A Delphi Study for Development of Disaster Nursing Education Contents in Community Health Nursing

Purpose@#This study was conducted to develop the contents of disaster nursing education in community health nursing at universities. @*Methods@#To validate contents, the Delphi method was used. We categorized two domains(indirect disaster management and direct disaster management) and developed 48 draft items. This study applied two round surveys and 23 experts participated in this study. The content validity was calculated using content validity ratio and coefficient of variation. @*Results@#Indirect disaster management domain was composed of three categories including 12 items: 1) Understanding of the disaster, 2) disaster management system, and 3) response by disaster stage and recovery. Direct disaster management domain was composed of nine categories including 30 items: 1) Ethical considerations, 2) communication in disasters, 3) nursing activity by disaster stage, 4) emergency nursing in disasters, 5) patient severity classification in disasters, 6) disaster nursing for vulnerable groups, 7) disaster nursing for victims, 8) psychosocial nursing and health in disasters, and 9) cases of disaster nursing in communities. @*Conclusion@#This Delphi study identified the contents of disaster nursing education curriculum, and confirmed the validity for disaster education program in community health nursing. Based on the results, it will be helpful for training the disaster nursing and improving the competency on disaster nursing of the nursing students.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

Purpose@#The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. @*Methods@#This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. @*Results@#The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation.Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). @*Conclusion@#In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

Purpose@#The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. @*Methods@#This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. @*Results@#The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation.Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). @*Conclusion@#In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.

Factors Influencing Participation in National Health Screening Program among Korean Older Adults by Cognitive Function Level

PURPOSE: The aim of this study was to identify the participation rate of the National Health Screening Program (NHSP) and its influencing factors by cognitive function level in Korean older adults.METHODS: This study was a secondary analysis using data from the survey of the Korean Longitudinal Study of Aging in 2016. The data were analyzed using χ² test and multiple logistic regression.RESULTS: The participation rates of the NHSP in the mild cognitive impairment group (79.6%) and the suspected dementia group (58.0%) were lower than the normal cognitive function group (88.1%). The factors influencing NHSP varied by cognitive function level. Especially, in the suspected dementia group, higher participation rates of the NHSP were associated with living in rural areas, enrollment in private health insurance, no depressive symptoms, participation in social activities, and no living with children. Depression and participation in social activities influenced participation in NHSP in all groups.CONCLUSION: This study suggests that interventions differentiated by cognitive function level are important for increasing the participation in the health screening.

Predictors of Health-related Quality of Life among Spouses of Older Adults with Dementia in the Community-dwelling

PURPOSE: The purpose of this study was to identify the factors influencing health-related quality of life among spouses of older adults with dementia based on an ecological model.METHODS: This study used data from the 2015 Korean Community Health Survey with the subjects of 541 spouses of older adults with dementia. The data were analyzed using descriptive statistics, independent t-test, ANOVA, and hierarchical multiple regression.RESULTS: In this study, 26.5% of quality of life was explained by employment status, physical activity, perception of stress, perception of depressive symptom, self-rated health status, self-rated oral health status, and contact with neighbors.CONCLUSION: To develop more effective nursing intervention for improvement of quality of life, it needs to consider not only the individual system related factors but also community system related factors including contact with neighbors.

Effects of Multifactorial and Follow-up Programs Applying a Capacity Building Strategy: Focusing on Older Adults Living in a Urban-rural Complex Area

PURPOSE: The purpose of this study is to examine effects of a multifactorial program for preventing the frailty of older adults and effects of a follow-up program applying a capacity building strategy. METHODS: A quasi-experimental pretest-posttest design was used for the nonequivalent control group. The follow-up group (n=75) and non-follow-up group (n=68) received the same multifactorial program comprising muscle strength exercise, cognitive training, and psychosocial programs for 12 weeks. After completion of multifactorial program, the follow-up group took follow-up programs applying the capacity building strategy for following 12 weeks. The data of physical function, cognitive function, and psychological function, and self-rated health were collected from both groups three times: before intervention, after intervention, and 12 weeks after intervention. The data were analyzed using χ2 test and t-test. RESULTS: In comparison with the non-follow-up group, the scores of Timed Up & Go Test, and physical activities energy expenditure were significantly improved in the follow-up group. CONCLUSION: These results indicate that a multifactorial program with follow-up adapting the strategies of capacity building for the older adults group is feasible to prevent the physical frailty in community.

