Feasibility Evaluation of Korean Advance Directives (K-AD) / 한국간호교육학회지

PURPOSE: This study evaluates the feasibility of Korean Advance Directives (K-AD) developed earlier. METHODS: From January 1 to February 28, 2013, data were collected from 330 adults through a self-reported questionnaire established by the authors based on literature review and expert consultation. The feasibility of K-AD was multi-dimensionally evaluated through four criteria: cognitive, psychological, document making and socially expecting aspects. Data were analyzed using t tests, one-way ANOVA, and Scheffe post hoc tests via the SAS 9.1.3 program. RESULTS: The feasibility of K-AD differed significantly by gender (p=.003), educational level (p<.001), religion (p=.002), and self-reported health status (p=.039). Differences in the level of easiness with K-AD by gender (p=.008) and education (p=.047) were significant. Perceived simplicity of AD differed significantly by religion (p=.005), and the necessity of AD differed significantly by gender (p=.025) and religion (p=.005). CONCLUSION: K-AD are sufficiently feasible to be tentatively utilized in practice. This is the first study to explore the feasibility of K-AD on the basis of multiple aspects. However, further studies involving diverse populations and methodologies to validate the usefulness of K-AD are warranted.

Development of a Korean Version of an Advance Directive Model via Cognitive Interview / 한국호스피스완화의료학회지

PURPOSE: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). METHODS: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. RESULTS: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. CONCLUSION: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

Death Anxiety and Terminal Care Stress among Nurses and the Relationship to Terminal Care Performance / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to examine how nurses' death anxiety and terminal care stress affect their terminal care performance in the clinical setting. METHODS: The study enrolled 180 registered nurses with experience of attending dying patients at a university hospital located in Seoul, Korea. Collected data were analyzed with descriptive statistics, one-way ANOVA and Pearson's correlation using SPSS 18.0 for Windows. RESULTS: Nurses showed significant differences in the level of death anxiety and terminal care stress as well as terminal care performance by working division, marital status, educational background and hospice training. A significant relationship was found between terminal care stress and terminal care performance. CONCLUSION: The study results showed that efforts to ease nurses' death anxiety and terminal care stress could improve their terminal care performance. Further study should be conducted to investigate other factors that affect nurses' terminal care performance from various perspectives and develop a terminal care manual which can be used as guidance for nurses in charge of terminal patient care.

Influence of Personal Characteristics, Childhood abuse and Stressful Experience on Suicidal Ideation in Middle School Students

PURPOSE: The purpose of this study is to investigate the factors influencing suicidal ideation in middle school students. METHODS: Suicidal Ideation Questionnaire (SIQ) results, personal characteristics, child abuse experiences, and stress were obtained from a sample of 657 middle school students from 3 conveniently selected schools in S city. RESULTS: Suicidal ideation of participants was positively correlated with child abuse experience, stress, psychosomatic symptoms, antisocial personality and depressive tendencies, whereas sociability and self-esteem were negatively correlated with suicidal ideation. Significant factors influencing suicidal ideation included an antisocial personality tendency, stress related to the family environment, mental abuse, gender (female), depressive trend, running away from home, sociability, and stress related to academic performance. These factors explained 39.9% of the variance. CONCLUSION: These results suggest that earlier screening and intervention programs for depression and stress in middle school students will be helpful in reducing suicidal ideation. Further studies are needed in which other strategies that could prevent suicidal ideation in middle school students are examined.

Trend of Mortality Rate and Injury Burden of Transport Accidents, Suicides, and Falls / 예방의학회지

OBJECTIVES: Recently injury has become a major world-wide health problem. But studies in Korea about injuries were very few. Thus, this study was conducted to analyze the trend of major injuries from 1991 to 2006 and to provide basic data for preventing injuries. METHODS: This study was based on the National Statistical Office data from 1991 to 2006 and calculated to estimate the burden of major injuries by using the standard expected years of life lost (SEYLL) and total lost earnings equation. RESULTS: For transport accidents, mortality, SEYLL and total lost earnings were increased from 1991 to 1996 and decreased from 2000 to 2006. On the other hand, for suicides, these were increased gradually. Since 2003, falls were included in ten leading causes of death. This study showed that injury causes major social and economical losses. CONCLUSIONS: We could reduce injury related premature death through active interest in injury prevention program.

