Updates of Nursing Practice Guideline for Pressure Injury / 임상간호연구

PURPOSE: This study was conducted to update the existing evidence-based nursing clinical practice guideline in management of pressure injury in South Korea. METHODS: The update process underwent the 22 steps according to the update method based on the international standards. RESULTS: The updated nursing practice guideline for pressure injury consists of 4 domains and 436 recommendations. The numbers of recommendations in each domain were 25 for hospital policies, 51 for assessment, 350 for prevention and management, and 10 for education. There were 2.5% of A, 13.3% of B, 84.2% of C in terms of grading of recommendations. Among these, the major revision was done in 32 recommendations (7.4%). A total of 299 recommendations (68.6%) were added newly. Minor revisions, such as change or addition of some words, were also made in 25 recommendations(5.7%). No change was made in 80 recommendations (18.3%) compared to the previous ones. CONCLUSION: The nursing practice guideline for pressure injury has been updated. This updated guideline can be used as educational materials for both healthcare workers and patients with pressure injury.

Path Analysis of Factors Influencing Career Preparation Behavior of Korean Nursing Students - Based on Social Cognitive Career Theory

PURPOSE: The purpose of this study was to identify personal, contextual, and cognitive factors influencing the career preparation behavior of Korean nursing students. In this study, an examination was done of the fitness of a path model for the relationship among these factors based on the social cognitive career theory. METHODS: The participants were 413 nursing students in South Korea. Data were collected using self-report questionnaires that included self-esteem, social support, self-efficacy, outcome expectation, career decision level, and career preparation behavior. Data were analyzed using descriptive statistics, Pearson correlation analysis, and path analysis. RESULTS: The factors influencing career preparation behavior were self-efficacy, career decision level, self-esteem, outcome expectation, and social support. The factors influencing career decision level were self-efficacy, outcome expectation, self-esteem, and social support. CONCLUSION: The findings indicate that self-efficacy is an important factor influencing the career behavior of Korean nursing students. Nurse educators should consider personal, contextual, and cognitive factors of nursing students and develop systemic career guidance programs to help nursing students' career preparation behavior.

Experience of Career Decision of Korean Nursing Students

PURPOSE: The purpose of this study was to explore and describe the experiences of career decision making by Korean nursing students. METHODS: The participants were 18 nursing students from one nursing college. Data were collected through in-depth individual interviews, and the main question was, “Could you describe your experience of making a career decision?” Data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: Core category of nursing students' experiences in making career decisions was ‘trying to find the way of being a nurse’. Action/interaction strategies were ‘becoming one's own self’, ‘actively exploring the way of being a nurse’, and ‘experiencing one’s own achievement as a future nurse’. Consequences were ‘deciding on the career on one’s own’ and ‘career indecision on one's own’. CONCLUSION: The findings indicate that nursing students tried to know themselves, explore careers and experience their achievements, and that their efforts were influenced by real situations and support systems. Therefore, nurse educators should develop systems and programs to help students in nursing make career decisions.

High prevalence of TP53 mutations is associated with poor survival and an EMT signature in gliosarcoma patients

Gliosarcoma (GS) is a rare variant (2%) of glioblastoma (GBM) that poses clinical genomic challenges because of its poor prognosis and limited genomic information. To gain a comprehensive view of the genomic alterations in GS and to understand the molecular etiology of GS, we applied whole-exome sequencing analyses for 28 GS cases (6 blood-matched fresh-frozen tissues for the discovery set, 22 formalin-fixed paraffin-embedded tissues for the validation set) and copy-number variation microarrays for 5 blood-matched fresh-frozen tissues. TP53 mutations were more prevalent in the GS cases (20/28, 70%) compared to the GBM cases (29/90, 32%), and the GS patients with TP53 mutations showed a significantly shorter survival (multivariate Cox analysis, hazard ratio=23.9, 95% confidence interval, 2.87–199.63, P=0.003). A pathway analysis showed recurrent alterations in MAPK signaling (EGFR, RASGRF2 and TP53), phosphatidylinositol/calcium signaling (CACNA1s, PLCs and ITPRs) and focal adhesion/tight junction (PTEN and PAK3) pathways. Genomic profiling of the matched recurrent GS cases detected the occurrence of TP53 mutations in two recurrent GS cases, which suggests that TP53 mutations play a role in treatment resistance. Functionally, we found that TP53 mutations are associated with the epithelial–mesenchymal transition (EMT) process of sarcomatous components of GS. We provide the first comprehensive genome-wide genetic alternation profiling of GS, which suggests novel prognostic subgroups in GS patients based on their TP53 mutation status and provides new insight in the pathogenesis and targeted treatment of GS.

A Structural Equation Model of Pressure Ulcer Prevention Action in Clinical Nurses

PURPOSE: The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study. METHODS: A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting pressure ulcer prevention action among clinical nurses. RESULTS: The model fitness statistics of the hypothetical model fitted to the recommended levels. Attitude, subjective norm and perceived control on pressure ulcer prevention action explained 64.2% for intention to perform prevention action. CONCLUSION: The major findings of this study indicate that it is essential to recognize improvement in positive attitude for pressure ulcer prevention action and a need for systematic education programs to increase perceived control for prevention action.

Validation of QF-PCR for Rapid Prenatal Diagnosis of Common Chromosomal Aneuploidies in Korea

PURPOSE: Quantitative fluorescent polymerase chain reaction (QF-PCR) allows for the rapid prenatal diagnosis of common aneuploidies. The main advantages of this assay are its low cost, speed, and automation, allowing for large-scale application. However, despite these advantages, it is not a routine method for prenatal aneuploidy screening in Korea. Our objective in the present study was to validate the performance of QF-PCR using short tandem repeat (STR) markers in a Korean population as a means for rapid prenatal diagnosis. MATERIALS AND METHODS: A QF-PCR assay using an Elucigene kit (Gen-Probe, Abingdon, UK), containing 20 STR markers located on chromosomes 13, 18, 21, X and Y, was performed on 847 amniotic fluid (AF) samples for prenatal aneuploidy screening referred for prenatal aneuploidy screening from 2007 to 2009. The results were then compared to those obtained using conventional cytogenetic analysis. To evaluate the informativity of STR markers, the heterozygosity index of each marker was determined in all the samples. RESULTS: Three autosomes (13, 18, and 21) and X and Y chromosome aneuploidies were detected in 19 cases (2.2%, 19/847) after QF-PCR analysis of the 847 AF samples. Their results are identical to those of conventional cytogenetic analysis, with 100% positive predictive value. However, after cytogenetic analysis, 7 cases (0.8%, 7/847) were found to have 5 balanced and 2 unbalanced chromosomal abnormalities that were not detected by QF-PCR. The STR markers had a slightly low heterozygosity index (average: 0.76) compared to those reported in Caucasians (average: 0.80). Submicroscopic duplication of D13S634 marker, which might be a unique finding in Koreans, was detected in 1.4% (12/847) of the samples in the present study. CONCLUSION: A QF-PCR assay for prenatal aneuploidy screening was validated in our institution and proved to be efficient and reliable. However, we suggest that each laboratory must perform an independent validation test for each STR marker in order to develop interpretation guidelines of the results and must integrate QF-PCR into the routine cytogenetic laboratory workflow.