Development and Testing of a Mastery Learning Program of Nursing Skills for Undergraduate Nursing Students

PURPOSE: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. METHODS: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. RESULTS: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. CONCLUSION: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.

The Airflow Obstruction and Subjective Health Status Among Stable Chronic Obstructive Pulmonary Disease Patients Residing in the Community

PURPOSE: This study was undertaken to examine the relationship between airflow obstruction and subjective health status reported by stable patients with chronic obstructive pulmonary disease (COPD) residing in the community. METHODS: A cross-sectional descriptive study was conducted with 78 stable COPD patients aged 69.7 years old on average and selected by a convenient sampling from an outpatient department of pulmonology in tertiary hospitals. They completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI) and pulse oxymetry for O₂ saturation (Sat O₂). Medical records were reviewed to obtain disease-related characteristics including duration of the disease, cardiovascular comorbidity, and forced expiratory volume in 1 second (FEV₁). Data were analyzed using PASW statistics 20.0. RESULTS: Mean FEV₁% and CAT scores were 55.11% and 17.73, respectively. Those in the lower stage of mMRC showed significantly higher FEV1 and lower CAT. FEV1 and CAT showed significant negative correlations; age and BMI with FEV₁, and Sat O₂ with CAT. CONCLUSION: The findings suggest that the less airway obstruction was, the better health status was, and provide the support for using subjective measures in clinical practices for COPD patients.

Sex Differences of the Relationships between Cardiovascular Risk Markers and Psychosocial Factors in Community-Residing Adults

PURPOSE: This study was undertaken to explore sex differences in the risk markers of cardiovascular disease (CVD) and psychosocial factors and the relationships among these variables for the community-residing adults. METHODS: A cross-sectional study was conducted with a total of 114 participants consisting of 65 men aged 42.85 years old and 49 women aged 46.86 years old. Participants were selected by a convenient sampling of at community cultural centers and churches. They completed a structured questionnaire including demographic characteristics, physiologic risk markers of CVD; lifestyle factors; and depression, social support, and stress. RESULTS: The male participants showed significantly higher systolic and diastolic blood pressures than their counterparts. Significantly higher percent of women were currently non-smokers, and practiced moderate alcohol intake, physical activity, and low fat diet. Among women, the higher the scores of depression and stress were and the lower that of the social support was, the higher blood pressure, waist circumference and BMI were. Among men, those who were less depressed and with higher scores of social support had more physical activity. CONCLUSION: The findings suggest further studies to explore sex differences of CVD risk markers and psychosocial factors, and their relationships in a larger sample, and to find the mechanism underlying these differences with a prospective design.

Developing a Home-based Self-management Support Intervention for Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease / 재활간호학회지

PURPOSE: The purpose of this study was to develop a home-based self-management support intervention (SMSI) for enhancing pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) in Korea. METHODS: This methodological study was conducted by following these 4 steps: constructing the preliminary draft of a home-based SMSI from existing recommendation and a literature review on PR and self-management interventions; testing content validity with 6 experts in COPD; exploring clinical applicability of the intervention by applying it to 4 COPD patients; determining the final intervention. RESULTS: The final intervention included 4 components and contents identified from the literature review as essentials for self-management of COPD patients: education; exercise training and practice including breathing, muscle strengthening and aerobic exercises; cognitive behavioral strategies including informative self-decision making, collaborative goal setting and supportive advice; and action planning for exacerbation. The intervention was designed to be run by a trained nurse and had 8 weekly sessions consisting of three 60-minute face-to-face sessions and five 20-minute phone-call sessions. CONCLUSION: The intervention developed in this study incorporates essential components of self-management, i.e. action plan and cognitive behavioral strategies, and will contribute to enhancing and maintaining effects of PR by increasing self-management in COPD patients.

Effectiveness of a Stroke Risk Self-Management Intervention for Adults with Prehypertension

PURPOSE: The aim of this study was to evaluate the effectiveness of a community-based intervention for prehypertensive adults, to enhance stroke risk awareness and to adopt a preventive lifestyle for primary stroke prevention. METHODS: This was a single-blinded, repeated measures quasi-experimental study with 47 participants (23 in the experimental group and 24 in the control group) recruited through convenience sampling from two urban areas. The stroke risk self-management intervention consisted of three weekly, 2-hour, face-to-face sessions and two booster telephone sessions, utilizing strategies to enhance motivation for behavioral changes based on the Self-Determination Theory. All participants completed a pretest, a 1- month and a 3-month post test of stroke risk awareness and preventive lifestyle including blood pressure self-monitoring, healthy diet, and regular physical activity. Data were analyzed using descriptive statistics, chi-square test, two sample t test, repeated measures analysis of variance, and Friedman test with PASW Statistics 18.0. RESULTS: After the intervention, significant improvements were found in the experimental group for stroke risk awareness, blood pressure self-monitoring and regular physical activity, and were sustained over time. CONCLUSIONS: Our preliminary results indicate that the stroke risk self-management intervention is feasible and associated with improvement in self-management of stroke risk factors for primary stroke prevention among a prehypertensive population.

