Analysis of Current Status of the Community Health Nursing Practice Education

PURPOSE: The purpose of this study was to provide basic evidence to improve community health nursing practice education by analyzing the current status of actual operation, program outcomes and evaluation methods, and the level of achieving learning goals. METHODS: Data were collected through an e-mail survey from 155 professors teaching community health nursing in April 2016. Out of 45 responses in total, 42 cases were used for analysis (response rate 29.0%). RESULTS: Community health nursing practice was a 3-credit course in most of the schools (66.7%) and included a practice at public health centers without exception. The most common diagnosis classification system was OMAHA (81.0%). The core fundamental nursing skills evaluated during the practice were subcutaneous injection, vital signs, oral administration, and intradermal injection. Among the subjects of community health nursing practice, the area with the highest potential for achieving learning goals was primary health care provision (4.4/5) and the area with the lowest potential was disaster management (2.4/5). CONCLUSION: The results of this study show that there would be active efforts to complement and improve several problems of the community health nursing practice among the community health nursing practice instructors for more effective and qualitative community health nursing practice.

Substrate reduction therapy in three patients with Gaucher disease

PURPOSE: Gaucher disease (GD) is the most common lysosomal storage disease caused by beta-glucocerebrosidase (GBA) deficiency. Oral substrate reduction therapy with miglustat (Zavesca®) was approved for the treatment of adults with GD type 1, for whom enzyme replacement therapy (ERT) is unsuitable or not a therapeutic option. In this study, we report the effect of miglustat (Zavesca®) in three Korean GD patients. MATERIALS AND METHODS: Clinical findings comprising age at diagnosis, presenting signs, laboratory findings at diagnosis, GBA activity and mutations, and clinical courses of the three patients were reviewed. RESULTS: Miglustat was administered to three patients who reported allergic reactions during intravenous imiglucerase infusions. One patient withdrew after 15 months of miglustat administration owing to continuous elevation of disease biomarker levels (chitotriosidase, acid phosphatase, and angiotensin-converting enzyme). Poor adherence to medication was suspected but was denied by the patient. In the other two patients, platelet count and levels of hemoglobin and other biomarkers remained stable during miglustat administration. However, they suffered from severe diarrhea and weight loss, which led to miglustat discontinuation after 1 and 12 months of administration. CONCLUSION: Our study shows that although miglustat is suggested to GD patients as an alternative treatment to ERT, significant adverse reactions may lead to discontinuation of miglustat. In addition, it is difficult to monitor the drug adherence.

Phelan-McDermid syndrome presenting with developmental delays and facial dysmorphisms / 소아과

Phelan-McDermid syndrome is a rare genetic disorder caused by the terminal or interstitial deletion of the chromosome 22q13.3. Patients with this syndrome usually have global developmental delay, hypotonia, and speech delays. Several putative genes such as the SHANK3, RAB, RABL2B, and IB2 are responsible for the neurological features. This study describes the clinical features and outcomes of Korean patients with Phelan-McDermid syndrome. Two patients showing global developmental delay, hypotonia, and speech delay were diagnosed with Phelan-McDermid syndrome via chromosome analysis, fluorescent in situ hybridization, and multiplex ligation-dependent probe amplification analysis. Brain magnetic resonance imaging of Patients 1 and 2 showed delayed myelination and severe communicating hydrocephalus, respectively. Electroencephalography in patient 2 showed high amplitude spike discharges from the left frontotemporoparietal area, but neither patient developed seizures. Kidney ultrasonography of both the patients revealed multicystic kidney disease and pelviectasis, respectively. Patient 2 experienced recurrent respiratory infections, and chest computed tomography findings demonstrated laryngotracheomalacia and bronchial narrowing. He subsequently died because of heart failure after a ventriculoperitoneal shunt operation at 5 months of age. Patient 1, who is currently 20 months old, has been undergoing rehabilitation therapy. However, global developmental delay was noted, as determines using the Korean Infant and Child Development test, the Denver developmental test, and the Bayley developmental test. This report describes the clinical features, outcomes, and molecular genetic characteristics of two Korean patients with Phelan-McDermid syndrome.

The Effects of an Individual Cognitive Improvement Program on the Elderly with Mild Cognitive Impairments

PURPOSE: This study was conducted to investigate changes in cognitive functions, depression and life-satisfaction for elderly participants with mild cognitive impairments participating in an individual cognitive improvement program. METHODS: A quasi-experimental with non-equivalent control group pretest-posttest design was implemented. The participants were senior citizens over 65 years of age who had been clinically diagnosed with mild cognitive impairments in G City and J Province (experimental group: 29, control group: 27). The experimental group participated in the individual cognitive improvement program based on Korean traditional tales and games for nine weeks. RESULTS: After the intervention, only the participants in the experimental group reported significant improvement in K-MMSE (t=-2.5, p=.016), MoCA-K (t=-2.6, p=.008), depression (t=3.51, p=.001), and life satisfaction (t=-2.75, p=.008) when compared to those in the control group. CONCLUSION: These results indicated that the individual cognitive improvement program was effective in improving cognitive functions, depression, and life-satisfaction among the elderly with mild cognitive impairments. Therefore, the application of this individual cognitive improvement program developed in this study by visiting nurses may strengthen the cognitive functions of seniors with mild cognitive impairments.

