Purpose This study analyzed nursing students’ guided reflective journals following simulation-based practice using standardized patients for the initial care of older adults experiencing falls. It aimed to provide a deeper understanding of how changes in students’ thinking occurred through the learning experience and to describe their levels of reflection.
Methods An eight-hour simulation-based education program was implemented during a geriatric clinical practicum. The program consisted of orientation, pre-learning activities, simulation practice, and a wrap-up session. Reflective journals from 53 third-year nursing students were analyzed using qualitative content analysis.
Results Fifty-three third-year nursing students participated and submitted reflective journals. Three categories emerged from the analysis: “preparing for simulation-based practice,” which involved students setting care plans and employing observation; (2) “experiencing patient fall management through simulation-based practice,” where students actively engaged in realistic fall management scenarios; and (3) “critical reflection after simulation-based practice,” encompassing students’ acquisition of new insights and their personal growth. In the first category, students prepared for patient encounters by developing care plans and conducting observations. The second category highlighted realistic fall management scenarios utilizing standardized patients. The third category focused on personal growth through critical reflection. In the 53 reflective journals (185,021 words), level 3 reflections accounted for 31.6% of the content, while level 5, the highest reflection level, comprised only 8.6%.
Conclusion Post-simulation reflective journaling stimulated critical thinking and self-assessment, enabling nursing students to analyze and reflect deeply on clinical practices. This process reinforced their knowledge base and behavioral foundations essential for clinical practice.
Purpose This study aimed to explore the roles, facilitators, barriers, and future directions of rapid response teams (RRTs) in Korean hospitals from the perspectives of both RRT and ward nurses.
Methods Focus group interviews were conducted with 10 RRT nurses and 10 ward nurses across three hospitals that employed RRTs in Korea from August 2021 to February 2022. The interviews were recorded, transcribed, and analyzed using qualitative content analysis to identify themes relevant to RRT operations.
Results The analysis yielded 10 subtopics and 4 main themes: the exploration of RRT's essential roles, the facilitators and barriers impacting RRT operations, and the construction of a blueprint for future systems. Notable barriers included unclear job assignments without legal safeguards, conflict arising from hierarchical structures, and insufficient organizational support. The following facilitators were identified: transformed perceptions through collaborative efforts, organizational recognition and support, and self-reinforcement by demonstrating expertise.
Conclusion This study highlights the challenges and opportunities associated with implementing RRTs in Korean hospitals, including the need for clear role definitions, effective interprofessional collaboration, and organizational support. Based on these findings, future efforts should focus on establishing legal frameworks that define the scope of practice for RRT nurses.
Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
Korean J Adult Nurs 2024;36(3):191-202. Published online August 31, 2024
Purpose The purposes of this study were to develop a prediction model for pressure injury using a machine learning algorithm and to integrate it into clinical practice. Methods This was a retrospective study of tertiary hospitals in Seoul, Korea. It analyzed patients in 12 departments where many pressure injuries occurred, including 8 general wards and 4 intensive care units from January 2018 to May 2022. In total, 182 variables were included in the model development.
A pressure injury prediction model was developed using the gradient boosting algorithm, logistic regression, and decision tree methods, and it was compared to the Braden scale. Results Among the 1,389,660 general ward cases, there were 451 cases of pressure injuries, and among 139,897 intensive care unit cases, there were 297 cases of pressure injuries. Among the tested prediction models, the gradient boosting algorithm showed the highest predictive performance. The area under the receiver operating characteristic curve of the gradient boosting algorithm's pressure injury prediction model in the general ward and intensive care unit was 0.86 (95% confidence interval, 0.83~0.89) and 0.83 (95% confidence interval, 0.79~0.87), respectively. This model was integrated into the electronic health record system to show each patient's probability for pressure injury occurrence, and the risk factors calculated every hour. Conclusion The prediction model developed using the gradient boosting algorithm exhibited higher performance than the Braden scale. A clinical decision support system that automatically assesses pressure injury risk allows nurses to focus on patients at high risk for pressure injuries without increasing their workload.