Education Retention of Cardiopulmonary Resuscitation Skills after Hands-only Training versus Conventional Training in Novices: A Randomized Controlled Trial

PURPOSE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study was to compare the retention rate of CPR skills in laypersons between the two hands-only and conventional CPR training methods. METHODS: Participants were randomly assigned to one of the two training groups: The hands-only CPR group with 80 minutes of training or the conventional CPR group with 180 minutes of training. The CPR skills for each participant were evaluated at the end of the training session and at 3 months thereafter, using the Resusci Anne® manikin with a skillreporting software. RESULTS: A total of 252 participants completed the training sessions; of which, 125 participants were in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in the average compression rate (p=0.015), average compression depth (p=0.031), and proportion of adequate compression depth (p=0.011). Contrastingly, there were no differences with respect to the retention of skills in the conventional CPR group after 3 months. CONCLUSION: The conventional CPR training appears to be more effective with respect to retention of chest compression skills compared with hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training remains poor.

Human Coronavirus in the 2014 Winter Season as a Cause of Lower Respiratory Tract Infection

PURPOSE: During the late autumn to winter season (October to December) in the Republic of Korea, respiratory syncytial virus (RSV) is the most common pathogen causing lower respiratory tract infections (LRTIs). Interestingly, in 2014, human coronavirus (HCoV) caused not only upper respiratory infections but also LRTIs more commonly than in other years. Therefore, we sought to determine the epidemiology, clinical characteristics, outcomes, and severity of illnesses associated with HCoV infections at a single center in Korea. MATERIALS AND METHODS: We retrospectively identified patients with positive HCoV respiratory specimens between October 2014 and December 2014 who were admitted to Severance Children’s Hospital at Yonsei University Medical Center for LRTI. Charts of the patients with HCoV infection were reviewed and compared with RSV infection. RESULTS: During the study period, HCoV was the third most common respiratory virus and accounted for 13.7% of infections. Coinfection was detected in 43.8% of children with HCoV. Interestingly, one patient had both HCoV-OC43 and HCoV-NL63. Mild pneumonia was most common (60.4%) with HCoV, and when combined with RSV, resulted in bronchiolitis. Two patients required care in the intensive care unit. However, compared with that of RSV infection, the disease course HCoV was short. CONCLUSION: Infections caused by HCoVs are common, and can cause LRTIs. During an epidemic season, clinicians should be given special consideration thereto. When combined with other medical conditions, such as neurologic or cardiologic diseases, intensive care unit (ICU) care may be necessary.

Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial

OBJECTIVE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. METHODS: Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant's CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. RESULTS: In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. CONCLUSION: Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor.

Factors Affecting Smoking Cessation Intention of Female Workers: Using Community Health Survey, 2014 / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing smoking cessation in female workers. METHODS: This study was secondary analysis based on the data from the Community Health Survey, 2014 with the subjects of 2,007 female workers. The data were analyzed using χ² test and multiple logistic regression. RESULTS: 29.2% of female workers had the intention to quit smoking. The subjects with office jobs showed higher smoking cessation intention than non-office jobs. Smoking cessation intention was influenced by the amount of smoking per day, previous attempts to quit smoking, sleeping time, the presence of chronic disease, the presence of depressive symptoms, weight control behavior and subjective body images. CONCLUSION: These findings show that tailored interventions should be provided depending on the types of occupations in order to increase smoking cessation in female workers. In addition, smoking cessation programs need to consider not only the smoking related factors but also physical and psychological health including chronic disease, weight, and depression.

