The Effect of Virtual Presence and Self-Efficacy on Nursing Students' Evaluation of Virtual Simulation Training.

The study aims to determine the effect of virtual simulation practice in nursing students using the Virtual Patient Learning System Evaluation (VPLSE) tool. The study uses descriptive research, centering on correlation and regression analysis. 295 nursing students in Grades 3 and 4 who have experienced virtual simulation practice within the past year were included. The main variables of VPLSE comprise four sub-domains: nursing knowledge improvement, clinical competency development, confidence in nursing performance, and nursing care plan application. In addition to the VPLSE, two other tools, measuring virtual presence and self-efficacy, were utilized. The VPLSE was significantly positively correlated with virtual presence and self-efficacy, respectively. The VPLSE subdomain of "clinical competency development" had a strong positive correlation with virtual presence. To increase the effect of virtual simulation education, it is necessary to maintain the advantages of virtual simulation practice, such as freedom from space and time, repeated learning, psychological stability and application of nursing plans.

Relationships among Perceptions of Dying Well, Attitudes toward Advance Directives, and Preferences for Advance Directives among Elderly Living Alone.

Purpose: This study investigated awareness of dying well, as well as attitudes and preferences toward advance directives (ADs), among elderly individuals who lived alone. Methods: The participants were 173 elderly people living alone. Data were collected from July 2019 to September 2019 using questionnaires on perceptions of dying well, awareness of advance directives, and general characteristics. Results: The majority of participants (68.2%) stated that they had never heard of advance directives. The information they requested to include in their advance directives mostly involved decisions on pain treatment, such as the use of analgesic drugs in the final stages of a terminal disease. Perceptions of dying well were statistically significantly different according to age and education. Conclusion: This study discussed the attitudes and preferences of elderly living alone regarding advance directives to provide basic resources for the systematic and active use of advance directives.

A meta-analysis of the variables related to job satisfaction among Korean nurses.

BACKGROUND: The shortage of nursing workforce has been a critical and global issue and associated with job satisfaction. OBJECTIVES: To evaluate the strength of the relationships between job satisfaction and organizational commitment, job stress, and turnover intention among Korean nurses. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; Korean Education & Research Information Service, KISS, DB pia, PubMed, and CINAHL databases were searched. The meta-analysis software package, R program (version 3.0.1), was used. RESULTS: Thirty-eight of 1245 screened studies had appropriate data. The overall relationships were high and significant, and increased organizational commitment (WES = .62), decreased turnover intention (WES = -.47), and decreased job stress (WES = -.37) were associated with job satisfaction. CONCLUSION: The strongest relationship was identified between organizational commitment and job satisfaction. These findings have important implications for improving organizational commitment to increase job satisfaction among nurses.

[Effects of Learning Activities on Application of Learning Portfolio in Nursing Management Course].

PURPOSE: This study was conducted to examine effects of a learning portfolio by identifying the learning of nursing students taking a learning portfolio-utilized nursing management class. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 83 senior students taking the nursing management course in one of the Departments of Nursing at 2 Universities. Experimental group (n=42) received a learning portfolio-utilized nursing management class 15 times over 15 weeks (3 hours weekly). Self-directed learning abilities, approaches to learning and learning flow of the participants were examined with self-report structured questionnaires. Data were collected between September 2 and December 16, 2014, and were analyzed using chi-square test, Fisher's exact test, independent t-test and ANCOVA with SPSS/PC version 21.0. RESULTS: After the intervention the experimental group showed significant increases in self-directed learning abilities, deep approaches to learning and learning flow compared to the control group. However, no significant difference was found between groups for surface approaches to learning. CONCLUSION: Learning activities using the learning portfolios could be effective in cultivating the learning competency for growth of knowledge, technology and professionalism by increasing personal concentration and organization ability of the nursing students so that they can react to the rapidly changing environment.

[Structural Equation Modeling on Living and Brain Death Organ Donation Intention in Nursing Students].

PURPOSE: The purpose of this study was to test and validate a model to predict living and brain death organ donation intention in nursing students. The conceptual model was based on the theory planned behavior. METHODS: Quota sampling methodology was used to recruit 921 nursing students from all over the country and data collection was done from October 1 to December 20, 2013. RESULTS: The model fit indices for the hypothetical model were suitable for the recommended level. Knowledge, attitude, subjective norm and perceived behavioral control explained 40.2% and 40.1% respectively for both living and brain death organ donation intention. Subjective norm was the most direct influential factor for organ donation intention. Knowledge had significant direct effect on attitude and indirect effect on subjective norm and perceived behavioral control. These effects were higher in brain death organ donation intention than in living donation intention. CONCLUSION: The overall findings of this study suggest the need to develop systematic education programs to increases knowledge about brain death organ donation. The development, application, and evaluation of intervention programs are required to improve subjective norm.

Results of a community vision-screening program using the Spot photoscreener.