Purpose This study examined the relationships of health literacy, physical activity, and grip strength with self-care compliance in older male patients with chronic heart failure. Methods A cross-sectional descriptive was conducted, and 106 older male outpatients with chronic HF were recruited from a veterans’ hospital in Seoul. Data were collected from February 7, 2022 to April 10, 2022 using a self-reported questionnaire and were analyzed using SPSS/WIN 23.0. Results The average age of the participants was 76.3±4.5 years, and the average time elapsed since the heart failure diagnosis was 3.22±2.01 years. The mean self-care compliance score was 42.21±6.03 out of 60 points.
In the univariate analysis, grip strength was not significantly correlated with self-care compliance. The hierarchical regression analysis indicated that health literacy (β=.33, p<.001), physical activity (β=.32, p=.001), and alcohol drinking (β=-.28, p=.001) had statistically significant effects on self-care compliance, collectively explaining 34% of the variance (adjusted R2 =.34, F=12.00, p<.001). Conclusion The study highlights the necessity of periodically assessing and considering health literacy and the level of physical activity when developing educational strategies to promote self-care compliance among older male patients with heart failure in outpatient nursing practice.
Purpose This study aimed to comprehensively understand the experiences of emergency nurses performing triage during the peak and plateau periods of the Coronavirus Disease 2019 (COVID-19) pandemic over the past two years.
Methods: Twenty triage nurses from three emergency medical centers were recruited through purposive and snowball sampling. Data collection occurred from February to May 2022 via focus group interviews and was analyzed using qualitative content analysis.
Results: The experiences of emergency nurses in triage revealed four themes: "changes in priorities due to infectious diseases", "barriers to tirage", "the emotional burden experienced by triage nurses", and "the journey toward growth". The pandemic heightened the focus on infection screening in triage. Triage nurses faced numerous challenges concerning their own safety and that of their patients and encountered difficulties in performing triage. Nonetheless, these experiences provided them with opportunities for professional growth.
Conclusion: The experiences of nurses performing triage during the peak and plateau periods of the COVID-19 pandemic provide valuable insights for future preparedness and coping strategies in the face of similar infectious disease outbreaks. It is necessary to establish integrated triage guidelines for patient safety, develop operations manuals for triage, implement policies on staffing standards, and provide mental health support for triage nurses during pandemics.
Purpose The purpose of this study was to identify factors influencing the readmission of heart transplant recipients through survival analysis.
Methods: We collected data from heart transplant recipients who were discharged after surgery between November 2005 and September 2020 from the electronic medical records of Y University Hospital in Seoul. The Kaplan-Meier estimation was utilized to calculate the survival rate, and Cox's proportional hazards model was employed to determine the factors influencing readmission within 1 year.
Results: Out of 150 heart transplant recipients, 81 (54.0%) were readmitted within one year. The median time to readmission was 231 days.
An increased duration of postoperative days was associated with a higher risk of readmission (p=.016). Groups with abnormal sodium levels (p<.001), those requiring postoperative hemodialysis (p=.013), patients with chronic kidney disease (p=.002), dyslipidemia (p=.040), or diabetes mellitus (p=.045) also faced higher readmission risks. In the final model, sodium levels (hazard ratio [HR]=2.31, p<.001) and chronic kidney disease (HR=1.67, p=.045) were significant risk factors for readmission (x2 =31.90, p<.001).
Conclusion: Interventions to improve kidney function and a multidisciplinary approach are needed to reduce readmission of heart transplant recipients.
Purpose Sarcopenia is significantly associated with frailty, readmission, and mortality in patients with heart failure. This review aims to provide an overview of the literature on sarcopenia in individuals with heart failure. Methods A comprehensive literature review was conducted regarding the current state of knowledge on assessment tools for the diagnosis, prognosis, and optimal management of sarcopenia in patients with heart failure. Results Sarcopenia can be defined as the loss of muscle mass with low muscle strength and/or poor physical performance. Sarcopenia has been officially listed as a disease in the eighth revision of the Korean Classification of Diseases in 2021. The causes of sarcopenia in patients with heart failure are multifactorial, including chronic inflammation, hormonal imbalances, nutritional deficiencies, low muscle blood flow, and endothelial dysfunction. The management of sarcopenia is primarily focused on exercise and/or nutritional management because there is no specific pharmacological therapy to treat sarcopenia. Conclusion Healthcare professionals should be aware of the significance of early detection and timely management of sarcopenia to avoid physical disability, long-term institutional care, and mortality in individuals with heart failure. Clinical trials are required to evaluate the effectiveness of interventions including exercise and nutrition, alone or in combination, on sarcopenia in patients with heart failure. In addition, more research is required to identify multidimensional risk factors and diagnostic biomarkers for sarcopenia.
