Research Trends of Articles Published in the Journal of Korean Clinical Nursing Research from 2000 to 2017: Text Network Analysis of Keywords / 임상간호연구

PURPOSE: The aim of this study was to identify the research trends of articles published in the Journal of Korean Clinical Nursing Research from 2000 to 2017 by a text network analysis using keywords. METHODS: This study analyzed 600 articles. The R program was used for text mining that extracted frequency, centrality rank, and keyword network. RESULTS: From 2000 to 2009, keywords with high-frequency were ‘nurse’, ‘pain’, ‘anxiety’, ‘knowledge’, ‘attitude’, and so on. ‘Pain’, ‘nurse’, and ‘knowledge’ showed a high centrality. ‘Fatigue’ showed no high frequency but a high centrality. Keywords such as ‘nurse’, ‘knowledge’, and ‘pain’ also showed high frequency and centrality between 2010 and 2017. ‘Hemodialysis’ and ‘intensive care unit’ were added to keywords with high frequency and centrality during the period. CONCLUSION: The frequency and centrality of keywords such as ‘nurse’, ‘pain’, ‘knowledge’, ‘hemodialysis’, and ‘intensive care unit’ reflect the research trends in clinical nursing between 2000 and 2017. Further studies need to expand the keyword networks by connecting the main keywords.

Factors Influencing Quality of Nursing Service among Clinical Nurses: Focused on Resilience and Nursing Organizational Culture / 임상간호연구

PURPOSE: The purpose of this study was to examine nursing organizational culture and resilience and their effects on quality of nursing service. METHODS: A cross-sectional study was conducted. A convenience sampling method was used to collect data from 199 participants who worked in a tertiary hospital in G city. Demographic and work related variables, quality of nursing service, resilience, and nursing organizational culture were measured using validated self-report questionnaires. RESULTS: All of the participants were women and the majority were staff nurses and single. A statistically significant difference in quality of nursing service was found for age, marital status, educational level, clinical career, position and perceived health status. Age, educational level, clinical career, position, resilience, innovation-oriented culture, relation-oriented culture, and hierarchy-oriented culture were significant predictors of quality of nursing service, explaining 47% of total variance. Among the predictors, resilience was the strongest predictor, followed by innovation-oriented culture, and hierarchy-oriented culture. CONCLUSION: Findings indicate that quality of nursing service can be improved by raising individual nurse's resilience and advancing nursing organizational culture. Considering the identified factors, researchers and administrators need to develop and provide clinical nurses with a variety of programs to improve the quality of their nursing service.

Annual Report on the External Quality Assessment of Therapeutic Drug Monitoring and Testing for Drugs of Abuse in Korea (2015)

As an annual function of the Therapeutic Drug Monitoring Subcommittee of Korean Association of External Quality Assessment Service (K-EQAS), we organised two trials for an external quality assessment of therapeutic drug monitoring (TDM) and testing for drugs of abuse (DOA) in 2015. For the TDM assessment, we sent low- and high-level control materials from various clinical institutions, and for the DOA testing, we sent positive and negative control materials. The number of participating laboratories was 105 for the TDM trial and 106 for the DOA test. The average number of drug items provided was 5.6 per institution. The most commonly tested substances, in descending order, were: valproic acid, digoxin, vancomycin, tacrolimus, and carbamazepine. The mean inter-laboratory coefficients of variation for low- and high-level TDM control materials were 7.3% and 7.4%, respectively. The most widely used TDM analysers were the Architect i System (Abbott Diagnostics, USA), followed by the Cobas Integra (Roche Diagnostics, Switzerland) and the Cobas c501 analyser (Roche Diagnostics). The number of participating laboratories for the DOA analysis was 16% higher that than of our 2014 study. In 98.6% of cases, our analysis confirmed the reliabilityviability of the tests at participating DOA laboratories in both trials. In the external quality assessment of TDM by the TDM subcommittee of K-EQAS in 2015, the overall performance of TDM testing was found to be similar to that reported in previous years, and inter-laboratory precision was higher than that of 2014. Continuous improvement in the quality of TDM testing through participation in a proficiency-testing program will remain necessary in the future.

