Factors Associated with Sleep Quality in Patients with Coronary Artery Disease / 중환자간호학회지

Purpose@#: This study aimed to examine the relationship between sleep quality and its influencing factors in patients with coronary artery disease (CAD). @*Methods@#: This descriptive correlational study included 130 patients with CAD admitted to the cardiology department of a general hospital in B City between September 2019 and February 2020. Data were collected using structured questionnaires and research instruments to measure sleep quality, anxiety, depression, chronotype, and daytime sleepiness. @*Results@#: The mean scores for sleep quality, daytime sleepiness, anxiety, and depression were 7.59±3.45, 6.45±3.46, 6.58±3.88, and 7.74±4.05, respectively. In terms of chronotypes, 10.8%, 48.5%, and 40.7% of the participants had evening-, intermediate-, and morning-type patterns, respectively. Sleep quality was significantly correlated with anxiety (r=0.38, p＜.001), depression (r=.37, p＜.001), and daytime sleepiness (r=.26, p =.002). Factors associated with sleep quality in patients with CAD included anxiety (β=.29), heart failure (β=.22), daytime sleepiness(β=.21), and sleeping alone (β=.19). Collectively, these factors had an explanatory power of 23.1% for sleep quality variance. @*Conclusion@#Patients with CAD often experience poor sleep quality owing to various factors such as anxiety, daytime sleepiness, heart failure, and sleeping alone. It is recommended that healthcare providers objectively evaluate sleep and identify factors that influence sleep quality. This will enable the development of effective methods for sleep management as part of nursing care.

Comparison of Arterial Oxygen Saturation Measured by Pulse Oximetry at Different Sensor Sites in Neurocritical Patients / 중환자간호학회지

Purpose@#: This study aimed to compare peripheral pulse oxygen saturation (SpO2) values, measured at different monitoring sites, and arterial oxygen saturation (SaO2) of neurocritical patients. @*Methods@#: The study included 110 patients admitted to the neurosurgical intensive care unit of a university hospital. The patients’ SpO2 values were measured in their index fingers, both second toes, both earlobes, and foreheads, using the patient monitoring system. These values were compared with the standard value of SaO2 measured using a blood gas analyzer. Data were analyzed using descriptive values, Pearson’s correlation coefficients, Lin’s concordance correlation coefficients (CCC), and Bland-Altman plots.Result : Regardless of the measuring site, SpO2 was correlated with the paired measurements of SaO2 (r=.40~.60, p＜.001, CCC range=.40~.58). No significant bias in paired measurements of SpO2 and SaO2 was observed at all sites (-0.06~0.19%, p＞.05). SpO2 values at the left finger and right earlobe had the narrowest range, with a 95% limits of agreement (LOA) (left finger -3.04~2.93% and right earlobe -3.18~2.79%). SpO2 at the index finger, on the side without an arterial catheter, had a narrower range of 95% LOA than that of the opposing finger (-3.00~2.97% vs. -3.73~3.26%). @*Conclusion@#: SpO2 at the finger without an arterial catheter had the highest level of precision. This study suggests using the index finger, on the side without an arterial catheter, for pulse oximetry in neurocritical patients.

Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit / 중환자간호학회지

PURPOSE: The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients.METHODS: This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC).RESULTS: Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson).CONCLUSION: The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Effectiveness of Intervntion for Cardiovascular Disease Prevention in Construction Workers / 한국직업건강간호학회지

PURPOSE: This study aimed to assess the risk of developing cardiovascular disease (CVD) and to evaluate the effects of intervention for CVD prevention in construction workers. METHODS: A total of 497 workers participated the health status survey and finally 90 workers were analyzed for evaluation of the intervention with the one-group pretest-posttest design. The data were collected from the questionnaires and health examinations in the healthcare service for road constructor's CVD prevention as secondary analysis. The intervention of the healthcare was composed of CVD prevention education for all workers and face to face counselling for the high risk group of CVD risk during 6 months in workplace. Data were analyzed with descriptive statistics, χ² test, Wilcoxon signed rank test, and paired t-test. RESULTS: The moderate and high risk groups of CVD were 9.7% and 0.8%. After the intervention, the physical activity (MET-min/week) significantly increased (Z=-5.46, p<.001). But, there were no significant differences in blood pressure, fasting glucose, body mass index, and CVD risk appraisals between pre and post intervention. CONCLUSION: The findings imply that it is necessary to develop the health promotion program for construction workers which fully reflects the characteristics of individuals and the organization.

