Exploring nurses' experiences in pressure sore care in long-term care facilities.

BACKGROUND: This study uses an interpretive description approach to explore nurses' experiences with pressure sore care in long-term care facilities, highlighting the complexity of their encounters. METHODS: 10 experienced nurses from South Korean small to medium-sized hospitals were chosen via purposive sampling for interviews. Data analysis utilized Braun and Clarke's reflexive thematic analysis. RESULTS: The study's findings collectively reflect the intricate journey of nurses in Long-term care facilities as they grapple with the challenges of pressure sore care. These nurses transform their perception of pressure sores, encountering a dynamic shift in their understanding. They face multifaceted challenges in providing optimal care, marked by resource constraints and the absence of standardized guidelines. Emotionally, they navigate a complex terrain of sentiments, oscillating between feelings of accomplishment and helplessness. Despite these hurdles, they persistently strive for excellence in pressure sore nursing, driven by an unwavering commitment to delivering the best possible care within the confines of their healthcare environment. CONCLUSION: The study enhances understanding of pressure sore care in long-term facilities and suggests avenues for improving nursing practices and care quality through targeted interventions.

The Poetry of Recovery in Peer Support Workers with Mental Illness: An Interpretative Phenomenological Analysis.

This study was conducted to investigate and understand various aspects related to participants' experiences in peer support activities, with a particular focus on their personal growth and the influence of these activities on their lives. In this qualitative study, peer support workers with mental illness were the main subjects, and they were recruited from G Metropolitan City, South Korea. The study used purposive sampling, guided by recommendations from peer support worker support organizations. A total of five participants were selected using purposive sampling to ensure maximum variability in the sample. Data collection involved semi-structured individual interviews, and data analysis was conducted using the interpretative phenomenological analysis (IPA) method. Following the IPA procedure for data analysis, the study revealed six themes that encapsulated the recovery experiences of peer support workers with mental illness: (1) Facing confusion and challenges, (2) Rising and refining myself, (3) Navigating the paths of relationships, (4) Gazing at the desired horizons, (5) Awakening the inner hero, and (6) Standing as a person who cherishes life. This research underscores the positive impact of peer support activities on individuals who have faced mental health challenges. It emphasizes the significance of self-discovery, the development of supportive relationships, and the aspiration for a brighter future. These findings contribute to the expanding body of knowledge regarding the benefits of peer support in the context of mental health recovery.

Using the design-thinking method to develop and validate a peer evaluation scale for team-based learning (PES-TBL) for nursing students.

BACKGROUND: Peer evaluation in team-based learning provides meaningful information about the learning process and dynamics. Despite the importance of peer evaluation in learner-centred learning, there is a lack of valid and reliable scales that reflect students' experiences in the classroom. OBJECTIVES: To develop and validate a peer evaluation scale for team-based learning. DESIGN: A cross-sectional methodological study. SETTING: Four universities located in Gwangju, Republic of Korea. PARTICIPANTS: Eight nursing students exposed to team-based learning voluntarily participated in a design-thinking project, and eight nursing professors were selected for content validity. For the validation of the Scale, 722 nursing students were randomly selected. METHODS: The design-thinking method was implemented to develop the Scale, and a questionnaire was used to assess the Scale's construct validity and reliability. The construct validity was examined in a split-half analysis with exploratory and confirmatory factor analyses. Cronbach's alpha, McDonald's omega, and composite reliability were investigated for the peer evaluation scale for team-based learning. RESULTS: A 12-item tool, with each item using a 5-point scale for peer evaluation, was developed through the empathise, define, ideate, prototype, and test stages of the design-thinking method. Exploratory factor analysis identified three factors from the 12 items: responsibility, initiative, and collaboration. Confirmatory factor analysis demonstrated that the tool had acceptable convergent and discriminant validity, thus confirming good construct validity. All values for reliability were >0.70. CONCLUSIONS: This study was noteworthy in that it employed the design-thinking method to reflect learners' opinions in developing a peer evaluation instrument. Moreover, the study demonstrated adequate evidence of reliability and validity. Consequently, the developed Scale can be effectively applied to team-based learning assessments for nursing students.