Purpose The purpose of the study was to describe andropause-related difficulties experienced by men.
Methods: Two focus group interviews were conducted to collect the data from 10 Participants with andropause-related difficulties experienced. All interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis.
Results: We organized the responses concerning andropause symptoms into five essential categories: 1) uncontrollable physical changes, 2) intellectual decline, 3) changes in sexual function, 4) difficulties in controlling emotions, and 5) separation from society. The attempts to alleviate andropause were classified into seven distinct categories: 1) dietary modifications, 2) engaging in physical activities, 3) pursuing leisure and hobbies, 4) enhancing self-esteem and self-perception, 5) seeking support and comprehension from one's social circle, 6) utilizing informational resources concerning andropause, and 7) embracing and accepting andropause reality.
Conclusion: We analyzed the issues arising from andropause and the corresponding efforts to address them. A comprehensive understanding of andropause's causes, mechanisms, effective nursing interventions, and essential development of management programs, including education, is imperative.
Purpose COVID-19 is both a national crisis and a cause of individual trauma. This trauma is experienced during the period of acute illness and for an unpredictable duration after recovery. This study explored experiences of COVID-19 patients in hospital isolation, providing a detailed account of their experiences to furnish basic data necessary for establishing strategies to address the psychosocial problems that may arise from the hospital isolation process and recovery period.
Methods: We conducted comprehensive interviews and qualitative content analysis.
We held in-depth interviews with five COVID-19 patients from May 16 to August 22, 2021, and also analyzed data from interviews with five patients conducted as part of another study on COVID-19 patients' perceptions. Thus, 10 participants' interviews were analyzed in this study.
Results: From the qualitative data, 34 codes, 9 subcategories, and 4 categories were identified. The categories included "Prioritization of epidemic prevention over treatment," "Victims who have been labeled as perpetrators," "Gratitude felt in difficult moments," and "Demand for respect from the system and society." After analyzing these categories, we derived the overarching theme of "It's okay, but it's not okay." Conclusion: During isolation treatment, it is crucial to uphold human rights as much as possible by prioritizing patient care, providing a comfortable environment, and offering clear guidance on their progress. Communication between patients and caregivers should be facilitated to provide psychological support.
Furthermore, national policies such as economic compensation and strategies for post-traumatic growth should be implemented to address grievances and facilitate recovery.
Purpose The purpose of this study is to identify the characteristics of Korean nurses' research participation experiences; their resulting consent satisfaction; pressure to participate; satisfaction in participating; and the factors influencing research participation satisfaction.
Methods A descriptive cross-sectional design was used. Data were collected using a questionnaire distributed to nurses who are employed at hospitals or higher medical institutions nationwide and have participated in nursing research at least once. 197 nurses participated in this study. 173 data were analyzed using descriptive statistics, correlation, and regression.
Results Senior nurses made the most participation requests (21.4%). The coercion to participate in the research (2.67±0.64) was lower than normal (3). However, the coercion level to participate in the study was significantly higher when notified by the institution or department (F=5.29, p<.001), the department head requested participation (F=5.17, p<.001), or senior nurses instructed other nurses to participate (F=7.96, p<.001). Satisfaction with informed consent (β=.55, p<.001) and coercion to participate in the research (F=93.16, p<.001) were significant variables influencing the satisfaction with research participation (R2=.52).
Conclusion In order to protect the rights of nurses as research participants, it is necessary to improve researcher awareness and quality of nursing research, as well as provide ethical research environments for research participants.
Purpose This study aims to explore the relationship between the discharge process and two-year prognosis in patients with Heart Failure (HF) who were hospitalized because of HF exacerbation.
Methods Medical records were reviewed to identify patients admitted for HF exacerbation. Information regarding the following discharge processes was collected: follow-up visits, discharge educational contents, and the presence of family caregivers during patient education. HF-related events, including emergency department visits, readmissions, or death because of HF, were defined as a composite of events. A multivariate Cox proportional hazards regression model was used after adjusting for covariates to explore the association between the discharge process and HF-related events.
