Development of the Cultural Competence Scale for Registered Nurses (CCS-RN)

PURPOSE: This study is to develop the Cultural Competence Scale for Registered Nurses (CCS-RN) and to examine its validity and reliability. METHODS: The item pool was generated based on related scales, a wide review of the literature, and in-depth interviews with nurses according to Purnell's cultural competence model. Content validity was verified by nursing experts. Construct validity using exploratory factor analysis, convergent validity using correlation coefficients, discriminant validity, internal consistency reliability, and test-retest reliability were examined. RESULTS: The CCS-RN consists of a 35-item/7-factor solution with 54.1% of the total variance explained. The convergent validity of CCS-RN was supported. Cronbach's α was .94 for the total scale and ranged from .77 to .90 for the seven factors. Test-retest reliability was moderate. CONCLUSION: The evaluation of the psychometric properties of the CCS-RN shows that this scale is expected to be a valid and reliable measure of cultural competence among nurses. This scale may be useful for assessing nurses' own cultural competence and thus contribute to strengthening cultural competence.

Effects of a cultural nursing course to enhance the cultural competence of nursing students in Korea / 보건의료교육평가

Purpose@#With Korea’s recent rapid change into a multicultural society, cultural competence is being emphasized as a core nursing competency. This study investigated the effects of a cultural nursing course that aimed to enhance the cultural competence of nursing students in Korea. @*Methods@#This was a single-group pre- and post-comparison study. The subjects were 69 nursing students at Dongyang University who attended a cultural nursing course in 2015, of whom 62 students responded to the survey. The 13-week cultural nursing course was held for 2 hours a week. The methods of the course included small group activities, discussions and presentations, experiential learning, reflective activities, and lectures. Nursing students’ cultural competence was measured pre- and post-course with the Cultural Competence Scale for Korean Nurses, which contains 33 items scored on a 7-point Likert scale. @*Results@#After completing the cultural nursing course, students’ total cultural competence scores increased, as did their scores in each category (cultural awareness, cultural knowledge, cultural sensitivity, and cultural skills) (P<0.001). There was no significant difference in cultural competence by gender (P<0.001). @*Conclusion@#This cultural nursing course was found to be effective in enhancing the cultural competence of nursing students. Therefore, the educational program developed in this study can be extended to other university-level nursing programs in Korea.

Knowledge, Confidence, and Learning Needs Regarding Advance Directives among Hospital Nurses / 중환자간호학회지

PURPOSE: Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses.METHOD: This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire.RESULTS: The mean score of knowledge, confidence and learning needs were 5.00±1.73, 29.81±7.52, and 64.54±8.48 respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005).CONCLUSION: Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.

Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing Examination / 보건의료교육평가

PURPOSE: The purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge. METHODS: We conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory. RESULTS: A total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%–100% for 12 items; 60%–80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below −2.0), easy for 8 items (−2.0 to −0.5), medium for 6 items (−0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate. CONCLUSION: We surmised that the low reliability of the mock examination was influenced by the timing of the test for the examinees and the inappropriate difficulty of the items. Our study suggested a methodology for the development of future case-based items for the Korean Nursing Licensing Examination.

Relevance of the test content of the Korean Nursing Licensing Examination to nursing job / 보건의료교육평가

PURPOSE: This study aimed at identifying if there is a relevance of content of the Korean Nursing Licensing Examination (KNLE) revised in 2014 to nursing job. It will be able to provide the validity of revised content of the KNLE. METHODS: From October 13 to November 13, 2015, print version of 8 duties with 49-tasks, 155-job item questionnaires were distributed to 1,305 hospital nurses and 202 nursing faculties in Korea. Results were treated by descriptive statistics and comparison analysis. There were responses from 946 nurses or professors (72.5%). RESULTS: The relevance of test content of KNLE to nursing job was shown to be valid with over 3 points out of 4 point Likert scale in all items: from 3.23 at lowest to 3.64 at top. CONCLUSION: Above results showed that the revised version of KNLE in 2014 was valid to test the nursing students' knowledge for job performance.

The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination / 보건의료교육평가

PURPOSE: This study aimed at characterizing Korean nurses' occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. METHODS: First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. RESULTS: The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. CONCLUSION: The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses.

Metabolic syndrome in the overweight and obese adolescents and the impact of obesity on the cardiovascular system / 소아과

PURPOSE: Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. METHODS: tal cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. RESULTS: MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. CONCLUSION: Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

Simultaneous Detection of Adenovirus types 3, 7 and 11 by a Multiplex PCR from Cell Cultured Clinical Specimens of Hospitalized Patients

Adenovirus (AD) is classified into A, B, C, D, E and F subgenera on the basis of neutralization, hemagglutination and DNA homology tests. Six AD subgenera have 51 serotypes. We selected AD types 3, 7, and 11 since they are known to frequently cause respiratory disease, gastrointestinal disease and meningitis, which often require hospitalization of the patients. The purpose of this study was to detect and to evaluate the correlation of AD types 3, 7 and 11 and the diseases. The detection method, used for AD types 3, 7 and 11, was a multiplex polymerase chain reaction (PCR) with HEp-2 cell cultured with clinical samples. The result was as follows: AD 3 (22/62, 35.5%), AD 7 (27/62, 43.5%), and AD 11 (50/62, 80.6%) were detected by the multiplex PCR in 62 clinical samples. AD 3 detection rate in cerebrospinal fluid was relatively higher than in other specimens but its statistical significance was low (p=0.07). AD 11 was detected (50/62, 80.6%) with the highest frequency and appeared to significantly be associated with gastroenteritis, respiratory disease, and meningitis in hospitalized children, and arthritis in adult patients. AD 3, AD 7 and AD 11 types were detected singly in 21/62 (33.9%), doubly in 15/62 (24.2%), and triply in 16/62 (25.8%). The multiplex PCR method using Hep2 cell culture with clinical specimens could detect AD types 3, 7, and 11 in children with meningitis, respiratory infection, or gastroenteritis, and in adults with cancer and arthritis.

Gender Differences in Dieting, Eating Habits and Depression of Obese Adolescents / 아동간호학회지

Recently, the number of obese people have been increasing due to westernized diets and increased sedentary activity. In particular, obese adolescent have been newly recognized as having significant health problems. This study focuses on determining the gender difference of obese adolescents through implementation of a structured questionnaire on general characteristics, attitudes toward dieting, eating habits and emotional depression due to obesity. Data collection was carried out by 291 students in attendance at 3 high schools in Pusan from 11. 2. 1998 to 11. 30. 1998. The targes were 148 boys and 143 girls who were judged as obese in the school's physical check-up. The test of reliability of this research was calculated by chronbach's alpha . Data analysis was managed by computer and statistics by SPSS/WIN. The results of the survey are as follows: 1.For the questionnaire regarding attitudes toward dieting which include 28 items, 10 out of 28 items (about 36%)showed gender difference. 2. For the questionnaire regarding eating habits which include 17 items, 5 out of 17 items (about 30%)showed gender difference. 3.For the questionnaire regarding emotional depression about obesity, 30.6% of boys and 27.3% girls answered but no statistical significance. The results of this survey indicated that this study will be important as a good guideline for treating obese adolescents. It is hoped that much more research on gender difference in obese adolescents will be implemented in the future. In addition, the development of effective treatments for obesity should be based on the gender of the adolescent.