Trends and Meta-Analysis of Research on the Operation of Programs for Bereaved Families in South Korea / 한국호스피스완화의료학회지

Purpose@#This study aimed to analyze interventions for bereaved families and evaluate their effectiveness, with the ultimate goal of supporting evidence-based nursing for bereaved families. @*Methods@#Research trends were identified based on a search of domestic databases from January 2000 to December 2022, and a meta-analysis was conducted on interventions for bereaved families. Forty-five papers were selected, and information was extracted on participants, research design, and interventions. A meta-analysis of seven papers was performed, and the effect size was calculated. @*Results@#Fourteen papers dealt with interventions for middle-aged women who had lost their spouses, 20 used qualitative research methods, and 20 were on art therapy programs. Thirty studies had fewer than 10 participants, and most interventions had 60~120 minutes per session and 9~16 sessions in total.There were seven randomized controlled trials, and all studies included in the quality evaluation showed a low risk of bias. Four papers measured grief as an outcome, and the effect size was -1.9577 (95% CI: -2.9206 to -0.9947), indicating that the treatment significantlydecreased grief (P＜0.001). Six papers measured depression as an outcome, and the effectsize was -1.6775 (95% CI: -2.1835 to -1.1716), showing that the treatment significantly decreased depression (P＜0.001). @*Conclusion@#Intervention programs for bereaved families were shown to be effective in relieving grief and depression. However, programs should be developed that target middle-aged men who have lost their spouses and children who have lost their parents. Randomized controlled trials should also be conducted on interventions to reduce grief and depression.

The Reliability and Validity of a Korean version of the Quality of Life in Life Threatening Illness - Family Carer Version 3: Focused on the families of patients with terminal cancers

Purpose@#This study aimed to evaluate the validity and reliability of the Korean version of the Quality of Life in LifeThreatening Illness - Family Carer Version 3 (QOLLTI-F v3) among Korean family caregivers of patients with terminal cancers. @*Methods@#A total of 198 family caregivers of terminal cancer patients were investigated using the Korean version of QOLLTI-F v3. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, criterion validity and internal consistency. @*Results@#The convergent validity of the Korean version of QOLLTI-F v3 showed that the standardized regression weights for each item were above .50 except for two out of 16 items, the average variance extracted was above .50 for four out of five factors, and the critical ratio ranged from .50 to .85. The discriminant validity of the items across all factors was confirmed. The value for Cronbach’s α of 16 items was .84. @*Conclusion@#The Korean version of the QOLLTI-F v3 is a reliable instrument with acceptable convergent and high discriminant validity for measuring the quality of life of families of people with life-threatening illnesses, including families of people with terminal cancers.

Content Analysis of Multifaceted Needs for Improving the Quality of Pediatric Palliative Care Among Parents of Children With Life-threatening Conditions.

This study aimed to identify parental needs for pediatric palliative care and obtain their opinions on developing pediatric palliative care in South Korea. This qualitative research design used inductive and deductive methods. The data were collected through semistructured interviews. A total of 6 parents actively caring for a child with life-threatening conditions and 7 bereaved parents participated in this study. A total of 707 significant statements, 43 subthemes, and 16 themes according to 6 structured matrices (advance care planning and symptom control, psychological and spiritual care, supporting everyday lives, end-of-life care and bereavement support, delivery model of pediatric palliative care, and unmet needs within current services) on the care and bereavement experiences of parents of children with life-threatening conditions were derived. Palliative care for children is a multidisciplinary approach to evaluate, prevent, and manage multifaceted symptoms and to support children with life-threatening conditions and their families. Our findings suggest that parents of children with life-threatening conditions in South Korea present multidimensional needs across the diagnostic groups and the illness trajectories and inform policy makers and health care professionals to design a pediatric palliative care delivery model. Further studies examining the unmet needs are required to enhance the quality of pediatric palliative care.