Drug Attitude and Medication Adherence of Patients with Early Psychosis in South Korea: Mediating Effect of Medication Adherence Self-Efficacy.

Purpose: This study examined the mediating effect of medication adherence self-efficacy (MASE) on the relationship between drug attitude (DA) and medication adherence (MA) in patients with early psychosis. Patients and Methods: A total of 166 patients, aged 20 years or older, and who had received treatment within 5 years of their initial psychotic episode at a University Hospital outpatient center, participated in the study. Data were analyzed using descriptive statistics, t-tests, one-way analysis of variance, Pearson's correlation coefficients, and multiple linear regression. Additionally, a bootstrapping test was conducted to determine the statistical significance of the mediating effect. All study procedures adhered to Strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. Results: This study found a significant correlation between MA and DA (r=0.393, p<0.001), and between MA and MASE (r=0.697, p<0.001). MASE had a partial mediating effect on the association between DA and MA. The model that integrated both DA and MASE accounted for 53.4% of the variation in MA. Bootstrapping analysis indicated that MASE was a significant partial parameter (lower limit confidence interval [CI] 0.114; upper limit CI 0.356). Further, 64.5% of the study participants were either currently enrolled in college or had higher levels of education. Conclusion: These findings could potentially lead to a more personalized approach to medication education and adherence, considering the unique DA and MASE of each patient. By identifying the mediating effect of MASE on the relationship between DA and MA, healthcare providers could tailor interventions to enhance the ability of patients with early psychosis to adhere to prescribed medication regimens.

Effects of Dietary Habits on General and Abdominal Obesity in Community-dwelling Patients with Schizophrenia.

Objective: To investigate the effects of dietary habits on general and abdominal obesity in community-dwelling patients with schizophrenia spectrum disorder according to sex. Methods: A total of 270 patients with schizophrenia spectrum disorder registered at mental health welfare centers and rehabilitation facilities were recruited. General obesity was defined as a body mass index ≥ 30 kg/m2, and abdominal obesity was defined as a waist circumstance ≥ 90 cm in men and ≥ 85 cm in women. Dietary habits were evaluated using dietary guidelines published by the Korean Ministry of Health and Welfare. Demographic and clinical characteristics along with dietary habits and information related to obesity were collected. Factors related to obesity were evaluated separately by sex. Results: Dietary habits differed according to sex, in that scores for healthy eating habits were lower in men than in women. In men, the prevalences of general and abdominal obesity were 17.0% and 37.3%, respectively. In women, the prevalences of general and abdominal obesity were 23.1% and 38.5%, respectively. Regression analysis showed that the scores of regular eating habits were negatively associated with general and abdominal obesity in men, and the scores of healthy eating habits were negatively associated with general and abdominal obesity in women. Conclusion: Among patients with schizophrenia, regular eating habits might reduce the risk of obesity in men, and healthy eating habits might reduce the risk of obesity in women. Nutrition education should be provided to community- dwelling patients with schizophrenia to prevent obesity in this population.

Effectiveness of a service design training program to improve clinical nurses' compassion and problem-solving in Korea.

Service design is an innovative tool used to improve the quality of patient experience, therefore, making it necessary for nurses to be able to implement it. The aim of this study was to examine the effects of a training program for patient experience-based nursing service design (PEN-SD) on clinical nurses' compassion and problem-solving ability. This study employed a mixed-methods design: a one-group, pretest-posttest design was used as the quantitative approach, and structured interviews were used as the qualitative approach. The participants were 21 nurses recruited from a university hospital in Korea. A PEN-SD training program was conducted from September 1 to October 6, 2018. After the training program, the participants' compassion significantly improved (p = .025) but there was no significant difference in their problem-solving ability (p = .313). In the structured interviews, majority of the participants (n = 17) felt that they were able to consider problems from the patient's perspective. They also reported being able to identify solutions to problems through careful observation (n = 5). The PEN-SD training program was effective in improving compassion among nurses.

Nurses' Electronic Medical Record Workarounds in Mental Healthcare Settings.