Effects of Postpartum Depression and Temperament of Infant on Child-care Stress among Mothers of Newborn Infants

PURPOSE: This study was designed to identify mother and infant related factors that influence child-care stress among the mother of newborn infants. METHODS: Data were collected through self-administered questionnaires and descriptive statistics, correlation and multiple regression were used to analyze the data. The data survey was conducted with 957 conveniently selected mothers of infants when they visited a public health center in Seoul to have their children immunized. RESULTS: The average item score for the Childcare Stress Inventory was 38.03, for the Edinburgh Postnatal Depression Scale, 9.31 and for the Degree of Bother Inventory, 23.42. The CSI was positively correlated to EPDS (r=.44, p<.001) and DBI (r=.40, p<.001). Also these two variables explained 30.0% of CSI in infants' mothers. CONCLUSION: These findings are expected to expand the understanding about postpartum mothers' child-care stress and can contribute to the development of comprehensive interventions based on community health nursing.

Study on Pediatric Nurses' Attitudes and Compliance with Hospital Infection Standard Precautions

PURPOSE: The purpose of this study was to identify pediatric nurses' attitudes to, and compliance with, standard precautions in the prevention of hospital infections by enhancing their practice of standard precautions. METHODS: The participants were 206 nurses who worked in pediatric nursing departments of a general medical institution in Seoul. The questionnaire was a modification of Kim (2008) and consisted of 18 questions about hand washing, personal protective equipment, sharps, linen and patient care equipment. Collected data were processed using SPSS 15.0 WIN. RESULTS: Mean scores for attitudes to standard precautions and for compliance with standard precautions were 4.43 (+/-0.83) and 4.22 (+/-0.44) respectively. This difference was statistically significant (t=3.368, p=.001). The nurses' compliance with standard precautions differed significantly according to the general characteristics of age (F=8.705, p<.001), total clinical experience (F=9.426, p<.001), current department experience (F=6.555, p<.001), and education experience (t=0.616, p<.043). There was a positive correlation between attitudes to, and compliance with, standard precautions (r=.156, p=.025). CONCLUSION: The results of this study indicate that educational programs and policy on infection control and standard precautions for pediatric nurses are needed. Also these results should contribute to baseline data for establishing appropriate clinical policy on infection control.

A Study on Gender-role Identity and Cyber Delinquency in High School Students / 정신간호학회지

PURPOSE: The purpose of this study was to explore gender-role identity and cyber delinquency in high school students. METHODS: Data were collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, and ANOVA. The data survey was conducted with 1,208 conveniently selected high school students in Seoul, Gyung-gi and Chung-chung province. RESULTS: The cyber delinquency score was 38.94 and androgyny gender role identity was most common (34.0%). There were significant differences in cyber delinquency by academic year, gender, school record, economic status, educational background of parents, experiences of smoking, drinking, runaway, and gender-role identity. According to gender-role identity, the masculinity group showed highest cyber delinquency and the undifferentiated, androgyny, and femininity groups followed respectively. CONCLUSION: These findings are expected to make a contribution to creation of ideal interventions and to help discover early stage cyber delinquency in high school students as approached by gender role identity.

A Study on Gender-role Identity and Cyber Delinquency in High School Students / 정신간호학회지

PURPOSE: The purpose of this study was to explore gender-role identity and cyber delinquency in high school students. METHODS: Data were collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, and ANOVA. The data survey was conducted with 1,208 conveniently selected high school students in Seoul, Gyung-gi and Chung-chung province. RESULTS: The cyber delinquency score was 38.94 and androgyny gender role identity was most common (34.0%). There were significant differences in cyber delinquency by academic year, gender, school record, economic status, educational background of parents, experiences of smoking, drinking, runaway, and gender-role identity. According to gender-role identity, the masculinity group showed highest cyber delinquency and the undifferentiated, androgyny, and femininity groups followed respectively. CONCLUSION: These findings are expected to make a contribution to creation of ideal interventions and to help discover early stage cyber delinquency in high school students as approached by gender role identity.