Results A total of 201 patients were included in this study. In the two-year follow-up periods, 41 patients (20.4%) experienced at least one HF-related event. Follow-up visits were scheduled at an average of 8.11±2.92 days after discharge. Approximately 95.0% of the patients received discharge education with an average of 1.66±1.04 topics, and 69.7% of the families participated in this educational activity. In the multivariate Cox regression model, not having family members during education was associated with a longer time to HF-related events (hazard ratio: 2.09; 95% confidence interval: 1.001~4.346). However, follow-up visits and the amount of educational content received were not associated with time to HF-related events.
Conclusion The presence of family caregivers during education appears to be a protective factor against adverse prognosis in patients with HF. Our results highlight the importance of family engagement during discharg
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Purpose We aimed to systematically review and synthesize qualitative evidence on the experiences of nurses caring for hemodialysis patients. Methods We used Noblit and Hare’s meta-ethnography. Seven databases (PubMed, EMBASE, CINAHL, Web of Science, RISS, KISS, National Assembly Electronic Library) were used for the literature search. There were no restrictions placed on publication dates. A total of 10 studies published in English and Korean up until July 2021 were finally selected for review. Results Three themes were identified from the literature review, which were then divided into six subthemes: acquiring the technical skills of hemodialysis, responsibility for prolonging patients’ lives, and maintaining stable hemodialysis in patients’ daily lives. Conclusion The results of this study provide basic data that emphasizes the specific role of nurses in the hemodialysis unit, a specialized area of nursing, and can be utilized as educational material for hemodialysis unit nurse education.
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Purpose The purpose of this study was to compare and verify the effects of aroma essential oil inhalation and music listening on stress response, vital signs, and bispectral index.
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Results The perceived stress was significantly different between three groups at 10 minutes and 30 minutes after the intervention. The stress responses of the AG and MLG were significantly lower than that of the control group. At 10 minutes and 30 minutes after the intervention, there were significant differences in the Bispectral index (BIS) between three groups, and the BIS of the AG and MLG were significantly lower than that of the control group. At 30 minutes after the intervention, the stress index, systolic blood pressure, and heart rate were significantly different between three groups.
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Purpose Patients with heart failure report low levels of physical activity and quality of life, both of which are important predictors of patient prognosis. This study aimed to investigate the effects of nurse-led motivational interviewing on self-efficacy for exercise, engagement in regular exercise, exercise capacity, and quality of life among patients with heart failure. Methods A randomized controlled trial design was used, and 66 Korean participants (i.e., 38 in a control group and 28 in an intervention group) aged 40~80 years who were diagnosed with heart failure were recruited between May 2012 and September 2013. The intervention group received telephone-based motivational interviews twice a week for one month. All participants were assessed for exercise regularity, levels of exercise, exercise capacity, and quality of life at baseline, one month, and three months. The data were analyzed using independent t-tests, repeated measures ANOVA, and nonparametric tests. Results At one month, there were significant group differences in exercise regularity (x2 =6.10, p=.013) and levels of exercise (Z=-2.56, p=.024). There was a significant group-by-time effect on the quality of life (F=3.76, p=.044). Conclusion Nurse-led motivational interviewing was effective in increasing exercise levels and quality of life in patients with heart failure. In the future, we propose a study with a larger number of participants and a long-term follow-up study with additional contact to maintain the intervention effect.
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Purpose This study aimed to explore the clinical practice experience of nursing students during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods We used the qualitative content analysis steps presented by Graneheim and Lundman. The participants were 11 nursing students from two universities. We collected data by iterative work through in-depth interviews and observations and analyzed it using content analysis and dialogue between the authors to enhance interpretation. Results Four themes emerged from the participants' clinical practice experiences during the pandemic: increased uncertainty in clinical practice and daily life, reduced opportunities for practice experiences and networking, differences in the meaning of clinical practice, and new implications of clinical practice. Conclusion Participants were experiencing clinical practice, including themselves and the surrounding world, under the strong influence of the COVID-19. Therefore, the development of practice guidelines that can be communicated quickly between institutions, students, and universities and cope flexibly with the pandemic alarm levels will reduce uncertainty in clinical practice and minimize changes in activities and networking. Additionally, the nurses’ professional intuition should be improved by expanding the awareness of nurse roles in clinical practice during the COVID-19 pandemic.