Lifestyle Risk Factors and Awareness of Stroke among Adults in Urban Areas

BACKGROUND: Modifying risk factors and improving stroke awareness in the general community have been emphasized for preventing stroke. This study aimed to explore modifiable lifestyle risk factors and the awareness of stroke and to compare scores for stroke knowledge according to lifestyle risk factors and recognition of important indicators among adults in urban areas. METHODS: A cross-sectional study was conducted with a total of 196 participants aged 40 to 65 selected by a convenient sampling of community cultural centers, churches, and recreational groups. Participants completed a structured questionnaire including general characteristics, risk factors of stroke, and awareness of stroke including general knowledge, risk factors, reactions to warning symptoms, and knowledge on personal risk factors of stroke such as body weight, blood pressure, blood sugar, and cholesterol level. RESULTS: Less than 30% of the participants engaged in regular physical activity and low fat diet and 33% of the participants were classified as having 'higher' level of knowledge on stroke. Knowledge on their personal risk factors of stroke were generally poor. Scores for knowledge on stroke were not different for lifestyle risk factors and knowing whether their body weight and blood pressure level were within normal limits. Meanwhile, scores for knowledge on stroke were significantly higher among those knowing whether their blood sugar and cholesterol level were within normal limits. CONCLUSIONS: There is a need to improve stroke awareness among community adults by providing more targeted information on warning symptoms, risk factors of stroke, and important indicators of major conditions related to stroke and their contribution to stroke prevention.

Effects of Foot Massage and Supportive Communication by Hospice Volunteers on Depression, Anxiety, and Mood of Cancer Patients Who Undergo Intravenous Chemotherapy at Out-patient Department / 한국호스피스완화의료학회지

PURPOSE: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). METHODS: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained-hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. RESULTS: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. CONCLUSION: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

A Descriptive Study for Developing a Program to Promote Compliance with Regular Breast Self-Examination(BSE) / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify knowledge, facilitators, and barriers of breast self -examination(BSE) in Korean couples for developing a continuous regular BSE promotion program. METHOD: This descriptive study was undertaken with a focus group methodology including 27 couples of husbands and wives recruited by convenience-sampling. Data transcribed from audiotapes was analyzed to identify common themes. RESULTS: Knowledge of breast cancer and BSE included 'the risk factors of breast cancer', 'prevention of breast cancer', and 'how to do BSE'. Facilitators to BSE included 'self, health professional, and spouse-facilitating factors'. Barriers to BSE included 'cognitive, psychological, informational, and physical barriers'. CONCLUSION: To promote compliance with BSE among women, tailored programs according to the stage of change of BSE adoption are crucial, not only reflecting the specific needs of the individual by the stage of change, but also utilizing husbands as facilitators.

Effects of Action Oriented Breast Self-examination(BSE) Education on Knowledge, Self-efficacy, and Performance Competence in Nursing Students / 여성건강간호학회지

PURPOSE: This study was undertaken to test effects of action oriented BSE education on knowledge, self- efficacy, and performance competence in nursing students. METHODS: A non-equivalent pre-posttest of time serial quasi-experimental design was used to prevent diffusion of the experiment. Out of 53 nursing students selected by convenient sampling in the third grade at a nursing college, 27 students were randomly assigned to the control group and were first given a traditional lecture on BSE. For the experimental group of 26 students action oriented BSE education consisted of lectures, demonstrations with breast models, and BSE skill practice by micro teaching. RESULTS: There was no significant difference in general and BSE-related characteristics between the two groups. Scores of the experimental group in knowledge, self-efficacy, and performance after the intervention were significantly higher than those of the control group. CONCLUSIONS: Results showed that action-oriented BSE education was effective in increasing knowledge, self-efficacy and performance competence in nursing students. Education for students should incorporate strategies reinforcing confidence by practicing actual BSE skills as well as acquiring knowledge of BSE, so that students can become competent and practical cancer prevention educators.

Perceived Benefits and Barriers According to the Stage of Mammography Adoption in Adult Women* / 성인간호학회지

PURPOSE: This descriptive study was undertaken to explore the distribution of stages of mammography adoption and identify benefits and barriers perceived by women according to the stage of mammography adoption. METHODS: A total of 227 women aged between 30-60 was selected by the convenient sampling in W city. The instrument developed by the researcher based on the scales of Champion(1993), Champion & Skinner(2003), and Rakowski et al (1992) was used. RESULTS: The distribution of stages of mammography adoption was as following; precontemplation 30.7%, contemplation 23.8%, relapse 20.2%, action 14.4%, and maintenance 10.8%. Women in maintenance and actors showed high scores in benefits and low scores in barriers. Those in relapse reported high scores in both benefits and barriers, while precontemplators and contemplators showed high score in barriers and low scores in benefits. CONCLUSION: Despite the rate of mammography participation has increased, the proportion of maintenance stage is still low and that of relapse is high. For those in relapse, strategies to eliminate barriers hindering regular and continuous mammography are necessary. For precontemplators and contemplators, detail information including purpose, procedure and benefits of mammography should be given primarily.