This study aimed to examine nurses' EMR workarounds in mental healthcare settings. Of the 52 nurses invited to participate in this study, 50 nurses (96.1%) completed the survey using the EMR nursing workaround instrument and open-ended questions. The data collected were analyzed using descriptive statistics and Pearson's correlation coefficients. The descriptive data were grouped into four units including the cases, contributing causes, and consequences of EMR workarounds, and suggestions for improving EMR implementation. The results showed scores above an average of 3.0 in all of the EMR workaround items, indicating the considerable involvement of nurses in EMR workarounds. The workarounds related to EMR use were using the physician's login account for medication access, performing retrospective documentation, performing documentation before an expected busy situation, and seeking and entering information on external medications. The workarounds associated with colleagues unfamiliar with EMR use included waiting for, filling in for, teaching, and assisting unskilled colleagues. This study identified the problems, consequences, and suggestions associated with EMR implementation for psychiatric patient care. This study added useful information for the administrative, technical, and clinical improvement of EMR implementation in mental healthcare practice.

Construction of Exercise Behavior Model in Patients with Rheumatoid Arthritis.

BACKGROUND: Despite the awareness that regular exercise has a positive impact on maintaining health, patients with rheumatoid arthritis (RA) engage in markedly less exercise than do the general population. Weaimed to construct and test a structural equation model of exercise behavior in patients with RA based on self-determination theory and self-efficacy theory. METHODS: Participants were 214 outpatients with RA at Chonnam National University Hospital located in the Gwangju City, South Korea from Mar to Apr 2018. A structured self-report questionnaire was used to assess autonomy support, autonomy, competence, relatedness, autonomous motivation, self-efficacy, and exercise behavior. Collected data were analyzed using SPSS 22.0 and AMOS 22.0 program. RESULTS: The structural model showed a good fitness with the data (χ2= 727.27, df = 392, P<0.001, TLI = 0.92, CFI = 0.93, RMSEA = 0.07, SRMR = 0.07). Autonomous motivation and self-efficacy had a significant effect on exercise behavior in patients with RA. This model explained 21.2% of the variance of exercise behavior in patients with RA. CONCLUSION: Self-efficiency and autonomous motivation should be promoted in order to strengthen the exercise behavior of patients with RA.

[Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial].

PURPOSE: This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma. METHODS: Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables. RESULTS: There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL. CONCLUSION: This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

[Factors affecting social competence in school-aged children according to alcohol consumption by parents'].

PURPOSE: The purpose of this study was to identify factors affecting the social competence of school-aged children according alcohol consumption by their parents. METHODS: The participants were 558 5th grade elementary school students. Data were collected using structured questionnaires from September 17 to October 2 2013, and analyzed using descriptive statistics, χ²-test, t-test, ANOVA, Pearson correlation coefficients, and Stepwise multiple regression analysis with the SPSS PC+ 21.0 program. RESULTS: Participants were classified into three groups according to alcohol use; Non-use parent group (52.7%), social use parent group (31.0%), and problem use parent group (16.3%). Participants whose parents were problem users had significantly lower scores on emotional awareness and expression (F=14.45, p<.001), social support (F=5.82, p=.003), and social competence (F=16.33, p<.001) compared to students in the other two groups. In school-aged children with parents who were alcohol abusers, the variables that predicted social competence was friend support (66.0%). CONCLUSION: These results emphasize the importance of focusing on the crucial role of peer support in the development of social competence in school-aged children of parents who abuse alcohol. Further, for these children, interventions aimed at improving social support and children's emotional awareness and expression may be most beneficial.

[Effects of a cultural competence promotion program for multicultural maternity nursing care: case-based small group learning].

PURPOSE: The purpose of this study was to examine the effects of a cultural competence improvement program for maternity nurses. METHODS: A quasi-experimental study using a non-equivalent control group pre and posttest design was used. Participants were 67 maternity nurses caring for multicultural pregnant women in G city. The cultural competence improvement program was developed based on the 3-D Puzzle Model and was provided using case-based small group learning methods for the experimental group (n=31). The control group (n=36) did not receive any intervention. Data were collected using self-report structured questionnaires at two time points: prior to the intervention and after the intervention and were analyzed with descriptive statistics, χ²-test, and t-test. RESULTS: Compared to the control group, the experimental group reported significant positive changes for cultural knowledge (t=6.39, p<.001), cultural awareness (t=3.50, p<.001), and cultural acceptance (t=4.08, p<.001). However, change in cultural nursing behaviors (t=0.92, p=.067) was not significantly different between the two groups. CONCLUSION: Findings from this study indicate that a cultural competence improvement program with case-based small group learning is a useful intervention strategy to promote multicultural maternity care. Further, strategies to improve cultural nursing behavior should be developed to promote culturally congruent nursing care.

