Factors Associated with Post-Traumatic Growth in Patients with Breast Cancer Based on a Model of Post-Traumatic Growth

Purpose@#The study was to identify factors associated with post-traumatic growth (PTG) in patients with breast cancer based on Tedeschi and Calhoun’s model of PTG. @*Methods@#The participants were 150 patients who were diagnosed with breast cancer at C University Hospital and were undergoing treatment or attending regular follow-up visits after the completion of all treatments. Data were collected using structured self-administered questionnaires from January 20, 2021, to February 24, 2021. The data were analyzed through linear multiple regression. @*Results@#Factors associated with PTG were resilience (β=.51, p<.001), social support (β=.25, p<.001), and deliberate rumination (β=.14, p=.030), and these variables explained 45.0% of PTG. @*Conclusion@#Resilience was included in this study instead of self-exposure in Tedeschi and Calhoun’s PTG model. Oncology nurses should actively intervene to increase personal resilience, to strengthen social support systems, and to encourage patients to perceive breast cancer occurrence as a meaningful event since breast cancer patients can experience PTG throughout the entire period of treatment and post-treatment.A revised model should be validated in future studies.

Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy

Purpose@#The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. @*Methods@#The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. @*Conclusion@#The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy

Purpose@#The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. @*Methods@#The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. @*Conclusion@#The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

Knowledge Structure of Chronic Obstructive Pulmonary Disease Health Information on HealthRelated Websites and Patients’ Needs in the Literature Using Text Network Analysis

Purpose@#The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD). @*Methods@#Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis. @*Results@#The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management. @*Conclusion@#The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients’ needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.

Comparison of the Characteristics Among Deceased Do-Not-Attempt-Resuscitation (DNAR) Cancer Patients in Hospice and Oncology Wards

Purpose@#This was a descriptive study to compare the characteristics and outcomes among deceased cancer patients that had do-notattempt-resuscitation (DNAR) agreements in hospice and oncology wards. @*Methods@#Subjects of this study were 250 patients with terminal cancer who died after making DNAR agreements from January 1, 2015 to December 31, 2016 . The subjects were divided into two groups those that died in hospice (n=150) and those that died in oncology wards (n=100). Data were collected from August 2017 to February 2018. Two trained investigators independently reviewed the medical records for subjects using survey tools developed by the researchers (r=.81). @*Results@#Among the general characteristics between two groups, there were differences in age (t=-2.54, p=.012) and education (χ2=5.96, p=.015). Among the disease related characteristics, there were differences in surgery history (χ2=10.09, p=.001), chemotherapy history (χ2=11.08, p=.002) and symptoms (t=5.14, p<.001) between the two groups. Among the treatment related characteristics, there were differences in chemotherapy at death (χ2=9.61, p=.002), radiotherapy at death (χ2=5.60, p=.018) and cardiopulmonary resuscitation (χ2=6.15, p=.029) between the two groups. Among nursing related characteristics, there was a difference in the frequency of nursing intervention after DNAR consent (t=3.72, p<.001) between the two groups. Among outcomes related characteristics, there were differences in consciousness state at the DNAR consent (χ2=64.82, p<.001), self-written consent (χ2=18.26, p=.001), hospitalization days (t=2.31, p=.022) and the cost per day of hospitalization (t=-4.81, p<.001) between the two groups. @*Conclusion@#This study found that the patients, families, and medical staff need to change their perception of hospice and palliative care to prevent medical expenses from rising due to unnecessary life-support treatment while preparing for death with family members.

A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design

PURPOSE@#This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students.@*METHODS@#In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test.@*RESULTS@#The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=−6.49, p < .001) and clinical judgment (t=−4.71, p < .001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202).@*CONCLUSION@#The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.

A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design

PURPOSE: This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students. METHODS: In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test. RESULTS: The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=−6.49, p < .001) and clinical judgment (t=−4.71, p < .001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202). CONCLUSION: The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.