Relationships of Factors Affecting Self-care Compliance in Acute Coronary Syndrome Patients Following Percutaneous Coronary Intervention

PURPOSE: This study was conducted to identify direct and indirect factors influencing self-care compliance in patients with first acute coronary syndrome through examining the relationship among multidimensional factors. METHODS: Outpatients who made hospital visits to receive a follow-up care at more than 6 months after percutaneous coronary intervention were recruited at a national university hospital in Korea. Data of 430 participants were collected through self-administered questionnaires and analyzed using AMOS version 7.0. The fitness of the hypothetical model and the degree of significance of direct and indirect paths were analyzed. RESULTS: Three paths were found to have a significant effect on self-care compliance in the modified model. Social support indirectly influenced self-care compliance through enhancing self-efficacy, reducing anxiety and increasing perceived benefit. In addition, social support and body function indirectly influenced self-care compliance through reducing depression which affected self-efficacy. Self-efficacy was the most influential factor and played an important role as a mediating variable. CONCLUSION: Results of this study suggest that nurses' counselling and education as a form of social support should be encouraged to enhance self-efficacy and self-care compliance among outpatients during follow-up care after percutaneous coronary intervention.

Predictive Factors for the Recovery of Left Ventricular Dysfunction in Patients with Acute Myocardial Infarction

BACKGROUND AND OBJECTIVES: The left ventricular ejection fraction (LVEF) is known to be a significant prognostic factor for patients with acute myocardial infarction (AMI). The aim of this study was to investigate clinical or therapeutic factors associated with the recovery of a low LVEF for patients with AMI. SUBJECTS AND METHODS: From January to December 2004, we enrolled 89 patients (mean age: 62.5+/-10.6 years, 43 males and 26 females) with AMI and who had a LVEF less than 50%. Forty five patients whose LVEF improved more than 10% were classified as group I (mean age: 62.4+/-10.4 years, 34 males and 11 females) and 44 patients whose LVEF was not changed or decreased were classified as group II (mean age: 62.3+/-10.9 years, 29 males and 15 females). The clinical variables, including risk factors and the pain-to-door time, the biochemical markers of myocardial injury, the coronary angiographic findings and the treatment-related variables, were compared between the two groups. RESULTS: The cardiovascular risk factors were not different between the groups. The location of infarction, the success rate of percutaneous coronary intervention and the coronary angiographic lesion morphologies were not different between the groups. However, the pain-to-door time was significantly shorter in group I than in group II (6.0+/-9.5 vs 22.4+/-7.5 hours, respectively, p=0.046). Improved control of risk factors was not associated with the recovery of LV function. The use of beta-blocker, statin, anti-platelet agents, vasodilators and diuretics were not different between the groups. However, the use of angiotensin converting enzyme inhibitor (ACEI) was more common in group I than group II (79.3% vs 47.4%, respectively, p=0.03). CONCLUSION: A shorter pain-to-door time and the use of ACEI were significant predictors of the recovery of LV dysfunction for patients with AMI.

Clinical Value of GRACE Score in the Prediction of Mortality in Patients with Acute Coronary Syndrome / 대한구급학회지

BACKGROUND: This study was aimed to evaluate the validity of the Global Registry of Acute Coronary Event (GRACE) in patients with acute coronary syndrome (ACS). METHODS: One thousand thirty hundred seventy eight patients (63.6+/-12.0 years, 921 male), who were admitted at coronary care unit (CCU) of Chonnam National University Hospital between January 2004 and December 2005, were analyzed. The patients were divided into two groups: the survived group (n=1,298, 871 male, 63.1+/-9.7 years) and the moribund group (n=80, 50 male, 67.4+/-8.5 years). Clinical characteristics, risk factors for atherosclerosis, echocardiographic findings, GRACE score and NT-proBNP were compared between groups. RESULTS: The overall mortality was 5.8 %, 80 out of 1,378 patients. Mortality was higher in patients with Killip IV (46.7%, 50 out of 107 patients) than Killip II or III and elderly patients more than 80 years (42.7%, 38 out of 89 patients). High Killip class and old age were associated with high mortality (p<0.0001 respectively). Total score of GRACE was elevated in the moribund group (142+/-40.3 vs. 240+/-40.0) and high GRACE score was significant predictor of mortality (p<0.0001, r=0.827). Predictive factors for mortality by multiple logistic regression analysis were GRACE score (OR 1.15, 1.11~1.20 95%CI, p<0.0001) and old age (OR 0.88, 1.14~1.33 95%CI, p<0.001). CONCLUSIONS: GRACE score is useful predictor for the mortality of ACS at CCU.