PURPOSE: To describe the results of vision screenings performed with the Spot photoscreener in the community setting. METHODS: Low-income, predominantly Hispanic children in day care and preschool settings were screened by lay operators using the Spot photoscreener. Inclusion criteria were age 6-72 months and availability of a complete photoscreening record. Referral criteria were based on Vision Screening Committee of American Association for Pediatric Ophthalmology and Strabismus guidelines. Data were stratified by age group and analyzed for percentage of children referred for hyperopia, myopia, astigmatism, anisometropia, anisocoria, and ocular misalignment. Vision screening records were compared with comprehensive eye examination records from an optometrist or ophthalmologist to determine positive predictive value. RESULTS: Vision screening examinations were performed on 8,317 subjects from September 2011 through May 2012. The mean age of the 7,814 subjects (3953 males) meeting inclusion criteria was 44.4 months. The Spot referred 2,393 (30.6%). Of the screened population, the suspected reason for referral was astigmatism in 1,863 (23.8%), ocular misalignment in 879 (11.3%), anisometropia in 90 (1.2%), myopia in 82 (1.1%), hyperopia in 63 (0.8%), and anisocoria in 16 (0.2%). Comprehensive examination reports, including a cycloplegic refraction, were available for 300 referred children (12.5%). The reason for referral was confirmed in 55.7%, with an overall positive predictive value of 65.7%. CONCLUSIONS: The Spot photoscreener yielded a high overall referral rate. Although a high prevalence of astigmatism may be expected in this population, a high referral rate for suspected ocular misalignment led to a very high proportion of false positive referrals, suggesting that the software for this algorithm is in need of refinement.

Sodium Bicarbonate Solution versus Chlorhexidine Mouthwash in Oral Care of Acute Leukemia Patients Undergoing Induction Chemotherapy: A Randomized Controlled Trial.

PURPOSE: The objective of this study was to compare the effectiveness of sodium bicarbonate (SB) solution with chlorhexidine (CHX) mouthwash in oral care of acute leukemia patients under induction chemotherapy. METHODS: Forty-eight patients were randomly selected and assigned to an SB solution group or CHX-based product group according to acute myelogenous leukemia or acute lymphoblastic leukemia. Patients were asked to rinse their mouth four times a day from the day before chemotherapy started until discharge. The World Health Organization mucositis grade, patient-reported Oral Mucositis Daily Questionnaire, and clinical signs associated with infection were assessed on a daily basis. The oral microbial count was assessed on a weekly basis from the 1st day of chemotherapy started to the 28th day or to the day of discharge from the hospital. RESULTS: Of all the patients in the SB group, 25.0% developed ulcerative oral mucositis, whereas 62.5% in the CHX group did. The onset of oral mucositis was later in the SB group than the CHX group. The oral bacterial colonization in the SB group was significantly higher than that in the CHX group, but clinical signs associated with infection did not differ in both groups. CONCLUSION: As a result of this study, it was found that oral care by SB solution for acute leukemia patients undergoing chemotherapy was an effective intervention to improve oral health.

Emergence of community-associated methicillin-resistant Staphylococcus aureus strains as a cause of healthcare-associated bloodstream infections in Korea.

BACKGROUND: The prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea. OBJECTIVE: We sought to determine the prevalence of CA-MRSA strains among isolates recovered from patients with MRSA BSIs and to explore epidemiological changes in Korea. We also sought to evaluate clinical characteristics relevant to the development of healthcare-associated BSIs. METHODS: We prospectively collected consecutive MRSA isolates from patients with BSI at 4 hospitals from July 1 through November 30, 2007, and we also included MRSA isolates recovered from culture of blood samples collected during a previous year (October 1, 2004 through September 30, 2005) at a different hospital. Molecular typing studies were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, Staphylococcus protein A (spa) typing, and staphylococcal cassette chromosome mec (SCCmec) typing. We compared the clinical characteristics and outcomes of patients with healthcare-associated BSI due to CA-MRSA strains with those of patients with healthcare-associated BSI due to healthcare-associated MRSA (HA-MRSA) strains. RESULTS: There were 76 cases of MRSA BSI, of which 4 (5.3%) were community-associated and 72 (94.7%) were healthcare-associated. Among the 72 HA-MRSA BSIs, 18 (25%) were community onset, and 54 (75%) were hospital onset. PFGE type D-ST72-spa B-SCCmec type IVA MRSA, the predominant genotype of CA-MRSA in Korea, accounted for 19 (25%) of all 76 MRSA BSIs, including 17 (23.6%) of 72 HA-MRSA BSIs and 11 (20.8%) of 53 hospital-onset HA-MRSA BSIs. Patients with healthcare-associated BSIs due to CA-MRSA strains carrying SCCmec type IVA tended to have fewer healthcare-associated risk factors, compared with patients with healthcare-associated BSIs due to HA-MRSA strains carrying other SCCmec types. The presence of a central venous catheter or other invasive device was the only independent factor differentiating patients infected with hospital-associated genotype strains from patients infected with other strains. Clinical outcomes were similar between both groups. CONCLUSIONS: CA-MRSA strains are emerging as a major cause of BSI in healthcare settings in Korea. This changing epidemiology of MRSA poses a challenge to public health and infection control in hospital settings.