Distribution of five common subtypes of spinocerebellar ataxia in the Korean population

PURPOSE: Spinocerebellar ataxia (SCA) is a genetically heterogeneous disease for which more than 30 subtypes have been identified. However, 5 subtypes, SCA1, SCA2, SCA3, SCA6, and SCA7, account for more than 60% of cases. In this study, we report the distribution of these 5 subtypes in Korean patients. MATERIALS AND METHODS: Six hundred and thirty-eight unrelated patients with a presumptive diagnosis of SCA were included in this study. Trinucleotide (CAG) repeat number (TNR) repeat number was determined using fluorescently labeled primers and fragment analysis. RESULTS: A total of 128 unrelated patients (20.1% of all individuals tested) tested positive for SCA subtypes, including SCA1 (5 patients, 3.9% of those testing positive), SCA2 (38 patients, 29.7%), SCA3 (30 patients, 23.4%), SCA6 (39 patients, 30.5%), and SCA7 (16 patients, 12.5%). The mean copy number of pathogenic TNR alleles was 45+/-8.5 for SCA1, 42+/-3.1 for SCA2, 72+/-5.4 for SCA3, 23+/-1.5 for SCA6, and 50+/-11.4 for SCA7. TNR copy number was inversely correlated with onset age in SCA2, SCA6, and SCA7. CONCLUSION: SCA2, SCA3, and SCA6 are common SCA subtypes in Korean patients and could be screened as a first-line test. Expanded pathogenic allele size was associated with early onset age.

A familial case with brachydactyly type C with a GDF5 mutation

Brachydactyly type C is a limb malformation characterized by shortening of the second, third, and fifth middle and/or proximal phalanges, but it has variable phenotypic expressivity. Mutations in the growth differentiation factor-5 (GDF5) gene cause isolated brachydactyly C. Herein, we report a familial case with isolated brachydactyly type C characterized by brachymesophalangy of both second and third digits, with a GDF5 missense mutation, and discuss the phenotypic variability of the condition. Identifying more cases with genetic confirmation will help elucidate the clinical and genetic characteristics of this condition in the Korean population.

Job Stress, Organizational Commitment, Way of Coping and Turnover Intention among Korean Visiting Nurses / 한국직업건강간호학회지

PURPOSE: The purpose of the study was to identify factors related to turnover intention among Korean visiting nurses. METHODS: The data from 192 of 208 nurses working in southern part of Korea were collected for analysis during in-service education in May 19~20, 2011. Descriptive statistics, chi-square tests, ANOVA, and logistic regression analysis were performed using SPSS 19.0 program. RESULTS: Among the general characteristic factors, young, married, university graduation, lower satisfaction with income and longer work experience as a nurse were associated with higher odds of turnover intention. Organizational commitment was associated with low turnover intention. Way of coping was not statistically significantly associated with turnover intension. CONCLUSION: Stress from the organizational system was found to be the most important variable that explains the turnover intention in this study. Use of sensible communication methods and introduction of effective conflict resolution system is suggested to reduce turnover intention. Further research is recommended to identify the job demands and organizational systems of visiting nurses.

The Effects of Pelvic Floor Muscle Exercise on Urinary Symptoms and Quality of Life in Women with Stress Urinary Incontinence

PURPOSE: The purpose of this study was to identify the effects of pelvic floor muscle exercise on reducing the symptoms of stress urinary incontinence and improving attitude toward exercise and quality of life. METHOD: The research adopted was a nonequivalent control group pretest posttest design. The subjects were 55 persons who were surveyed using a structured questionnaire, and 23 persons in the experimental group among the total sample were measured for the peak pressure and the duration of PMC and trained correct pelvic floor muscle contraction using peritron in the first week. Then, pelvic floor muscle exercise was implemented for 6 weeks. The data was analyzed by chi2-test and t-test with the SPSS 10.0 program. RESULTS: 1) The degree of stress urinary incontinence, frequency of urination, nocturia, urgency, noctural incontinence, the frequency and quantity of incontinence, outer clothing change and incomplete emptying decreased significantly more in the experimental group than in the control group. 2) Attitude toward pelvic floor muscle exercise and the quality of life were improved significantly more in the experimental group than in the control group. 3) The peak pressure and duration of PMC increased significantly more in the posttest. CONCLUSION: Based on the results above, it is judged that pelvic floor muscle exercise is an effective nursing intervention in order to care for stress urinary incontinence.