Effects of Cognitive Behavior Therapy on Heart Rate Variability in Young Females with Constipation-predominant Irritable Bowel Syndrome: A Parallel-group Trial

BACKGROUND/AIMS: The relation between heart rate variability (HRV) as non-invasive biomarkers of autonomic function and cognitive behavior therapy (CBT) as non-pharmacological treatments has rarely been examined in patients with constipation-predominant irritable bowel syndrome (IBS-C). The purpose of this study is to evaluate the efficacy of an 8-week CBT intervention on HRV and IBS symptoms, and the correlation of changes in HRV with changes in IBS symptoms among young female nursing students with IBS-C. METHODS: This study consisted of an exploratory subgroup analysis of 43 participants with IBS-C who had been randomly assigned to receive either 8 weeks of CBT (n = 23) or general medical information (control, n = 20). At baseline and 8, 16, and 24 weeks, participants completed a questionnaire assessing their gastrointestinal (GI) symptoms, anxiety, depression, and stress, and their HRV was measured via electrocardiography. RESULTS: At the 8-week follow-up, the high-frequency (HF) power was significantly higher, and the low-frequency (LF)/HF ratio was lower in the CBT group than in the control group (P < 0.001 for both), and the severity of GI symptoms (P = 0.003), anxiety (P < 0.001), depression (P < 0.001), and stress (P < 0.001) was significantly lower in the CBT group than in the control group. Changes in the HF power were significantly and inversely associated with changes in GI symptoms, anxiety, depression, and stress at 16 and 24 weeks (P < 0.05 for all; range of r from −0.37 to −0.68). Changes in the LF/HF ratio were also significantly and positively associated with changes in GI symptoms, anxiety, depression, and stress at 16 and 24 weeks (P < 0.05 for all; range of r from 0.38 to 0.60). CONCLUSIONS: CBT was effective in managing symptoms in young IBS-C patients and the improvement of symptoms was sustained at 24 weeks following the completion of CBT. Furthermore, indirect measurement of autonomic function using HRV may be a useful objective parameter for assessing response to CBT in young IBS-C patients.

Interpersonal Communication Competence and Social Anxiety in Nursing Students / 한국간호교육학회지

PURPOSE: This study aimed to identify a relationship between the communication competence and social anxiety in nursing students. METHODS: With a cross-sectional survey, a convenience sampling of 303 nursing students was taken from P-university in Y-city. The instrument for the study was a questionnaire that is consisted of the general characteristics, an Interaction Anxiousness Scale (IAS) and a Global Interpersonal Communication Competence Scale (GICC). Data was analyzed using descriptive statistics, t-test, one-way ANOVA, Kruskal-Wallis, Pearson's correlation coefficients and stepwise multiple regression with SPSS version 21.0. RESULTS: The mean score of the IAS was 41.89+/-8.74 and the GICC was 3.51+/-0.34. Communication competence significantly differed by the satisfaction of major (F=10.86, p<.001). In addition, the satisfaction of interpersonal relationships was significantly different in both communication competence (F=17.52, p<.001) and social anxiety (F=23.85, p<.001). Social anxiety had a negative correlation with communication competence (r=-.48, p<.001). Social anxiety accounted for 55.3% of the variance-social relaxation (beta=-.62), assertiveness (beta=-.18), interaction management (beta =.14) and efficiency (beta=-.13)- of communication competence's subcategories. CONCLUSION: It was found that communication competence has an influence on social anxiety. Therefore, education programs are needed to promote communication competence for a decline of social anxiety in nursing students.

A Structural Equation Modeling on Premenstrual Syndrome in Adolescent Girls

PURPOSE: The aims of this study were to construct a hypothetical structural model which explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with collected data. METHODS: The participants were 1,087 adolescent girls from 3 high schools and 5 middle schools in B city. Data were collected from July 3 to October 15, 2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS 16.0 programs. RESULTS: The overall fitness indices of hypothetical model were good (chi2 =1555, p<.001), chi2/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91, CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount of menstruation, test anxiety, social support, menstrual attitude and femininity but not by academic stress. This model explained 27% of the variance in PMS in adolescent girls. CONCLUSION: The findings from this study suggest that nursing interventions to reduce PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude and BMI. Also, social support from their parents, friends, and teachers needs to be increased.

Effects of Oral Care with 0.12% Chlorhexidine and Saline Solution on Oral Status, Incidence of Oral Pathogens and Clinical Pulmonary Infection Score in Children with Cardiac Surgery / 기본간호학회지

PURPOSE: The purpose of this study was done to investigate the effects of oral care using 0.12% chlorhexidine and saline solution on oral status, incidence of oral pathogens and pneumonia among children who had cardiac surgery. METHODS: The study participants were 84 children who underwent cardiac surgery and were admitted to the SICU of a university hospital. Oral care was provided with 0.12% chlorhexidine to the experimental group (n=43) and with saline solution to the control group (n=41), 3 times a day for 3 days. Before and after the intervention, the oral status, oral swab culture, and CPIS were checked. RESULTS: There was no significant difference in oral status score between the two groups. The incidence of oral pathogens in the experimental group was significantly lower than that of the control group (t=-5.780, p<.001). The CPIS in experimental group was significantly lower than that of control group (t=-3.665, p<.001). CONCLUSION: The oral care with 0.12% Chlorhexidine is more effective than with only saline solution for reducing incidence of oral pathogens and pneumonia.