A Comparative Study on the Characteristics of Cancer Patients and Cancer Survivors

PURPOSE: The purpose of the study was to identify and compare the characteristics of cancer patients and cancer survivors. METHODS: This study used data from the Korea National and Health Nutrition Examination Survey (2010~2015), conducted by the Center for Disease Control and Prevention. This study included 455 cancer patients and 567 cancer survivors. The data were analyzed by descriptive statistics, t-tests, and χ2. RESULTS: Cancer survivors were less compliant compared to cancer patients in drinking frequency (χ2=13.12, p ≤.001), drinking volume (χ2=13.35, p=.001) and cancer screening tests (χ2=4.79, p=.029). Cancer patients showed higher body weight change compared to cancer survivors (χ2=7.37, p=.025). There was no difference in quality of life (QoL) between the two groups (t=1.38, p=.169). CONCLUSION: This study indicates that cancer survivors have poor living habits and no improvement in QoL compared to cancer patients. Oncology nurses should pay attention to cancer survivors compliance of living habits to prevent secondary cancer and to improve their QoL.

Outcomes of patients treated with Sengstaken-Blakemore tube for uncontrolled variceal hemorrhage

BACKGROUND/AIMS: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. METHODS: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed. RESULTS: The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018). CONCLUSIONS: Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.

Effect of Debriefing Based on the Clinical Judgment Model on Simulation Based Learning Outcomes of End-of-Life Care for Nursing Students: A Non-Randomized Controlled Trial

PURPOSE: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. METHODS: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. RESULTS: ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p < .001), clinical judgment (F=18.33, p < .001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=−0.38, p=.704) between the experimental and control groups. CONCLUSION: This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial

PURPOSE: This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma. METHODS: Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables. RESULTS: There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL. CONCLUSION: This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

A Systematic Review of Home based Pulmonary Rehabilitation in COPD Patients: Randomized Controlled Trials / 재활간호학회지

PURPOSE: The purpose of this study was to review systematically the effects of home based pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients using qualitative synthesis. METHODS: Studies designed randomized controlled trials were identified to extract data and to assess the quality of studies in 8 domestic and 3 foreign search engines, and hand search reference reviews. RESULTS: A total of 9 studies met the inclusion criteria. Overall, the methodological quality of the studies ranged from average to poor. Home based pulmonary rehabilitation consisted of exercise, education, and psychosocial interventions. Several exercises such as aerobic, strength, respiratory muscle training, and flexibility were used in home based pulmonary rehabilitation for COPD patients. Upper muscle exercise and walking were the most frequently used exercises. The most common topics for education were ‘knowledge of the illness’ and ‘drug management’. Walking distance test (WDT) and quality of life (QoL) were the most frequently measured as the dependent variables to evaluate rehabilitation outcomes, followed by pulmonary function test (PFT) and dyspnea. WDT was the most effective outcome, followed by dyspnea, QoL and PFT. CONCLUSION: This study informed about the details of scientific and effective home based rehabilitation programs in COPD patients for future researchers and clinicians. These findings can help expand the recognition and accessibility of home based rehabilitation in COPD patients.

Effects of Dietary Program based on Self-efficacy Theory on Dietary Adherence, Physical Indices and Quality of Life for Hemodialysis Patients

PURPOSE: The purpose of this study was to examine effects of a dietary program based on self-efficacy theory on dietary adherence, physical status and quality of life (QoL) in hemodialysis patients. METHODS: A non-equivalent control group pre-post test design was used. The intervention group received the dietary program for 8 weeks from August 4 to September 26, 2014. The control group received only usual care. RESULTS: ANCOVA showed that dietary adherence (F=64.75, p<.001) was significantly different between the two groups. Serum albumin (F=12.13, p =.001), interdialytic weight gain (F=56.97, p<.001), calories (F=15.80, p<.001) as physical status indices were significantly different, but serum potassium (F=2.69, p=.106) and serum phosphorus (F=1.08, p=.303) showed no significant difference between the two groups. In terms of health-related QoL, the physical component scale (F=10.05, p=.002) and the mental component scale (F=16.66, p<.001) were significantly different between the two groups. In addition, in terms of diet related QoL, diet level (F=35.33, p<.001) and satisfaction level (F=15.57, p<.001) were significantly different between the two groups, but dietary impact level (F=1.23, p =.271) was not significantly different. CONCLUSION: Findings show that the dietary program based on self-efficacy theory is an effective nursing intervention program to improve adherence to diet, and to maintain physical status and QoL for hemodialysis patients.