The Effects of Taekwon Aerobic Exercise on Obesity Indices and Cardiovascular Risk Factors in Middle-Aged Obese Women

PURPOSE: The purpose of this study was to identify the effects of taekwon aerobic on obesity indices and cardiovascular risk factors in middle-aged obese women. METHOD: Data were collected from 19 middle-aged obese women who participated in taekwon aerobic exercise. This research adopted one-group pretest-posttest design. Taekwon aerobic was applied 3 times in a week for 12 weeks, and the obesity indices and cardiovascular risk factors were checked before and after the program. Body weight, BMI and % body fat for obesity indices were checked, and total cholesterol, triglyceride, HDL-cholesterol and the ratio of total cholesterol/HDL-cholesterol for cardiovascular risk factors were measured. The data was analyzed by paired t-test using SPSS/Win 10.0. RESULTS: There were significant differences in body weight, BMI and % body fat after the taekwon aerobic exercise. There was a significant difference in total cholesterol. However, there were no significant differences in triglyceride, HDL-cholesterol and the ratio of total cholesterol/HDL-cholesterol after the taekwon aerobic exercise. CONCLUSION: This study showed that taekwon aerobic exercise decreased obesity indices and lowered total cholesterol in the cardiovascular risk factors. The results of this study show that taekwon aerobic exercise is effective in enhancing the health of middle-aged obese women.

A Study of Health Concerns, Health Behavior, and Related Factors in Elders in Senior Centers / 기본간호학회지

PURPOSE: This study was conducted to analyze the health concerns, health behavior, and related factors for elders taking part in activities at senior centers. METHOD: A total of 811 elders were selected through conveniently sampling. Data were collected from November 21, 2006 to December 20, 2006. Data analysis included frequency, t-test, ANOVA, Duncan test, and Stepwise Multiple Regression using SPSS Win 15.0. RESULTS: For health concerns statistically significant differences were found for gender, age, family, pockety money, sleeping time, regular health check-ups, and exercise. For health behavior statistically significant differences were found for gender, age, family, pocket money, religion, medical insurance, perceived health status, sleeping time, regular health check-ups, chronic illness, regular breakfast, exercise, and drinking. Perceived health status was identified as a variable influencing the health behavior. CONCLUSION: The results suggest that perceived health status can be considered as factor for significant nursing interventions to help single elders and older elders in senior centers.

A Study through Individual Interaction on the Achievement Rate of Smoking Cessation Goal and Characteristics Related to Smoking Cessation in College Smokers

PURPOSE: This study was to examine the achievement rate of smoking cessation, to identify obstacles to smoking cessation, and to find means to achieve the goal of smoking cessation in college smokers. METHOD: This study was conducted from April 26th to September 13th 2004 and used a one-shot design. The subjects selected by convenient sampling were 29 college smokers who smoked over one cigarette a day, had a positive level of urine cotinine, participated in smoking cessation education 3 times. Thereafter, individual interaction was processed between the researcher and the subject using an interaction instrument. Data were analyzed based on frequencies.,percentages and means using SPSS/Win 10.0. RESULTS: The achievement rate of smoking cessation was 20.7% (6 students). The biggest obstacles smoking cessation were smoking stimuli (29 students) and lack of control (25 students). Among detailed obstacles, the biggest one was smoking at regular times, which was followed by withdrawal symptoms, smoking on drinking, and company with other smokers. The most effective means of smoking cessation mentioned by the subjects were in order of avoiding drinking situations, taking deep breaths, and exercising. CONCLUSION: The results of this study, using King's theory, showed that individual interaction is effective in achieving smoking cessation. Therefore, it is suggested to make further study and broaden smoking cessation education for college smokers.

Effect of an Agreement on Means to Achieve Smoking Cessation Goals among College Student Smokers / 간호학회지

PURPOSE: The purpose of this study was to identify the degree of attaining a smoking cessation goal when an agreement on means to achieve smoking cessation among male college student smokers was established. METHOD: This study was planned as a nonequivalent control group non-synchronized design and the sample was divided into an agreement group and a comparison group by convenience sampling in a college of G city. The data was analysed with SPSS Win10.0 using a Likelihood chi2-test, Odds ratio, Paired t-test and ANCOVA. RESULT: The theory that the degree of smoking cessation will be higher in the agreement group than the Comparison group was rejected (delta = 2.567, p = .055). The theory that nicotine dependency will be lower in the agreement group than the comparison group was supported (F = 3.965, p = .049); however, the theory that the number of cigarettes smoked per day will be lower in the agreement group than the comparison group was rejected (F = 1.342, p = .252). CONCLUSION: It has been shown that an agreement on means to achieve smoking cessation goals is a key factor to success in quitting smoking.