Nurses’ Perceived Needs and Barriers Regarding Pediatric Palliative Care: A Mixed-Methods Study / 한국호스피스완화의료학회지

Purpose@#This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). @*Methods@#Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. @*Results@#The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. @*Conclusion@#In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

Content Analysis of the Meaning of Spiritual Care as Perceived by Nursing Students / 한국호스피스완화의료학회지

Purpose@#This study aimed to describe the meaning of spiritual care as perceived by nursing students. @*Methods@#This study used a descriptive research design, and the participants were 126 fourth-year nursing students from three nursing colleges. Data were collected from August to September 2019, and were analyzed using the content analysis method. @*Results@#Four themes of spiritual care with 15 sub-themes were extracted from the content analysis: 1) “promoting spiritual well-being” (sub-themes: “providing religious help”, “caring for the patient as a spiritual being”, and “presupposing human dignity regardless of religion”); 2) “taking place in actual nursing practice” (representative sub-themes: “considering the perspective of the patient”, “reducing suffering”); 3) “caring for the multifaceted needs of human beings” (representative sub-themes: “providing physical, mental, and spiritual care”, “caring for both the mental and physical health of the patient”), and 4) “growing together”(sub-themes: “positively affecting patient well-being”, “beginning with the nurse’s self-transcendence”). @*Conclusion@#These results suggest that nursing students consider spiritual care to be a highly positive and practical form of nursing care. However, because few students have been exposed to religion and spirituality, more systematic training should be provided.

Effects of Non-pharmacological Interventions for Preoperative Anxiety in Surgical Patient: A Systematic Review and Meta-analysis / 기본간호학회지

PURPOSE@#The purpose of this study was to examine the effects of non-pharmacological interventions for preoperative anxiety in surgical patient.@*METHODS@#The search included the following: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL EMBASE, and Korean electronic databases (2000 to November 2018). Risk of bias in randomized studies was assessed using the Cochrane's Risk of Bias (RoB) tool for randomized studies and for non-randomized studies, the Risk of Bias Assessment tool for Non-randomized studies (RoBANS) was used. To estimate the effect size, meta-analysis of the studies was performed using the R program (version 3.5.1).@*RESULTS@#Nineteen trials were included (1,685 participants). The non-pharmacological interventions for preoperative anxiety in surgical patient were music intervention, aromatherapy, and patient education. Specifically, the twelve studies showing the effect of music intervention on anxiety were heterogeneous (χ²=23.42, p=.05, I²=40%). The effect size was −0.77 (95% CI:−0.93, −0.60). The four studies showing the effect of aromatherapy on anxiety were heterogeneous (χ²=8.95, p=.03, I²=66%). The effect size was −0.83 (95% CI: −1.30, −0.36). The three studies measuring the effect of patient education on anxiety identified as homogeneous (χ²=1.95, p=.38, I²=0%). The effect size was −2.85 (95% CI: −5.00, −0.71).@*CONCLUSION@#This meta-analysis indicates that non-pharmacological interventions including music intervention, aromatherapy and patient education may have a beneficial effect on preoperative anxiety. Therefore, the findings of this study provide evidence to incorporate various non-pharmacological interventions into nursing practice to reduce preoperative anxiety.

Palliative Care Competencies Required of Undergraduate Nursing Students in Korea / 한국호스피스완화의료학회지

A resolution adopted by the World Health Assembly in 2014 stated that all nurses should be equipped with palliative care skills in order to integrate palliative care into a day-to-day healthcare system. This article introduces the palliative nursing competency that was developed for the Korean environment by the Korean Hospice Palliative Nursing Research Network based on its study of overseas cases where this competency and competency-based training were developed. This is the first step towards the development of competency-based palliative nursing education, and active efforts should be made to integrate this competency into the undergraduate nursing curriculum.