Effect of Self-monitoring Rehabilitation Program after Stroke on Physical Function, Self-efficacy and Quality of Life / 재활간호학회지

PURPOSE: This study was conducted to identify the effects of a self-monitoring rehabilitation program based on the Bandura's self-efficacy theory on the activities of daily living (ADL), 6-minute walking distances, self-efficacy and quality of life (QoL) among stroke patients after three to six months. METHODS: The participants consisted of 29 patients in the experiment group and 28 patients in the control group who admitted at rehabilitation specific hospital. Self-monitoring program developed by the researcher lasted twice a week for 8 weeks from August to September, 2013. RESULTS: ANCOVA showed that all of dependent variables of this study, ADL and 6-minute walking distances as a physical function, self-efficacy and QoL for intervention group were higher than those for control group(p<.001). CONCLUSION: The self-monitoring rehabilitation program based on the self-efficacy theory was found to be effective in improving physical function, self-efficacy and QoL for early post-stroke patients. Early rehabilitation program for stroke patients was recommended to consider the self-monitoring of current physical and psychosocial status as a strategy of self-management.

Systematic Search for Guidelines to Prevent Catheter-associated Urinary Tract Infections-Part II: Using the Ovid MEDLINE / 간호행정학회지

PURPOSE: To implement evidence-based nursing, it is important to know where and how to find the best available evidence. This study was conducted to identify the results of a search from Ovid MEDLINE and to compare the results from Ovid MEDLINE with those from PubMed MEDLINE. METHODS: Four different approaches via Ovid MEDLINE were used to search for guidelines on preventing catheter-associated urinary tract infections. Outcomes of this study were the number of records and relevant literature, and the sensitivity and precision of the search methods via Ovid MEDLINE. RESULTS: The number of retrieved items ranged 23 to 6,005 and that of relevant studies, 5 to 8 of 8. Simple searches resulted in the highest sensitivity of 100.0%. When using MeSH terms and limits feature, the precision was highest (21.7%) among four approaches for literature searches. Simple searches in Ovid had higher sensitivity and lower precision than those in PubMed. CONCLUSION: Simple searches in Ovid may be inefficient for busy clinicians compared to PubMed. However, to ensure a comprehensive and systematic literature search, using Ovid MEDLINE in addition to PubMed is recommended.

Factors Associated with Early Nutritional Status after Radical Gastrectomy in Patients with Gastric Cancer

PURPOSE: The aims of this study was to identify factors associated with nutritional status after radical gastrectomy in patients with gastric cancer at the post 1 month and the post 3-6 months independently. METHODS: Participants consisted of 107 patients at the post 1 month and 131 patients at the post 3-6 months after radical gastrectomy. Data were collected from October 1, 2013 to May 14, 2014 using a Patient-Generated Subjective Global Assessment (PG-SGA), the Hospital Anxiety and Depression Scale (HADS) and the Connor-Davidson Resilience Scale (CD-RISC). RESULTS: Stepwise multiple regression showed that factors associated with nutritional status at 1 month after radical gastrectomy were age (beta=.55, p<.001), anxiety (beta=.25, p=.007), and depression (beta=.23, p=.017), which explained the 42.6% of total variance of nutritional status. However, factors associated with nutritional status at 3-6 months after radical gastrectomy were depression (beta=.41, p=.017), return to work (beta=.20, p<.001), and age (beta=.29, p=.024), which explained 27.1% of the total variance of nutritional status. CONCLUSION: In conclusion, oncology nurses should be sensitive to the risk group of aged, depressed, anxious and delayed return to work patients for nutritional status during the early recovery period after radical gastrectomy.

