malignancy in the U.S.A. Approximately one-fourth of patient treated for early endometrial cancer will develop reccure-nt disease. Kelly and Baker first descibed that the use of progestational agents for treatment of met- astatic endometrial cancer in 1961. Response of progesterone therapy in metastatic endometrial cancer is related to several factors. Higher response rates are observed in well differentiated tumors, longer disease free interval and tumors that positive for estrogen and progesterone re- ceptors. We experienced a case of complete response in recurrent endometrial cancer to metastasis to lung treated by tamoxifen and progesterone, we present this case with a brief review of lite- rature.

A Case of Respiratory Syncytial Virus Infection Presented with Apnea

Respiratory syncytial virus(RSV) is currently implicated as the most common and otentially serious viral respiratory pathogen of young infants. Apnea in association with RSV infection occurred in about 18% of the infants. Premature birth and a young postnatal age were risk factors for development of apnea with RSV disease. We experienced a case of RSV infection in a 37 day-old premature girl. The presenting complaint was apnea, with respiratory signs and symptoms developing later. She required mechanical ventilation.

A Case of Newborn Scpsis Caused by Streptococcus pneumoniae

No abstract available.

A Case of Prader-Willi Syndrome with Diabetes Mellitus

Prader-Willi syndrome is characterized by infantile hypotonia, mental retardation, hyperhagia, hypogonadism and obesity. Approximately 60% of all PLW syndrome show an interstitial deletion of chromosome 15, 37% have apparently normal chromosome, and 3.6% have a variety of other abnormalities involving chromosome 15. Diabetes mellitus has been considered a component of PLW syndrome and the incidence is about 7%. We experienced a 17-year-old female who revealed mental retardation, hypogonadism, obesity, and non-insulin dependent type DM, compatible with Prader-Willi syndrome.