Hand hygiene of nursing and midwifery students in Cambodia.

AIM: To determine the relationship between knowledge, attitude and the practice of hand hygiene by nursing and midwifery students in Cambodia. BACKGROUND: Hand hygiene is the most cost-effective means to prevent hospital-acquired infections. Techniques of hand hygiene are simple; however, many researchers have found hand hygiene knowledge, attitude and practice to be poor in many healthcare settings worldwide, especially in developing countries. Cambodia is a developing country in Southeast Asia and data regarding hand hygiene are limited. METHODS: A cross-sectional descriptive study was conducted to assess the level of knowledge, attitude and practice of hand hygiene. Students in nursing and midwifery programmes were the target population (n = 300). Survey data were collected from January to May 2017. Descriptive statistics, t-tests and correlation coefficients were calculated to assess relationships between student knowledge, attitude and hand hygiene practice. RESULT: The level of knowledge, attitude and practice of hand hygiene in nursing and midwifery students was moderate. A majority of students had received hand hygiene training. There was no significant difference between nursing and midwifery students in knowledge, attitude and practice of hand hygiene. However, a Pearson correlation of attitude and practice had a weak positive relationship. CONCLUSION: Both nursing and midwifery students demonstrated moderate levels of knowledge, attitudes and practice of hand hygiene. IMPLICATION FOR NURSING AND HEALTH POLICY: This study identified a need for hand hygiene training. Developing training programmes to improve attitudes about hand hygiene is strongly recommended. Effective training may contribute to change behaviours of hand hygiene (attitude), improve practice and ultimately reduce hospital-acquired infections.

Effect of a mind-body therapeutic program for infertile women repeating in vitro fertilization treatment on uncertainty, anxiety, and implantation rate.

PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.

The effect of a sexual life reframing program on marital intimacy, body image, and sexual function among breast cancer survivors.

BACKGROUND: Despite increasing awareness related to sexual health for breast cancer survivors, health care providers are passive in addressing their sexual issues. OBJECTIVE: The aims were to develop and investigate the effect of a sexual life reframing program on marital intimacy, body image, and sexual function (interest, dysfunction, and satisfaction) among breast cancer survivors. METHODS: Breast cancer survivors participated in this quasi-experimental study. The sexual life reframing program focused on the physical, psychological, and relational aspects of sexual health elements, and it consisted of 6 weekly 2-hour sessions. RESULTS: The participants reported poor body image and sexual function. There were no statistically significant differences in marital intimacy, body image, sexual interest, and sexual dysfunction following the program, although all the variables in the intervention group were improved. The sexual life reframing program was effective in increasing sexual satisfaction among breast cancer survivors. CONCLUSION: This study suggests that the quality of sexual life in breast cancer survivors could be improved with the sexual life reframing program provided as part of supportive group care. This program may be more effective if targeted at couples rather than survivors only and if delivered earlier and for a longer period. IMPLICATIONS FOR PRACTICE: The sexual life reframing program offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for breast cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction.

Mammography Screening according to Breast Cancer Disease and Social Network Characteristics of Married Korean Women.

PURPOSE: This study was done to examine differences in mammography screening according to breast cancer and social network characteristic. METHODS: Data were collected from 187 married women 35 years and older who were using public health centers, health promotion centers, cultural centers, obstetrics and gynecology hospitals or other relevant community sites. Data were collected between October 24 and December 4, 2008. Data were analyzed using the SPSS/WIN 15.0 program. RESULTS: The participation rate for mammography screening was 35.3%. The following general and breast cancer characteristics showed statistically significant differences: religion, family incomes, regular medical-care, general health examinations during past 2 years, and history of breast disease. The following social network characteristics showed statistically significant differences: social norms and subjective norms. Using logistic regression analysis, regular medical-care, breast cancer risk appraisal, social norm, and subjective norms were highly predictive of subsequent mammography. CONCLUSION: The results of this study indicate that it is important to develop and provide tailored intervention programs through integrated socially mediated programs. By consciously including social network and support systems, breast cancer detection efforts would not end as a one-time event, but naturally build on network structure of adults women, thus facilitating regular mammography screening.

Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization.

PURPOSE: The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF). METHODS: Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program. RESULTS: After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment. CONCLUSION: The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.

Empirical test of an explanatory theory of postpartum fatigue in Korea.

AIM: This paper is a report of a study designed to test an explanatory theory of postpartum fatigue. BACKGROUND: Postpartum fatigue is influenced by various factors and affects a mother's performance. A full understanding of postpartum fatigue is very important for developing effective nursing strategies to reduce postpartum fatigue and enhance mothers' performance. METHODS: Healthy postpartum women were recruited from five medical centers and one midwifery office in urban area in Korea (n = 291) by convenience sampling. Data were collected at 4- to 8-week follow-up visits after childbirth in 2006, using a self-report questionnaire. The proposed fatigue theory incorporated postpartum fatigue, postpartum depression, sleep quality, childcare stress, unsatisfactory feeding, social support, infant difficulty and satisfaction with Sanhujori, the Korean traditional postpartum care provided for 3 weeks following delivery by non-professional caregivers. Structural equation modelling was used to test the explanatory theory of postpartum fatigue. RESULTS: The modified fatigue theory showed good fit and high compatibility with the empirical data. In the final explanatory theory, postpartum depression and sleep quality directly affected postpartum fatigue, while childcare stress and the cultural phenomenon of Sanhujori had indirect effects on postpartum fatigue, via postpartum depression and sleep quality respectively. CONCLUSION: These findings suggest the potential role of comprehensive nursing focused on decreasing postpartum depression and improving sleep quality as a way to decrease postpartum fatigue. Also, nursing strategies for decreasing childcare stress and enhancing Sanhujori satisfaction may be helpful in reducing postpartum fatigue in Korean mothers.

[Development of college students' condom attitude scale].

PURPOSE: The aim of this study was to design and evaluate a scale for measuring the attitudes toward condom use in sexual relationships. METHOD: A questionnaire was administered to 631 college students using a convenience sampling method. The psychometric properties (reliability and validity) were evaluated. RESULT: As a result of the item analysis, 16 items were selected and the internal consistency alpha coefficient was .88. Results indicated that the condom attitude scale is composed of three factors: Interruption of sexual pleasure; Protection; and Image. The three factors accounted for 59.54% of the variance in the total scale. Also, condom attitude was statistically significant (t=7.389, p=.000) between consistent condom users and inconsistent users. CONCLUSION: The results demonstrate that condom attitudes are multidimensional, and the reliability and validity of the scale was supported.

[Differences of cesarean section rates according to San-Yin-Jiao(SP6) acupressure for women in labor].

PURPOSE: The purpose of this study was to explain differences of cesarean section rates according to San-Yin-Jiao(SP6) acupressure for women in labor. METHOD: A nonequivalent control group pre test--post test design was used to explain differences of cesarean section rates according to SP6 acupressure. The participants were 209 women who were assigned to one of three groups SP6 acupressure(n=86), SP6 touch(n=47), and control group(n=76). For 30 minutes, the SP6 acupressure group received SP6 acupressure,and the SP6 touch group received SP6 touch for the duration of each uterine contraction. The Control group was encouraged to deep breath and relax for the duration of each uterine contraction for 30 minutes. RESULT: The rates of cesarean section were 12.8%, 29.8%, and 22.4% for the SP6 acupressure group, SP6 touch group, and control group respectively. There was a significant difference among groups (p=0.049). Cesarean section rates were significantly different between the SP6 acupressure and non-SP6 acupressure group(p=0.035). CONCLUSION: This finding shows that 30 minutes of SP6 acupressure was effective in decreasing the cesarean section rate. Therefore, SP6 acupressure during labor could be applied as an effective nursing intervention.

Development and validation study of the breast cancer risk appraisal for Korean women.