Study to Develop Linkages between Nursing Diagnoses and Interventions / 성인간호학회지

PURPOSE: This study was performed to validate the linkage between nursing diagnoses and nursing interventions by identifying performance and importance of nursing interventions linked to five NANDA nursing diagnoses. METHOD: Data was collected from 153 staff and head nurses working in 4 hospitals in K city. The results were analyzed using mean, SD and spearman correlation for ranking correlation. RESULT: The most importantly considered interventions were Medication Administration (IV) for pain, Pain Management for Constipation, Intravenous (IV) Insertion for Diarrhea, treatment, Vital Sign Monitoring for Hyperthermia, and Vital Sign Monitoring for Infection risk. The most frequently performed interventions was Medication Administration (IV) for Pain, Fluid Management for Constipation, Intravenous (IV) Insertion for Diarrhea, Vital Sign Monitoring for Hyperthermia, and Vital Sign Monitoring for Infection: Risk for. The rank correlations between importance and performance were highest in Diarrhea and lowest in Constipation. CONCLUSION: The above findings can be used to develop a nursing information system which can be used to facilitate documenting the nursing process, and a nursing information system developed by this research process will ultimately contribute to identifying nurses contribution to patient health.

Comparison on Nursing Importance and Performance of Nursing Interventions linked to Nursing Diagnoses-focused on 5 NANDA Nursing Diagnoses / 간호학회지

PURPOSE: The purpose of this study was to identify nursing importance and the performance of nursing interventions linked to five nursing diagnoses and find out core nursing interventions to each of the five nursing diagnosis. The five nursing diagnoses were Pain, Diarrhea, Constipation, Hyperthermia, and Infection: Risk for. METHOD: Data was collected from nurses working in four different hospitals. Data were analyzed using mean, SD, and paired t-test to compare difference between importance and performance of each intervention. RESULT: In general interventions related to medication, such as Medication Administration: IV, Medication Administration: IM, Medication Administration: Oral, Medication Management were all considered highly important and performed very often regardless of nursing diagnoses. And the level of importance was higher than the performance in most of all the interventions linked to five nursing diagnoses. Only two interventions, Medication Administration and Intravenous (IV) insertion had higher level of performance than importance in the diagnoses of Pain and Diarrhea respectively. CONCLUSION: Using the above findings, we now know which intervention should be performed more frequently to solve nursing problems and which interventions are more critically important to nursing diagnosis. This information can be very helpful for developing nursing information system.

The Impact on Supportive Education on the Effectiveness of Breast Self-examination among College Women and Correlate to Self-Efficacy / 성인간호학회지

Currently, breast cancer ranks third among women's cancers, and as its incidence is increasing, the incidence age is also becoming lower. Therefore it is necessary to address breast cancer for women in their twenties. As there is no way presently to prevent breast cancer, it is imperative that women take available interventions against predisposing factors. It is thus advisable that women acquire the necessary skills to recognize their own health status. The purposes of this study were to identify the effects of education on breast self-examination (BSE) through supportive education among college women during the period from August 2000 to February 2001, and to attempt to design an effective BSE educational program. The first class was implemented through lectures, pamphlets, videotapes, breast palpation on cloths, demonstration and practice for identification of breast masses through palpation using breast model. Supportive education was implemented bimonthly to the experimental group, and effects of the education between experimental and control groups were compared 6 months later. The results of this study are summarized as follows: 1. The effects on supportive education of college women in BSE 1) The mean score of retained knowledge about breast cancer and BSE was 30.88 in the experimental group, and 29.66 in the control group and significantly greater in the experimental group than in the control group (t= -2.062, p= 0.041). 2) Frequency of BSE practice was significantly greater in the experimental group than in the control group(X2=0.045, p=0,012). 3) The mean accuracy score in BSE practice was 19.10 in the experimental group, and 18.29 in the control group; accuracy was higher in the experimental group than in the control(t= -2.035, p= 0.444). 4) The mean score of self-efficacy was 35.05 in the experimental group, and 31.22 in the control group. The experimental group mean score was higher(t=-3.016, p=0.003). 2. There was a statistically significant correlation between self-efficacy and accuracy of BSE(r= 0.447, p=0.000), knowledge of breast cancer and BSE(r= 0.306, p=0.000) and frequency of BSE(r=0,259, p=0,002) but no significant correlation between knowledge of breast cancer and BSE and frequency of BSE (r=0.071, p=0.403). On the basis of this study, periodic supportive education can increase knowledge of breast cancer and BSE, frequency of BSE, accuracy of BSE and self-efficacy. Suggestions: 1. There is a need to compare the effects of individual programs to acquire BSE behaviors in the young. 2. Further research is needed to test the continuity of the effects of BSE education.