The Effects of the Nursing Education Program on the Knowledge, Anxiety, and Coping Behavior of Mothers with Young Child Undergoing Cardiac Surgery / 성인간호학회지

PURPOSE: This study was to develop a nursing education program for mothers with a young child undergoing cardiac surgery and determine effects of the program on her knowledge, anxiety and coping behavior. METHODS: The research design was a nonequivalent control group non-synchronized design. 18 mothers were assigned to the experimental group and 18 to the control group. The effects were evaluated by measuring knowledge, anxiety, and coping behavior. The collected data was analyzed through independent t-test, and repeated measures ANOVA respectively using SPSS/WIN 12.0 program. RESULTS: The point of knowledge in the experimental group was significantly increased tan that in the control group. The point of subjective, physiological, and behavior anxiety in the experimental group was significantly decreased than that in the control group by time change. The point of coping behavior in the experimental group was significantly higher than that in the control group. CONCLUSION: The nursing educational program for a young child with cardiac surgery is expected to be clinically applied as an intervention program for mothers with a young child undergoing cardiac surgery.

Content Analysis of Male Hospital Nurses' Experiences / 성인간호학회지

PURPOSE: This study was conducted to identify job experiences of male hospital nurses. METHODS: Data were collected from 20 male nurses working at general hospitals, through semi-structured in-depth interviews. The interviews were recorded and subsequently transcribed verbatim. Using content analysis, data were coded and categorized. RESULTS: The analyzed domains were motivations for choosing nursing, occupational experiences (3 subdomains), and attitudes toward the future. A total of 85 significant statements were selected from the data and classified into 32 categories. The nurses' motivations for choosing nursing were advantages of employment, their aptitude, scarcity value of men, professionalism and job security, good promotion, stable income, and family influence. In occupational experiences, they were assigned to special fields and dissatisfied with vertical relationship, promotion system, their salary, and gaps in military service time; they had difficulties in adapting to female-dominated groups and encountered gender role stereotype and preconception; they were satisfied with their distinguished performance, but had damaged self-esteem, and were stressed and disappointed in their work. In their attitudes toward the future, they considered their career changes, but tried to make professional and personal advancement. CONCLUSION: These findings have implications for recruiting and retaining male nurses in clinical settings.

Self-Care, Symptom Experience, and Health-Related Quality of Life by COPD Severity / 성인간호학회지

PURPOSE: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. METHODS: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of FEV1/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, FEV1% predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. RESULTS: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). CONCLUSION: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

Comparison of Whole versus Split-Dose PEG Solution for Colonoscopy Preparation on Patient Compliance, Quality of Bowel Cleansing, and Endoscopist's Satisfaction / 성인간호학회지

PURPOSE: This study was a randomized single-blind trial of whole versus split-dose PEG solutions for colonoscopy preparation to compare the patient compliance, quality of bowel cleansing, and endoscopist's satisfaction. METHODS: The participants were recruited from outpatients who planned to receive colonoscopy of C hospital in Busan. Sixty participants were randomly assigned to receive either a spit-dose group(n=30) consuming 2 liter of PEG solution twice, or a whole-dose group(n=30), consuming 4 liter of PEG solution once. These participants completed the questionnaire to assess their compliance before colonoscopy. The quality of bowel cleansing was assessed using the Ottawa Scale with the endoscopist who was blinded to the type of preparation, and their satisfaction by using VAS. RESULTS: The participants who did not completely consume 4 liter of PEG solution were less in split-dose than in whole-dose group (0% vs 13.3%). The split-dose group complained less about abdominal pain(t=2.644, p=0.009) and abdominal bloating(t=2.802, p=0.013) with a statistical significance. For the quality of bowel preparation, there were no significant differences in the bowel cleansing scores and the endoscopist's satisfaction between two groups. CONCLUSION: Colonic preparation with split-dose of PEG solution could be a more useful method for better patient compliance, with no significant impact on bowel cleansing quality.