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Purpose This narrative review aims to provide an introduction and overview of dyadic research within the context of chronic illness. In addition, some methodological considerations and future directions for conducting dyadic research are presented. Methods The focus of this review is on adult participants in dyads and with chronic illness based on the previous studies and literatures on dyadic science. Results Theory of Dyadic Illness Management and Dyadic Regulation-Connectivity Model (DR-CM) may be appropriate for performing dyadic research. At present, there is a lack of qualitative and quantitative knowledge on the dyadic approach for research on chronic diseases. Dyadic health interventions for building collaborative relationships within a dyad may be beneficial to improve dyadic health outcomes. This article addressed some of the challenges regarding recruitment, data collection, and analysis when it comes to planning dyadic research pertaining to chronic illnesses. Conclusion Healthcare professionals should prioritize needs and preferences at the dyadic level when designing effective chronic disease management. Particularly, it is critical to regularly monitor the dyadic relationships or type of dyadic care during illness trajectories. More research should be undertaken on patient-family caregiver dyads in chronic care, considering the various types of chronic diseases and cultural diversities.
Soo Hyun Kim, Seongmi Moon, Seieun Oh, Youn-Jung Son, Youngrye Park, Soo Jung Chang, Kisook Kim, Jooyoung Cheon, Eun Hee Jang, Jeonghyun Cho, Sung-Hee Yoo, Hee Sun Kim, Sung Reul Kim, Yu Hyeon Choe
Korean J Adult Nurs 2021;33(4):406-414. Published online August 31, 2021
Purpose The purpose of this study was to assess the research performance during Coronavirus Disease 2019 (COVID-19) pandemic among nursing researchers.
Methods: A cross-sectional online survey was conducted for Korean Society of Adult Nursing where 103 subjects participated from April 15 to May 14, 2021. The survey tool developed by researchers had 32 items including difficulties in performing research activities, perception of the impact of COVID-19 on research validity, and three open-ended questions.
Results: In the research planning phase, 88 subjects (90.7%) reported difficulties in the recruitment plan and 83 subjects (89.3%) reported difficulties selecting a research design. In the recruitment and data collection phase, 85 subjects (88.6%) had difficulties accessing data collection site and 78 subjects (85.7%) had difficulties in face-to-face data collection. In the provision of intervention phase (for experimental study), 26 subjects (66.7%) reported that they should have changed the method of delivery of intervention. In research administration and manpower management, 62 subjects (75.6%) reported difficulties in face-to-face meeting. In research outcome management, 65 subjects (85.5%) reported that they should have changed the way of research-related events. Lastly, 80 subjects (81.6%) perceived that difficulties caused by COVID-19 impacted research validity.
Conclusion: Majority of participants perceived that the difficulties in research activities may decrease research validity. To ensure research quality during COVID-19 pandemic, we should recognize potential threats to research validity and actively pursue adaptable innovations of research designs and data collection methods.
Purpose The purpose of this study was to construct and test a hypothetical model of exercise behavior in patients with Heart Failure (HF) based on the Information-Motivation-Behavioral skills (IMB) model, and the IMB model including depression (IMBD).
Methods: Data collection was conducted from February 1 to March 15, 2019. A total of 306 patients who were diagnosed with HF and were receiving outpatient treatment at the D University hospital and S hospital located in B city were included in the final analysis. The collected data were analyzed using SPSS 24.0 and AMOS 25.0 program.
Results: The IMB model (x2 /df=2.45, SRMR=.07, RMSEA=.07, GFI=.98, AGFI=.94, TLI=.93, CFI=.97) and IMBD model (x2 /df=0.79, SRMR=.02, RMSEA=.003, GFI=.99, AGFI=.97, TLI=.98, CFI=.97) were a good fit for the data. In the exercise behavior IMB model, exercise behavior was explained by 55.1% by information, personal motivation, and behavioral skills. In the exercise behavior IMBD model, exercise behavior was explained by 60.4% by information, personal motivation, behavioral skills, and depression.
