Effects of a Multifaceted Pediatric Delirium Education Program for Pediatric Intensive Care Unit Nurses on their Delirium Knowledge, Self-confidence in Delirium Nursing, and Delirium Assessment Accuracy: A One Group Pretest-Posttest Design / 중환자간호학회지

Purpose@#: This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. @*Methods@#: This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. @*Results@#: After the Pediatric Delirium Education Program, nurses’ delirium knowledge (x2 =11.65, p =.001), confidence in delirium nursing (t=9.71, p＜.001), and delirium evaluation accuracy (t=6.07, p＜.001) improved significantly. @*Conclusions@#: Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

The Reliability and Validity of the Korean Version of the Cornell Assessment of Pediatric Delirium / 임상간호연구

Purpose@#This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). @*Methods@#For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's ⍺) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. @*Results@#Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's ⍺ was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist’s diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. @*Conclusion@#The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

Effects of Death Preparation Education on Awareness of Hospice Palliative Care and Withdrawing Life Sustaining Treatment in City Dwellers / 한국호스피스완화의료학회지

PURPOSE: This study was done to analyze how a death preparation education program have the effects on awareness of hospice palliative care and withdrawing life sustaining treatment in older adults. METHODS: This study employed a non-equivalent control group design among quasi-experimental designs. The experimental group was comprised with 35 adults and the control group with 40 adults. The death preparation program consisted of five two-hour sessions and was administered once a week for five straight weeks. Data were analyzed by descriptive statistics, t-test, chi2 test, Fisher's exact test, and ANCOVA using SPSS version 18.0. RESULTS: The mean age of the participants was 66.2 years. A significant difference between the experimental and control groups was observed in withdrawing life sustaining treatment (F=3.380, P=0.040). However, no significant difference was found in awareness of hospice palliative care (F=0.163, P=0.850). CONCLUSION: The study results indicate that death preparation training could positively affect people's awareness of withdrawing life sustaining treatment. More studies should be conducted to explore effects of death preparation education for all ages and help people better understand hospice palliative care.

Subcellular localization of the transmembrane inner ear (Tmie) protein in a stable Tmie-expressing cell line / 한국실험동물학회지

Mutations in the transmembrane inner ear (Tmie) gene, which encodes the Tmie protein, have been attributed to deafness autosomal recessive 6 (DFNB6), an autosomal nonsyndromic recessive hearing loss disorder. Although the Tmie gene was identified a few years ago, little is known about subcellular localization of the Tmie protein. In order to address this, we developed a stable cell line expressing Tmie protein. The expression of Myc-tagged Tmie protein was confirmed by Western blot analysis using an anti-Myc antibody and localization of the Tmie protein was confirmed by immunostaining, using the anti-Myc antibody as well as the anti-tmie antibody. Our study demonstrates that the Tmie protein is localized mostly in the cellular membrane and to a lesser extent in cytoplasm. These results suggest that our Tmie expressing stable cell line provides a suitable in vitro model to explore Tmie synthesis and functions.

The hemodynamic changes during the infusion of remifentanil for patients under sevoflurane anesthesia during arthroscopic shoulder surgery / 대한마취과학회지

BACKGROUND: In spite of its minimal invasiveness, hemodynamic instability frequently happens during arthroscopic procedures. This study was performed to investigate the clinical efficacy of remifentanil for controlling the intra-operative hemodynamics during the performance of arthroscopic shoulder surgery. METHODS: Sixty patients (ASA class 1 and 2) who were scheduled for arthroscopic shoulder surgery were recruited for this study. After the induction and maintenance of anesthesia with thiopental sodium, rocuronium bromide, sevoflurane and nitrous oxide, the patients were randomly allocated to receive either saline or three different doses of remifentanil (0.03, 0.05 or 0.07 microg/kg/min) to assess the hemodynamic changes such as the systolic blood pressure, the diastolic blood pressure and the heart rate. RESULTS: The hemodynamics in the remifentanil groups were more stable than those in the saline group (P < 0.05), but there were some cardiovascular side effects such as hypertension (remifentanil 0.03 microg/kg/min), hypotension and bradycardia (remifentanil 0.07 microg/kg/min) with using remifentanil. CONCLUSIONS: Remifentanil 0.05 microg/kg/min under anesthetic maintenance with sevoflurane showed better hemodynamic stability than the other two remifentanil groups during arthroscopic shoulder surgery.