The purpose of the present study was to develop and validate breast cancer risk factors, which can be used to identify women who are at a high risk of developing breast cancer. Fourteen risk factors for breast cancer were identified from extensive literature reviews and in consultation with a panel of experts. A case-control study was conducted, which aimed to validate these 14 risk factors. Cases were selected from four university hospitals in Korea and controls were selected from health screening centers in Korea. Interviews were used to obtain exposure history of each participant to the 14 risk factors. Group differences between the cases and controls were analyzed using a chi-squared test and a logistic regression method. Among the 14 risk factors, six were identified as significant: meat consumption more than once a week (odds ratio [OR] = 1.56, confidence interval [CI] = 1.32-1.85), breast disease experience (OR = 3.08, CI = 1.49-6.37), less than two children (OR = 1.61, CI = 1.09-2.35), family history of breast cancer (OR = 8.99, CI = 3.89-20.76), and no breast-feeding experience (OR = 3.08, CI = 1.41-3.85). Based on the OR, the risk scores were calculated by the absolute size of the OR having a total of 100 points.

Effects of SP6 acupressure on labor pain and length of delivery time in women during labor.

OBJECTIVE: The purpose of this study was to evaluate the effects of SP6 acupressure on labor pain and delivery time in women in labor. DESIGN: Randomized clinical trial. SETTING/LOCATION: Delivery room in a university hospital. PARTICIPANTS: Seventy-five (75) women in labor were randomly assigned to either the SP6 acupressure (n = 36) or SP6 touch control (n = 39) group. The participants were matched according to parity, cervical dilation, labor stage, rupture of amniotic membrane, and husband's presence during labor. There were no additional oxytocin augmentation or administration of analgesics during the study period. INTERVENTION: The 30-minute acupressure or touch on SP6 acupoint was performed. OUTCOME MEASURES: Labor pain was measured four times using a structured questionnaire, a subjective labor pain scale (visual-analogue scale [VAS]): before intervention, immediately after the intervention, and 30 and 60 minutes after the intervention. Length of delivery time was calculated in two stages: from 3 cm cervical dilation to full cervical dilatation, and full cervical dilatation to the delivery. RESULTS: There were significant differences between the groups in subjective labor pain scores at all time points following the intervention: immediately after the intervention (p = 0.012); 30 minutes after the intervention (p = 0.021); and 60 minutes after the intervention (p = 0.012). The total labor time (3 cm dilatation to delivery) was significantly shorter in the SP6 acupressure intervention group than in the control group (p = 0.006). CONCLUSIONS: These findings showed that SP6 acupressure was effective for decreasing labor pain and shortening the length of delivery time. SP6 acupressure can be an effective nursing management for women in labor.

[Difference in time of bowel sounds and passing of gas in abdominal hysterectomy patients having San-Yin-Jia (SP-6) acupressure].

PURPOSE: The purpose of this study was to compare differences in the time when bowel sounds were heard and gas was passed in women who had an abdominal hysterectomy and were treated for 5 minutes (experimental group A) or 10 minutes (experimental group B) with San-Yin-Jiao (SP-6) acupressure. METHOD: The design of this study was a nonequivalent control group non-synchronized post test only design. The participants included 142 women, 39 in experimental group A, 30 in experimental group B, and 73 in the control group. Data was collected using a structured questionnaire which included items on general characteristics and a self report of time when gas was passed. Differences for the three groups as to time when bowel sounds were heard and gas was passed were analyzed using ANOVA. RESULT: The time when bowel sounds were heard was statistically significantly shorter in both experimental groups compared to the control group(F=10.29, p=.000). The time when gas was passed was statistically significantly shorter in experimental group B(10 min) compared to the control group(F=4.68, p=.011). CONCLUSION: It could be concluded that SP-6 acupressure of 10 minutes was effective in shortening the time until bowel sounds were heard and gas was passed for women who had had an abdominal hysterectomy. Replication of the study with a larger number of participants is necessary in order to be able to generalize the results.

Commercial sex workers'condom use behavior in Korea.

PURPOSE: With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse. METHODS: Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion. RESULTS: The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients' reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse. CONCLUSION: Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.