The Effects of Abdominal Meridian Massage on Menstrual Cramps and Dysmenorrhea in Full-time Employed Women / 간호학회지

PURPOSE: This study was designed to examine the effects of abdominal meridian(Kyongrak) massage on menstrual cramps and dysmenorrhea. METHOD: Eighty-five women (of 110 screened) enrolled in this study and were employed full-time with more than 6.0 points(in 0~10.0 VAS scale) in menstrual cramps or more than 20 points on the dysmenorrhea scale(range 13~52). The forty-two participants in the experimental group received abdominal meridian massage for 5 minutes per day during 6 days from the fifth day before menstruation to the first day of menstruation and the forty-three participants in the control group didn't receive any treatment. Data were collected from June 1st to August 30th, 2003 and analyzed using descriptive statistics, chi2-test, and t-test. RESULT: Menstrual cramps and dysmenorrhea of the experimental group were significantly lower after abdominal meridian massage than those of the control group (p<.001). CONCLUSION: Abdominal meridian(Kyongrak) massage was very effective for relief of menstrual cramps and dysmenorrhea. Therefore, we suggest that abdominal Kyongrak massage can be a useful nursing intervention for women with menstrual cramps or dysmenorrhea.

Development of an E-learning Education Program for Preventing Nursing Errors and Adverse Events of Operating Room Nurses / 성인간호학회지

PURPOSE: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). METHOD: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. RESULTS: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http:// cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was 21.24+/-1.71(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z= -3.10, p=.756). CONCLUSION: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

Influence of Self-Esteem and Family-Support on Powerlessness of Hospitalized Elderly Patients with Chronic Disease / 성인간호학회지

PURPOSE: The purpose of this study was to identify an influence of self-esteem and family- support on powerlessness of hospitalized elderly patients with chronic disease. METHOD: The subjects were 151 hospitalized elderly patients, age over 60, with chronic disease and admitted for at least 1 week. The data were collected by individual interview using a tructured questionnaire during the period from July 10th to August l0th, 2003 from three general hospitals in Busan. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, hierarchical multiple regression. RESULT: The level of self-esteem, family support, and powerlessness was 38.00, 38.26, and 38.38, respectively. There was a significant positive correlation between self-esteem and family support and a negative correlation between self-esteem and powerlessness and between family support and powerlessness. Self-esteem and family support were each significant predictor of powerlessness. CONCLUSION: This study showed the hospitalized elderly patients need greater family-support and higher self-esteem to relieve the level of powerlessness. I suggest to study for replication in a larger sample size and considering the lengths of hospitalization for generalization of this study and to develop individual intervention programs for increasing family support and self esteem and testify their effects on the relief of powerlessness of the elderly.

Screening for High Risk Population of Dementia and Development of the Preventive Program Using Web / 간호학회지

PURPOSE: This study was to develop a screening model for identifying a high risk group of dementia and to develop and evaluate the web-based prevention program. METHOD: It was conducted in 5 phases. 1) Data were collected from dementia patients and non-dementia patients in a community. 2) A screening model of the high risk population was constructed. 3) The validity test was performed and the model was confirmed. 4) Four weeks-prevention program was developed. 5) The program was administered, and evaluated the effects. RESULT: The model consisted of age, illiteracy, history of stroke and hypercholesterolemia. The program was designed with 12 sessions, group health education using web-based individual instruction program, and 12 sessions of low-intensity physical exercise program. After the completion, their self-efficacy, and health behaviors in experimental group were significantly improved over those in the control group. The perceived barrier in the treatment group is significantly decreased. CONCLUSION: The screening model developed is very simple and can be utilized in diverse community settings. And the web based prevention program will encourage individual learning and timely feedback, therefore it can facilitate their active participation and promote health management behaviors at home.

Effects of Body Position and Time after Feeding on Gastric Residuals in LBW Infants / 간호학회지

PURPOSE: To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW). METHODS: A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding. RESULTS: In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F = 5.038, rho = 0.001; F = 429.763, rho < 0.001, respectively), but the interaction between position and time was found not to be significant. In pairwise comparisons, the gastric residuals were more reduced in the right anterior oblique and prone positions compared with the left lateral position (rho < 0.05) and the differences across time periods were significant (rho < 0.001). CONCLUSIONS: The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.

The Effect of Nursing Information on the Women's Emotional Adaptation Undergoinga Hysterectomy / 여성건강간호학회지

The purpose of this Quasi-experimental design was to assess the effects of a hysterectomy on women's emotional response and ultimately, to develop a nursing protocol recommending nursing education for women undergoing a hysterectomy. The subjects at D university hospital receiving a hysterectomy,( for benign gynecological disease) were invited to participate in the study. Subjects who agreed to participate were allocated into control or experimental groups. Each group consisted of 30 women. The subjects emotional adaptation was surveyed through mood questionnaires. The data were analyzed using SAS program. The findings of the study are as follows: In the post test, the "experimental group" reported higher emotional adaptation than the "control group". Between pre and post testing, the "experimental group" showed significant improvement in emotional response; the "control group" did not. In conclusion, allocating nursing information to women both before and after undergoing a hysterectomy was confirmed as an effective nursing intervention for promoting women's emotional adaptation. Therefore, we propose a nursing protocol should be adapted recommending nursing education for women undergoing a hysterectomy.