Assessment of Long-Term Care Service Needs in the Baby Boom Generation

PURPOSE: This research was conducted to identify long-term care service needs in the baby boom generation. METHODS: Data were collected from September 3 to October 9, 2012 targeting 196 baby boomers residing in Seoul and Gyeonggi-do with the measurement of long-term care service needs having five domains. Collected data were analyzed using the SPSS 20.0 program. RESULTS: Demand for long term care service in those who preferred nursing homes was highest as 4.40±0.69 in the safe environment domain. In case of those preferring home care services, demand was highest as 4.37±0.56 in the social interaction domain. People who preferred nursing homes had higher needs in personal health care and improvement of the service quality domains. Those who preferred home care services showed diverse needs according to their characteristics. CONCLUSION: The baby boom generation had high needs in all the domains of long-term care services and such needs were diverse according to their characteristics. However, long-term care services had limitations that they provided standardized and uniformed services only. Therefore, health care services and improved quality services should be provided in a way of meeting the users' needs, and tailored services should be provided in consideration of the users' characteristics.

Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection / 소아과

PURPOSE: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). METHODS: We retrospectively evaluated 298 pediatric patients (age≤36 months) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. RESULTS: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). CONCLUSION: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.

Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection / 소아과

PURPOSE: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). METHODS: We retrospectively evaluated 298 pediatric patients (age≤36 months) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. RESULTS: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). CONCLUSION: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.

IgG4-Related Systemic Disease Can Be Easily Mistaken as a Uroepithelial Tumor / 전남의대학술지

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic syndrome characterized by elevated serum IgG4 concentrations and tumefaction or tissue infiltration by IgG4-positive plasma cells. We experienced a case of IgG4-RD involving multiple organs in a 64-year-old female who was referred for a suspected uroepithelial tumor. A mass biopsy confirmed dense lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. We discuss this case and review the literature to bring IgG4-RD to the attention to clinicians because it responds dramatically well to steroid therapy and should be kept in mind as a differential diagnosis to avoid unnecessary surgery.

Sociodemographic Factors and Comorbidities Associated with Remission from Alcohol Dependence: Results from a Nationwide General Population Survey in Korea

OBJECTIVE: The lifetime prevalence of alcohol dependence in South Korea remains higher than other countries. The aim of our study is to identify factors associated with remission from alcohol dependence. METHODS: Data from the Korean Epidemiological Catchment Area-Replication (KECA-R) study were used in our study. The Korean version of the Composite International Diagnostic Interview 2.1 (K-CIDI 2.1) was administered. Remission was defined as having no symptom of alcohol dependence for 12 months or longer at the time of the interview. Demographic and clinical variables putatively associated with remission from alcohol dependence were examined by t-test, chi-square-test and logistic regression analysis. RESULTS: The lifetime prevalence rate of alcohol dependence was 7.0%. Among them, 3.2% of the subjects were diagnosed with active alcohol dependence in the previous 12 months, and 3.8% were found to be in remission. Subjects in 35- to 44-year-old group, not living with partner group, and lower level of educational attainment group were more likely to be in the active alcohol dependence state. Of the comorbid mental disorders, dysthymia, anxiety disorder, nicotine use, and nicotine dependence were more common among the actively alcohol-dependent subjects. CONCLUSION: There is considerable level of recovery from alcohol dependence. Attention to factors associated with remission from alcohol dependence may be important in designing more effective treatment and prevention programs in this high-risk population.

IgG4-Related Systemic Disease Can Be Easily Mistaken as a Uroepithelial Tumor / 전남의대학술지

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic syndrome characterized by elevated serum IgG4 concentrations and tumefaction or tissue infiltration by IgG4-positive plasma cells. We experienced a case of IgG4-RD involving multiple organs in a 64-year-old female who was referred for a suspected uroepithelial tumor. A mass biopsy confirmed dense lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. We discuss this case and review the literature to bring IgG4-RD to the attention to clinicians because it responds dramatically well to steroid therapy and should be kept in mind as a differential diagnosis to avoid unnecessary surgery.