A Prediction Model for Internet Game Addiction in Adolescents: Using a Decision Tree Analysis

PURPOSE: This study was designed to build a theoretical frame to provide practical help to prevent and manage adolescent internet game addiction by developing a prediction model through a comprehensive analysis of related factors. METHODS: The participants were 1,318 students studying in elementary, middle, and high schools in Seoul and Gyeonggi Province, Korea. Collected data were analyzed using the SPSS program. Decision Tree Analysis using the Clementine program was applied to build an optimum and significant prediction model to predict internet game addiction related to various factors, especially parent related factors. RESULTS: From the data analyses, the prediction model for factors related to internet game addiction presented with 5 pathways. Causative factors included gender, type of school, siblings, economic status, religion, time spent alone, gaming place, payment to Internet cafe, frequency, duration, parent's ability to use internet, occupation (mother), trust (father), expectations regarding adolescent's study (mother), supervising (both parents), rearing attitude (both parents). CONCLUSION: The results suggest preventive and managerial nursing programs for specific groups by path. Use of this predictive model can expand the role of school nurses, not only in counseling addicted adolescents but also, in developing and carrying out programs with parents and approaching adolescents individually through databases and computer programming.

The Relationship of Sexual Satisfaction and Daily Stress in the Breast Cancer Patients / 성인간호학회지

PURPOSE: The purpose of this study was to investigate the correlation of sexual satisfaction and daily stress in breast cancer patients. METHODS: Data was collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, ANOVA and Pearson's correlation. Data survey was conducted with 500 conveniently selected breast cancer patients who visited the out patient department in 5 university hospitals in Seoul, Gyung-gi and Gang-won province. RESULTS: The sexual satisfaction of breast cancer patients score was 31.34 and there were significant sexual satisfaction differences by age, education level, menopause and sexual activity frequency. Sexual satisfaction was negatively related with daily stress (r = -.177) especially personal stress (r = -.155), economic stress (r = -.138), stress of self (r = -.181), family stress (r = -.154) and stress about leisure (r = -.139). CONCLUSION: These findings are expected to make a contribution to creation of ideal sexual rehabilitation nursing interventions for breast cancer patients care nurse. Furthermore continuous and customized education and counseling programs can contribute to promote healthy sexual life for breast cancer patients.

Nosocomial Bloodstream Infection in Intensive Care Unit in a General Hospital / 한국역학회지

PURPOSE: Despite of the development of recent medical technology, bloodstream infection (BSI) still has significant influences on mortality and morbidity of patients admitted to the ICU. The BSI has the second most frequent site. Especially BSI in ICU have higher infection rate than general ward. This study was investigated the incidence rate of the nosocomial BSI, risk factors and bacterial pathogens of BSI in ICU for a general hospital. METHODS: This study was carried out for those 443 patients in ICU of general hospital during the period from March 2002 to February 2003. The definition for BSI was based on that of CDC. Data was collected by questionnaire, medical record review. The statistical SPSS(ver. 10.0) was used to analyze data that included chi-square, t-test and logistic regression. RESULTS: In the incidence rates of the BSI were 76.7 in 1,000 per patients, 7.0 in per 1,000 patients days and 32.1 in per 1,000 patients with central lines, 3.2 in per 1,000 cental line days. In the incidence rates of the BSI by type of ICU showed MICU 10.1, SICU 2.9 in per 1,000 patients days. The significant risk factors were identified as type of ICU(OR=5.119, p=0.001), length of stay(OR=1.039, p=0.001). The causal microbes of the BSI were CNS 35.5%, MRSA 23.6%. The bacterial pathogens of central catheter-related BSI were CNS 50%, MRSA 50%. CONCLUSION: The occurrence of ICU-acquired infection was significantly related to the increase in morbidity and mortality. Ongoing targeted surveillance and infection control strategies is necessary to control this problem.