[Effects of a maternal sexuality education program for mothers of preschoolers].

PURPOSE: The purpose of this study was to evaluate effects of a maternal sexuality education program for mothers of preschoolers. METHODS: A quasi-experimental with non-equivalent control group pretest-posttest design was conducted. The participants were 55 mothers of preschoolers in G city (Experimental group=27, Control group=28). The experimental group received the maternal sexuality education, and the control group received the program after the experiment. Data were collected during October and November 2012 through self-administered questionnaires at two times: prior to the intervention and after the intervention. Data were analyzed using χ²-test, Fisher's exact test and t-test. RESULTS: After the intervention, mothers in the experimental group reported significant differences in knowledge of sex (t=3.74, p<.001), attitude toward sex (t=4.31, p<.001), parent-efficacy on child sexuality education (t=11.96, p<.001). compared to mothers in the control group. CONCLUSION: These results indicate that a sexuality education program for mothers of preschoolers is effective in improving knowledge of sex, attitude toward sex, and parent-efficacy on child sexuality education. Therefore further study should be done with larger and varied participants to confirm the effects of sexuality education programs for mothers of preschoolers.

[Test of validity and reliability of the adolescent mental problem questionnaire for Korean high school students].

PURPOSE: This study was done to test the validity and reliability of the Adolescent Mental Problem Questionnaire (AMPQ) for Korean high school students. METHODS: The AMPQ was designed to assess adolescents' mental health status and problem behavior (Ahn, 2006). A methodological study design was used with exploratory factor analysis, Pearson's correlation coefficients, and a fitness of the modified model for validity. Also, Cronbach's alpha coefficients and alternative-form method for reliability were used. AMPQ was tested with a sample of 36,313 high school students. The participants consisted of 18,701 males and 17,612 females. RESULTS: Seven factors were extracted through factor analysis: 'Psychiatric problems', 'Delinquency', 'Academic troubles', 'Family problems', 'Hazardous behavior', 'Harmful circumstance', 'Eating problems'. These factors explained 51.1% of the total variance. The fitness of the modified model was good (X(2)=38,413.76, Goodness of Fit Index [GFI]=.94, Adjusted Goodness of Fit Index [AGFI]=.93, Comparative Fit Index [CFI]=.95, Root Mean Square Error of Approximation [RMSEA]=.05), and concurrent validity with Korea-Youth Self-Report [K-YSR] was .63. Cronbach's alpha coefficient of the 31 items was .85. CONCLUSION: The results of present study suggest that the modified AMPQ instrument may be useful for efficiently assessing mental health status and problem behavior in late adolescent, high school students.

[Health experience of depressive adolescents: reflected from Newman's praxis methodology].

PURPOSE: Guided by Newman's theory of health as expanding consciousness, this study was done to explore the health experience of adolescents having depression. METHODS: The researcher engaged in six to eight in-depth interviews with six adolescents. To begin the dialog, the researcher asked each participant to recount the first important memory he/she had. All the narrative and diagram sharing between the researcher and participants were summarized according to recognized patterns and later elaborated in following interviews based on Newman's praxis methodology. RESULTS: The significant individual pattern of early health experience was during the binding stage. At the turning point, individual patterns for participants revealed a personal journey of self-discovery and then emergence of reflecting behaviors. After the turning point, the participants changed as they evolved from the initial period of disruption and disorganization to organization at a higher level. The results suggest that adolescents who are depressive find new ways of relating to friends, family, healthcare providers, and the community by expanding their consciousness. CONCLUSION: Newman's praxis methodology is a good way of helping and studying adolescents with depression because it emphasizes participant-nurse/researcher partnership and pattern recognition as nursing practice.