[Effects of SP-6 acupressure on dysmenorrhea, cortisol, epinephrine and norepinephrine in the college students].

PURPOSE: The purpose of this study was to identify effects of the SP-6 acupressure on dysmenorrhea, and level of cortisol, epinephrine and norepinephrine in the college students. METHOD: Data were collected from May 1 to August 31, 2002. A total of 58 students from two universities participated in the study. Both groups were pretested before the intervention for three variables, the intensity of dysmenorrhea, level of cortisol, epinephrine and norepinephrine. Then, SP-6 acupressure was provided for 20 minutes for students in the experimental group. The instruments used in this study included the Visual Analogue Scale developed by Johnson(1974), Menstrual Attitudes Questionnaire Scale developed by Brooks-Gunn & Ruble(1980), and Stress scale developed by Cheun and Kim(1990). RESULT: There were statistically significant differences in the intensity of dysmenorrhea at the time immediately after, 30 minutes after, one hour after, and two hours after the intervention. The experimental group had a lower intensity than the control group. There was a statistically significant difference in level of norepinephrine at the time 30 minutes after the intervention with the experimental group. CONCLUSION: The SP-6 acupressure reduced the subjective perception of dysmenorrhea and the levels of norepinephrine. It was found out that the lasting period of 20 minutes of the SP-6 acupressure was two hours for college students.

[Effects of a sexual assertiveness training program in high school girls].

PURPOSE: This study was done to develop an applicable training program for high school girls on sexual assertiveness. METHOD: The design combined methodological study and non-synchronized quasi experimental study designs. The participants were 174 high school girls from two schools. Two questionnaires were used, one consisted of 23 questions on self efficacy and the other, of 22 items on sexual assertiveness. The SPSS 10.0 program was used for data analysis. Experimental group 1(3 hour program) and experimental group 2(6 hour program) were received on sexual assertiveness. The sexual assertiveness program was carried out by members of the research team. There were no differences in demographic characteristics between control group, experimental group 1, and experimental group 2. RESULT: There was no significant increase in self efficacy scores in experimental group 1 over the control group, but there was a significant increase in sexual assertiveness scores in the experimental group 1 over the control group. There was an increase in self efficacy scores in experimental group 2 over the control group, but it was not significant. There was a significant increase in sexual assertiveness scores in experimental group 2 over the control group. There was no significant increase in self efficacy scores in the experimental group 2 over the experimental group 1, and there was no significant increase in sexual assertiveness scores in experimental group 2 over the experimental group 1. CONCLUSION: The results show that a 3 hour program was as effective as a 6 hour program for sexual assertiveness. Therefore, it is advisable to use a 3 hour program for clinical convenience. But further study is needed to determine the lasting effect on sexual assertiveness.

[Sexual autonomy in college students].

PURPOSE: This study was to add to the understanding of sexual autonomy in college students in Korea. A descriptive survey design was used. METHOD: The participants in this study were 1,865 college students from 13 colleges, The questionnaire consisted of 15 items on general characteristics and 13 items measuring sexual autonomy. The SPSS 10.0 program was used for data analysis. RESULT: The global score for sexual autonomy was relatively high at 55.24 with a possible range of 13-65. The item on sexual autonomy with the highest score were, 'I can prevent repeated STD infections' and the item with the lowest sexual autonomy score was 'I can speak clearly about having intercourse'. Factors related to sexual autonomy were identified as gender, parents' attitude, year in university, experience with STD prevention and experience with pregnancy prevention. The score for sexual autonomy was lower in male college students (p=.000), students whose parents' attitudes to sex were vague, first year students (p=.000), students who had little experience with prevention of STDs (p=.002), students who had little experience with prevention of pregnancy (p=.001). CONCLUSION: The results showed that in setting priorities for sex education the following groups of students should be given first priority, male students, students whose parents' attitudes to sex were vague, first year students, students who have not had experience with prevention of STDs, and students who have not had experience with prevention of pregnancy.