Determinants of Limb-Bone Mineral Density in Healthy Men and Women Aged over 50 in Rural Area / 대한내분비학회지

BACKGROUND: Many studies have shown a strong inverse relationship between the bone mineral density (BMD) and osteoporotic fractures, with a doubling in the incidence of fractures for each standard deviation reduction in the BMD. Newer peripheral densitometry devices have recently been developed, with the advantages of a low cost and increased portability. In addition, studies focusing on the osteoporosis of rural populations are rare. The authors assessed the factors related with the BMD in rural areas, using peripheral bone densitometry. METHODS: 23 men (68.4+/-9.2[mean age+/-SD] years) and 32 women (63.9+/-8.3 years), living in rural areas, voluntarily participated in this community-based study. The BMD of the distal radius (BMDr) and calcaneus (BMDc) were measured using peripheral dual-energy X-ray absorptiometry. The BMI, waist to hip ratio, body composition, blood pressure, lipids, fasting glucose and insulin were measured. The sociodemographic characteristics and physical activities were investigated using questionnaires. RESULTS: 21.7% of the men and 34.4% of the women were diagnosed with osteoporosis according to the WHO definition. The BMDr and BMDc were 0.46+/-0.08 and 0.46+/-0.11 and 0.34+/-0.07 and 0.33+/-0.08g/cm2 in the men and women, respectively. In the men, age, BMI, physical activity and smoking were correlated with the BMDr, and age, lean body mass, physical activity, TV watching and smoking with the BMDc. In the women, age, weight and lean body mass were correlated with the BMDr, and age, weight, BMI, waist circumference, fat mass, lean body mass and year since menopause with the BMDc. From a multiple regression analysis, age and smoking in men, and year since menopause and lean body mass in women, respectively, had independent effects on the BMD. CONCLUSION: In the rural community studied, osteoporosis was as highly prevalent as in urban communities. Of the determinants for the BMD, smoking for men, and lean body mass for women, were modifiable factors. Education for quitting smoking in men, and maintenance of optimal weight in women, are required to prevent osteoporosis in rural areas.

The Physical Restraint Use in Hospital Nursing Situation / 간호학회지

This research is a field investigation to collect basic information about the safe and efficient use of physical restraint in hospitals and for the ultimate minimization of restraint use. The objects of this study were sixty-four patients. They were restrained physically. Add their 32 family members, 24 nurses of two university hospitals in Seoul were also involved in the study. From April 16, to May 27, 1999. Research data were collected throughout the observation and interview process. Also, the data was analyzed using frequencies and field study notes that were invented by researchers. Results of this study were as follows: 1. According to the sex and age distinction; male's restraint use was 75%, female's was 25% and pre-schoolage children 39.1%, middle age 26.5%, and senior citizens 20.3%. According to the disease distinction; neuro-system was 35.9%, respiratory system was 21.9%. In the Ward, 40.6% of ICU patients were restrained and 39.0% of pediatric ward children were also to restraint. 70.3% of patients were restrained under 5days, while 10.9% were restrained 10days. 2. Types of physical restraints were wrist restraint (45.21%), arm board (35.62%), leg restraint (8.22%), chest restraint (6.85%), elbow restraint (2.74%) and mitten restraint (1.37%). 3. The percentage was 3.5%, which was in 64 restrained out of 1828 hospitalized people. At 1st investigation, the ratio was 3.5%, the 2nd was 3.0% and the 3rd was 3.9%. 4. The reasons of using the physical restraint were 'to protect implements' (72.84%), 'to protect patients' (18.52%), 'to protect an operative site' (8.64%). 5. The result of the patients; family and nurses' response analysis was: 'It seems to be safe', 'It uses properly', 'It is convenient for relatives and nurses', 'It is helpful to treatment', 'Objective think it is not restraint' were 79.9%. 'It is discomfort and stuffy', 'The implement is ineffective' were 21.1%. However in interview of the patients who can do verbally communication, 6 of 7 was responded that 'It is stuffy and uncomfortable'. 6. When restraint is used, the main decision is usually made by the nurses 42.2% of the time. The statistics read as thus: nurses and the physician in charge 31.3%, nurses and family 12.5%, physician's order 7.8%, only family 6.2%. Although the record of restraint was only 15.6% so that only 10 cases out of all the 26 ICU patients restrained. This study shows that physical restraints which of infringe independent-right of patients, are used without using criterion, explaining the agreement. Also, subjective decision of physician, nurses, and family make the decision of using restraint. So development of practice manuals and rules for restraint implementation is urgent.