The predictive factor of mortality and prognosis of cardiovascular patients admitted at coronary care unit / 대한내과학회지

BACKGROUND: The mortality rate of cardiovascular patients has been decreased after the introduction of coronary care unit (CCU), however data about that of Korean patients is rare. METHODS: Two thousand and eighty one patients (63.6+/-14.6 years, 1,295 male), who were admitted at CCU of Chonnam National University Hospital between January 2002 and June 2004, were analyzed. The admitted patients were divided into two groups: the survival group (Group I: n=1,926, 1,205 male, 62.3+/-13.9 years) and the death group (Group II: n=155, 90 male, 64.9+/-15.3 years). Clinical characteristics, risk factors for atherosclerosis, laboratory, echocardiographic and coronary angiographic findings were compared between the two groups. RESULTS: The overall mortality at CCU was 7.4% (155 out of 2,081 patients). Mean age and sex ratio were not different between the two groups. Coronary artery disease was the most common causes of both admission (1,606 out of 2,081 patients) and death (107 out of 155 patients). The clinical diagnoses of group II were myocardial infarction (n=70), unstable anginas (n=30), variant angina (n=2), congestive heart failure (n=17), aortic dissection (n=14) and arrhythmia (n=34). Left ventricular ejection fraction (LVEF) by echocardiogram was higher in Group I than in Group II (56.2+/-20.7% vs. 42.6+/-17.1%, p<0.001). Predictive factors for mortality according to multiple logistic regression analysis were low LVEF, use of intra-aortic balloon pump (IABP), inability to perform percutaneous coronary intervention (PCI) and high level of myoglobin. CONCLUSIONS: Death due to acute coronary syndrome was most common cause of CCU mortality. Decreased LVEF, insertion of IABP, inability to perform PCI and high myoglobin were associated with mortality of CCU admitted patients.

Five-year Clinical follow-up after Revascularization for Chronic Total Coronary Artery Occlusion / 대한구급학회지

BACKGROUND: Chronic total occlusion (CTO) has been considered as an unsuitable lesion for percutaneous coronary intervention (PCI) because of technical difficulty and low success rate. Owing to technical advances and increased operator's experience, PCI has been attempted in a large number of patients with CTO in recent years, but there are few long-term follow-up reports for PCI to CTO. METHODS: We analyzed 83 patients (59.7+/-9.2 years, 28 female) with CTO on diagnostic coronary angiogram at the Heart Center and Coronary Care Unit of Chonnam National Hospital from January 1996 to July 1997. The patients were divided into two groups according to revascularization by PCI or CABG (coronary artery bypass graft): the revascularized group (received PCI or CABG, Group I) and non-revascularized group (Group II). RESULTS: PCI was tried in 46 patients and successful in 33 patients (71.7% of the success rate). Eleven patients (13.3%) were treated with the coronary artery bypass graft (CABG) and 31 (37.3%) patients were medically treated. During 5-year clinical follow-up 11 patients died [13.1%; cardiac death 6 (7.1%), non-cardiac death 5 (6.0%)] and the major adverse cardiac events occurred to 24 (28.6%) patients. Cardiac death occurred to one patient of the Group I and 5 patients of Group II (p=0.06). The mean survival time was significantly different (57.8+/-9.2 months in Group I and 50.9+/-19.5 months in Group II, p=0.038). CONCLUSIONS: Revascularization for CTO prolonged the mean survival time of the patients on long- term clinical follow-up.

Predictive Factors for the Mortality of Cardiovascular Patients at Coronary Care Unit / 대한구급학회지

BACKGROUND: Recently the incidence of coronary artery disease has been increased rapidly in Korea. After the introduction of coronary care unit, the mortality rate of cardiovascular patients has been decreased. The predictive factors for mortality in patients admitted at Coronary Care Unit (CCU) are important in the management of acutely ill cardiovascular patients. METHODS: One thousand one hundred and thirty patients (64.8+/-14.5 years), who were admitted at CCU from January 2002 to June 2003, were analyzed. The patients were divided into two groups according to mortality: the survived group (Group I: n=1055, 63.3+/-13.3 years) and the moribund group (Group II: n=75, 64.8+/-14.1 years). Clinical characteristics, risk factors, clinical diagnosis, laboratory, echocardiographic and coronary angiographic findings were compared between the two groups. RESULTS: The overall mortality at CCU was 6.6%, 75 out of 1130 patients. Age and sex were not different between both groups. Coronary artery disease was the most common cause of admission (886 out of 1130 patients) and death (46 out of 75 patients). Coronary angiographic findings were not different between the two groups. Left ventricular ejection fraction (LVEF) by echocardiogram was higher in Group I than in Group II (53.1+/-15.6% vs. 42.3+/-16.3%, p<0.05). Predictive factors for mortality by multiple logistic regression analysis were low LVEF (OR 11.4, 2.9-21.4 95%CI, p<0.001), no performance of percutaneous coronary intervention (PCI, OR 10.8, 2.5-17.8 95%CI, p<0.001) and clinical diagnosis of aortic dissection (OR 3.8, 1.3-9.8 95%CI, p=0.021). CONCLUSIONS: The predictive factors for mortality at CCU were low LVEF, no PCI and aortic dissection.