International collaboration for home care education, Part I: Creating the partnership.

This two-part series describes the collaborative summer home care nursing program for Korean nurses conducted by the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, in cooperation with the College of Nursing of Yonsei University, Seoul, Korea. Part I focuses on the development of the collaboration, and part II focuses on the content of the three-week summer home care program and describes related issues and problems as well as suggests solutions. The series concludes with the findings on the program from the postprogram evaluations of students, preceptors, and patients. The collaborative educational program was developed to give Korean home care nurses an opportunity to gain clinical experience in home care nursing in the United States so that they could learn how to deliver better-quality home care for patients and their informal caregivers. Therefore, the program focused on practice-oriented lectures and clinical experiences.

[Effect of shift interval for the clinical nurse with respect to circadian rhythm].

Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep-wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi-continuous shift schedule (sunday off) with a backward direction; that is, morning-evening-night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking time, sleep-wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep-wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep-wake cycle for subjects on the morning, evening, and night shift in both of the shift groups (weekly shift group: lambda = 0.121, p less than 0.01, lambda = 0.112, p less than 0.01, biweekly shift group: lambda = 0.116, p less than 0.01, lambda = 0.084, p less than 0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group.(ABSTRACT TRUNCATED AT 400 WORDS)

[A study on the effect of cold applications using a sponge bath in healthy adults].

This study was a quasi-experimental research study to test the characteristics of temperature regulation according to sponge bath methods of cold application. Thirteen volunteers were selected from among nursing college students according to an established criteria using a purposive sampling technique. Four different cold application methods were used: (1) tepid water sponge bath at 28 degrees C, (2) 20% alcohol sponge bath at 28 degrees C, (3) 40% alcohol sponge bath at 28 degrees C and (4) tepid water sponge bath at 28 degrees C plus an ice bag to the head. Changes in rectal temperature, mean skin temperature, mean body temperature, heat content change and thermal discomfort during the cold application were measured at 5 minute intervals over a 120 minute period. The data collection period was from Dec. 20, 1988 to Feb. 3, 1989. The data were analyzed using descriptive statistics, simple regression, ANOVA, Duncan's multiple range test and Pearson correlation coefficient using the SPSS-X Program. The results of the study are summarized as follows. Five general hypothesis were tested. Hypothesis 1 that "Change in heat content will be decreased for each cold application method according to the cold application time" was rejected. (tepid water sponge bath: after 10 minutes of cold application, 20% alcohol sponge bath: after 25 minutes of cold application: 40% alcohol sponge bath: after 45 minutes of cold application, tepid water sponge bath plus an ice bag to the head: after 80 minutes of cold application). Hypothesis 2 that "Thermal discomfort will be changed for each cold application method according to the cold application time" was rejected after 5 minutes of cold application. Hypothesis 3 that "Change in heat content will differ among the cold application methods" was accepted except 0-5, 0-10, 0-65, 0-105 and 0-120 minute. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 4 that "Thermal discomfort will differ among the cold application methods" was accepted at 15, 20, 35, 45, 75, 80, 90, 95, 100, 105, 110, 115 and 120 minute of cold application time. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 5 that "The higher the change in heat content, the higher the thermal discomfort during the cold application time" was accepted for between 10-60 and 75 minute of cold application.(ABSTRACT TRUNCATED AT 400 WORDS)