Perceived Importance and Performance Frequency of Nursing Interventions and Nursing Activities in the Physiological Domains of Nursing Intervention Classification(NIC) in Home Health Care Nursing / 성인간호학회지

PURPOSE: To identify perceived importance and performance frequency of nursing interventions with nursing activities of 5 nursing interventions from the physiological domains of NIC used in the home health care nursing. METHOD: Five nursing interventions in the physiological domain of NIC were selected based on the previous finding. Data were collected from 85 nurses working in 54 home health care centers between August and October, 2004 using mailing survey(return rates : 41.5%). The questionnaire consisted of 96 nursing activities in 5 interventions with definitions, asking perceived importance and performance frequency of them. RESULT: Skin surveillance was perceived as the most important(3.52+/-0.36) intervention and also performed most frequently(4.43+/-0.45). All the nursing activities in skin surveillance appeared to be used frequently, which was rated over 4 out of 5 point Likert, while only 4 nursing activities in exercise therapy: joint mobility did. Correlations between perceived importance and performance frequency of 5 interventions were all significant (r=0.591-0.718, p=0.000). CONCLUSION: Identifying the use of particular interventions and nursing activities will help nurses simplify documentations and to deliver better care to the patients in home health care nursing.

A Study of Knowledge, Attitudes, and Importance of Sexuality in the Aged / 여성건강간호학회지

PURPOSE: The purpose of this research was to identify knowledge of, attitude toward, and the importance of, sexuality in the elderly. METHOD: By convenience sampling, 152 elderly people aged 60 and over who registered at 3 elderly schools located in W city were selected. Knowledge and attitude toward sexuality were measured with ASKAS. Perceived importance toward sexuality was measured with an instrument developed by the investigator. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's correlation. RESULTS: Elderly males, elderly couples, and elders perceiving themselves as healthy reported higher scores in knowledge on and the importance of sexuality. Elderly males, elders with higher education, and elders perceiving themselves as healthy showed a more acceptable attitude toward sexuality. The higher knowledge of sexuality, the more acceptable the sexuality. The higher knowledge of and more acceptable attitude toward sexuality, the higher significance of sexuality. CONCLUSIONS: Sexuality is an important issue in elderly life. To improve knowledge, positive views of sexuality, recognition of its importance, education and consulting programs on sexuality need to be developed, reflecting characteristics of the elderly. These programs should be provided not only to the elderly but also to people caring for the elderly and their families.

Development and Application of a Web-Based Tailored Nutrition Management Program and Change in Knowledge of Nutrition and Eating Habits in Elementary Students / 대한의료정보학회지

OBJECTIVE: This study was undertaken to develop and apply a web-based tailored nutrition management program for elementary school students. METHODS: One group pretest, posttest design was used with a random sample of 5th and 6th grade students in two elementary schools out of the 20 elementary schools in W city. The web-based nutrition program was developed based on previous studies and existing web sites related to nutrition education and management. It consisted of a combination of web-based step-by-step self-checkups and web-based instructions on knowledge of nutrition, eating habits, and perception and satisfaction with body shape etc. Students completed web-based questionnaires on knowledge of nutrition and eating habits at baseline and three weeks later. Data were analyzed using descriptive statistics and paired t-test. RESULTS: Knowledge of nutrition and practice of correct eating habits increased significantly after the students completed the web-based program. CONCLUSION: These results suggest that a web-based nutrition management program is effective for nutrition education for children in terms of accessibility, compliance, and client-initiative.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

A Study on Nursing Diagnoses and Nursing Intervention Classification: focused on Home Health Care Clients / 간호학회지

The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows: 1. The most frequent nursing diagnoses were 'Risk for infection' and 'Altered nutrition : Less than body requirements', then 'Impaired skin integrity' and 'Ineffective airway clearance' in the Exchange patterns of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)'s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex domain most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was 'Risk for infection' and 19 interventions for 'Risk for infection' were used 267 times. Then 14 interventions for 'Impaired skin integrity' were used 258 times, 12 interventions for 'Ineffective airway clearance' were used 193 times, 12 interventions for 'Altered nutrition : Less than body requirements' were used 122 times, 10 interventions for 'Activity intolerance' were used 75 times, and 11 interventions for 'Knowledge deficit' were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.

A Study on Nursing Diagnoses and Nursing Intervention Classification: focused on Home Health Care Clients / 간호학회지

The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows: 1. The most frequent nursing diagnoses were 'Risk for infection' and 'Altered nutrition : Less than body requirements', then 'Impaired skin integrity' and 'Ineffective airway clearance' in the Exchange patterns of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)'s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex domain most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was 'Risk for infection' and 19 interventions for 'Risk for infection' were used 267 times. Then 14 interventions for 'Impaired skin integrity' were used 258 times, 12 interventions for 'Ineffective airway clearance' were used 193 times, 12 interventions for 'Altered nutrition : Less than body requirements' were used 122 times, 10 interventions for 'Activity intolerance' were used 75 times, and 11 interventions for 'Knowledge deficit' were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.

Subsequent Reproductive Experiences after Treatments for Gestational Trophoblastic Disease / 대한산부인과학회잡지

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.