Content Analysis of Debriefing after Simulation-based Nursing Education on Respiratory Distress Syndrome in the Neonatal Intensive Care Unit

PURPOSE: The purpose of this study was to explore nursing students' experiences of debriefing after simulation-based learning and to obtain fundamental data to support the development of effective teaching strategies. METHODS: Sixty-seven nursing students participated in this study from April to May, 2017. This was a descriptive study analyzing the content of students' descriptions of structured questions in 3 stages (description, analysis, and application) based on recorded videos. RESULTS: The description stage was classified into 3 categories for problem recognition, 4 categories for the nursing plan, and 6 categories for the nursing intervention. The analysis stage was classified into 6 categories for satisfactory practice, 3 categories for experience and 4 categories for what they learned through practice. The application stage was classified into 5 categories, that were to be mastered, and 6 categories, that were important to recognize. CONCLUSION: This study succeeded in charaterizing learners' experiences of debriefing. During the debriefing, students watched recorded videos, and we found that self-evaluation through structured questionnaires could be a very effective way to strengthen students' core competencies. Our content analysis of the debriefing is expected to contribute to the development of effective strategies in simulation-based education for students and nurses.

Parent Involvement Intervention in Developing Weight Management Skills for both Parents and Overweight/Obese Children

PURPOSE: The purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents' skills in managing children's weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity. METHODS: A randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly news-letters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect. RESULTS: After the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05). CONCLUSIONS: The results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in children's body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.

Disease Prevalence, Parent's Educational Needs, and Disease Management according to Severity of Respiratory Infections in Early Childhood

PURPOSE: The purpose of this study was to investigate disease prevalence, parent's educational needs, and disease management according to severity of respiratory infections in early childhood. METHODS: Participants for this study were 173 mothers whose child was admitted to I university hospital in Seoul and whose child was an infant or toddler. Data were collected from December, 17, 2014 to February, 15, 2015 using self-report structured questionnaires. Data were analyzed using IBM/SPSS 21.0 program. RESULTS: There were significant differences in the severity of respiratory infection according to neonatal admission due to dyspnea, feeding type, atopic dermatitis in the infant or allergic disease in father and siblings. Parent's educational needs for the severe respiratory infection group were higher than for the non-severe group. Parent's disease management for the severe respiratory infection group was lower than the non-severe group. CONCLUSION: As important care factors in neonatal admissions include dyspnea, cow milk feeding, eczema, family history of allergies, parent's educational needs and disease management, they should be considered when caring for young children with respiratory infections and their parents.

The Effects of Logotherapy on Meaning of Life of Early Adolescents with Cancer

PURPOSE: To evaluate the effects of a logotherapy program entitled 'Finding treasures in my mind' for early adolescents with cancer. METHODS: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 22 early adolescents with cancer. The experimental group (n=12) participated in the 'Finding treasures in my mind' program which consisted of five-day sessions for one week. The control group (n=10) received the usual nursing care. The effects were measured using meaning of life (MOL) for early adolescents. The collected data were analyzed using Fisher's exact test, t-test, and content analysis. RESULTS: There was a significant difference in MOL for early adolescents (t=3.20, p=.005) between the experimental and control groups. The main results of content analysis were having goals and hope, recovering health, returning to school life, and loving relationships with family. CONCLUSION: Logotherapy is effective in improving the meaning of life of early adolescents with cancer. This education program based on logotherapy can be used as an important nursing intervention in a cancer nursing care setting.

Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units

PURPOSE: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. METHODS: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. RESULTS: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. CONCLUSION: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

Analysis of Life Respect-related Content Portrayed in the 7th to 10th Grade Textbooks in Middle and High Schools

PURPOSE: The purpose of this study was to analyze life respect-related content in the 7th to 10th grade textbooks of middle and high schools. METHODS: Sixty two textbooks adopted as middle and high school textbooks were analyzed for content on life respect. RESULTS: There were 6 categories related to life respect content in the 7th to 9th grade textbooks ('prevention of accidents and the first-aid', 'mental health', 'sex and health', 'prevention of drug abuse, smoking and drinking', 'normal life and health', and 'society and health'). Content on life respect in the 10th grade textbooks was categorized as 'drug abuse, smoking, drinking, and health', 'sex and health', 'mental health', 'life science and treating human life too lightly', 'normal life and health', and 'society and health'. CONCLUSION: Content on life respect attached importance to more practical issue such as prevention of violence and suicide rather than fundamental understanding about self and life. These results suggest that the content on life respect should help adolescents find their own values and meaning of life within the concept of coexistence.