IgG4-Related Systemic Disease Can Be Easily Mistaken as a Uroepithelial Tumor / 전남의대학술지

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic syndrome characterized by elevated serum IgG4 concentrations and tumefaction or tissue infiltration by IgG4-positive plasma cells. We experienced a case of IgG4-RD involving multiple organs in a 64-year-old female who was referred for a suspected uroepithelial tumor. A mass biopsy confirmed dense lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. We discuss this case and review the literature to bring IgG4-RD to the attention to clinicians because it responds dramatically well to steroid therapy and should be kept in mind as a differential diagnosis to avoid unnecessary surgery.

A Comparison Study of Ballooning Time between Immediate and Conventional Deflation Method of Endoscopic Papillary Large Balloon Dilation for the Extraction of Difficult Bile Duct Stone / 대한췌담도학회지

BACKGROUND/AIMS: The ballooning time in endoscopic papillary large balloon dilation (EPLBD) remains controversial. The aim of this study was to evaluate the significance of the ballooning time comparing an immediate balloon deflation method with a conventional ballooning time of > 45 seconds. METHODS: Between January 2010 and December 2010, 126 patients with bile duct stones treated with EPLBD and endoscopic sphincterotomy were divided according to the ballooning time: the immediate deflation group (n=56) and the conventional inflation group (ballooning time 45s to < 60s) (n=70). RESULTS: The overall success rate and the success rate of the first attempt of ERCP (endoscopic retrograde cholangio-pancreatography) were 96.4% (54/56) and 80.4% (45/56) in the immediate group and 97.1% (68/70) and 77.1% (54/70) in the conventional inflation group. There were no statistically significant differences in the overall success and the first attempt of ERCP success rate (p=0.99, p=0.66). The frequency of mechanical lithotripsy was 0% in the immediate deflation group and 7.1% in the conventional inflation group (p=0.065). Complications occurred in 3.6% (2/56) patients in the immediate deflation group and 8.6% (4/70) patients in the conventional inflation group (p=0.298). CONCLUSIONS: The ballooning time in EPLBD does not affect the outcomes of the treatment for bile duct stones. And the feasibility of the immediate deflation method in EPLBD is acceptable.

Clinical Efficacy of Nonsurgical Treatment of Crohn's Disease-related Intraabdominal Abscess / 대한소화기학회지

BACKGROUND/AIMS: This study was conducted to compare the clinical efficacy between surgical and nonsurgical treatments for patients with Crohn's disease-related intraabdominal abscess. METHODS: A retrospective review of medical records was performed for patients admitted to a single institution due to Crohn's disease-related intraabdominal abscess from February, 1996 to February, 2008. Clinical outcomes were compared between surgical and nonsurgical groups in terms of treatment responses and recurrences. RESULTS: A total of 47 episodes of intraabdominal abscesses in 43 patients (12.7%) were identified from 339 patients with Crohn's disease. Of these, initially, 18 cases (38.3%) underwent surgical treatment and 29 (61.7%) were treated medically (antibiotic treatments with or without percutaneous drainage). The overall treatment response rates of surgical and nonsurgical group were 100% versus 89.7% (p=0.11) and recurrence rates were 27.8% versus 30.8% (p=1.00). Three patients in nonsurgical group (10.3%) showed no response to therapy and ultimately received surgical drainages. The median length of hospitalization in nonsurgical group was shorter than in surgical group (12 and 29.5 days, respectively. p=0.02). CONCLUSIONS: Nonsurgical treatment might be as effective as surgical treatment for the treatment of Crohn's disease-related intraabdominal abscess, especially considering shorter hospital stay.

A Case of Ileal Mucormycosis in a Patient with Gastrointestinal Behcet's Disease

Zygomycosis (mucormycosis) is a rare fungal infectious disease, usually found in association with an immunocompromised state. Gastrointestinal mucormycosis is extremely rare and fatal, thus it is important to detect and manage this disease at an early stage in an effort to improve survival. To date, no cases of mucormycosis superimposed on gastrointestinal Behcet's disease have been reported. Herein we report a case in which gastrointestinal mucormycosis occurred in a 17-year-old-female with Behcet's disease. The patient recovered from her disease after undergoing an ileocecectomy.