Present Condition and Future Direction of Clinical Practicum for Oncology Advanced Practice Nursing Programs

PURPOSE: This study was conducted to identify the present conditions of clinical practicum through analyzing guidebooks used in education institutions for oncology advanced practice nursing programs and to discuss future directions. METHODS: Ten of a total of 13 education institutions participated in this study and ten guidebooks were reviewed from June 1 to October 31, 2014. The standard curriculum developed by the Korean accreditation board of nursing education was used to analyze the present conditions and an analyzing frame was developed by a research team. Two coders independently recorded the data, agreement was 92% and all disagreements was concurrent after discussion. RESULTS: Courses in the area of 'advanced oncology nursing' were most highly established and, courses in the area of 'introduction of oncology nursing' were least established. Some learning objectives were never dealt with and some learning objectives were over dealt with. The national cancer center was most used for practicum. Diverse homework and evaluation methods were used. CONCLUSION: Through analyzing clinical practicum guidebooks for oncology advanced practice nursing students, we found that balanced practicum courses are needed to improve the quality of oncology advanced practice nurse programs.

Relationship of Body Weight, Anxiety Depression, and Quality of Life in Patients with Radical Gastrectomy according to Perioperative Period

PURPOSE: The purpose of this study was to identify the relationship of quality of life (QoL) with body weight, anxiety, and depression according to perioperative period. METHODS: Data were secondarily analyzed from 30 gastric cancer patients. RESULTS: There were positive relationships of anxiety with depression (r=.42, p=.019) and appetite symptoms of QoL (r=.41, p=.023) at preoperative day one. There were negative relationships of body weight with physical function of QoL (r=-.40, p=.026), and positive relationships of anxiety with depression (r=.37, p=.044) and constipation symptom of QoL (r=.38, p=.034) at postoperative day 7. Also, at postoperative one month, there were positive relationships of body weight with physical function (r=-.45, p=.011) and constipation symptom (r=.37, p=.039). There was a negative relationship of anxiety with emotional function (r=-.39, p= .035), a negative relationship of depression with physical function (r=-.43, p= .018), and a positive relationship of depression with finance (r=.39, p=.034). CONCLUSION: Oncology nurses should consider diverse factors during the early postoperative period to increase QoL. Also, appropriate and timely interventions should be provided to minimize the negative influence on QoL.

Comparison of Blended Practicum Combined E-learning between Cooperative and Individual Learning on Learning Outcomes / 한국간호교육학회지

PURPOSE: This study was conducted to compare blended practicum with clinical and lab combined e-learning between cooperative and individual group on learning outcomes. METHOD: A total of 63 junior Nursing students were recruited from C University in G city from May, 2012 to June, 2012. Ten hours lab practicum for two weeks was provided for both two groups during the period of adult nursing practicum. Prior to blended practicum, e-learning was conducted. For cooperative group, two hours off line team learning with a tutor for eight weeks was provided, in other hands, for individual group, any off line team learning was not provided and self study on line was not evaluated by the tutor. RESULTS: The result of ANCOVA showed that critical thinking and self directed learning were significantly improved in the individual group compared to the cooperative group (F=-18.15, p<.001; F=28.12, p<.001). In other hands, clinical competence was significantly higher in the cooperative group than in the individual group (F=16.61, p<.001). CONCLUSION: Through development of self-leaning facilitating online contents, the blended practicum combined e-learning could be effective in critical thinking, self-directed learning and clinical competence. Further studies about e-learning strategies of off-line learning are still needed.

An Example of Systematic Searching for Guidelines to Prevent Catheter-associated Urinary Tract Infections - Part I: Using the PubMed Database / 간호행정학회지

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.