Conclusion: The IMBD model showed high predictive power of exercise behavior. Therefore, in order to improve HF patients’ exercise behavior, it is necessary to identify and manage patients who experience depression. The development and application of integrated interventions to provide appropriate information, motivation, and confidence in exercise can be an effective strategy in increasing exercise compliance, and ultimately contribute to improving the health outcomes of patients with HF.
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Purpose This study was performed to explore the contexts and meanings of health life among patients with chronic kidney failure undergoing hemodialysis.
Methods: The ethnography steps presented by Spradley were utilized. The participants were 12 patients from two hemodialysis centers. Data were collected by iterative fieldwork through in-depth interviews and participant observations and analyzed using text analysis and taxonomic methods. Field notes were used along with interviews and dialogue between authors to enhance interpretation.
Results: Five themes on the health life of participants emerged: experiencing the loss of normality of the body and the collapse of daily life, establishing the role of dialysis patients, reorganizing the network, building an integrated coping pattern, and new normalization of the pattern of life. Patients' experiences differed in health life's patterns and meanings according to various individual situations and sociocultural contexts.
Conclusion: Establishing new patterns of life of hemodialysis patients was a normalization process to ensure the adequacy of physical indicators and stability amid physical, emotional, and social challenges. To achieve quality health life, patients should be provided with tailored nursing interventions that consider their individual, social, and cultural situations.
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Purpose During hospitalization, sleep can be disturbed and the quality reduced. This study investigated the effect of applying white noise on hospitalized patients for improving their sleep quality.
Methods: In a randomized controlled trial design, participants were randomly assigned to an experimental group (n=30) or a comparison group (n=31), enrolled from rehabilitation medicine wards at a university hospital in South Korea. For three days of the intervention, the experimental group listened to white noise for one hour before sleep. The comparison group wore only earplugs before sleep. Sleep quality was assessed by the Verran and Snyder-Halpern (VSH) sleep scale as a subjective measure and the Fitbit ® wrist band monitor as an objective measure. Data were collected pre- and three days post-intervention. Data were analyzed by repeated measures ANOVA using SPSS/WIN 22.0 program.
Results: The white noise group showed positive effects on subjective sleep quality (p<.001) compared to the earplug group.
Among the objective sleep quality measures, sleep time (p<.001) and sleep efficiency (p=.003) were statistically significant, but there were no statistically significant differences in time of awakening, number of awakening, time of restless and number of restless.
Conclusion: Findings indicate that applying white noise could be considered as a useful nursing intervention to improve subjective and objective sleep quality in hospitalized patients.
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Other variables, including the medical department, activation duration in minutes, total national early warning score, and respiratory distress as the reason for activation (compared to sepsis or septic shock) predicted unplanned ICU admissions. Conclusion Electronic medical record screening by RRT may facilitate the early detection and monitoring of physiological deterioration in patients in the general medical ward. This strategy may help prevent unplanned ICU admissions and potentially reduce mortality.
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Purpose The aim of this study was to identify the knowledge structure of nursing research on heart failure in Korea. Methods Fifty-two studies published in Korea and 41 published abroad by domestic researches from 1988 to 2019, were included. Meaningful morphemes from the abstracts were extracted and refined, and co-occurrence matrix was generated. Using Phython 3.7 for edge weight, degree centrality, closeness centrality, and betweenness centrality and Gephi 0.9.2 for visualization, 571 keywords were analyzed. Results The core keywords were “patient”, “heart failure”, “symptom”, “function”, “quality of life”, “self-care”, and “intervention”. The sociogram identified “patient”, “heart failure”, and “symptom” as the largest node, and the edge weight between the keywords was the highest. From 1988 to 2019, keywords such as “patient”, “heart failure”, and “symptom” ranked the highest.
Especially, from 2016 to 2019, “quality of life”, “NYHA”, and “medication” ranked lower, but “cognition”, “health literacy”, “behavior”, “self-efficacy”, “man”, “woman”, and “age” newly appeared or ranked higher. Conclusion It is recommended that Korean heart failure nursing researchers conduct researches related to self-care for symptom management of heart failure patients, especially on nursing interventions. In addition, nursing researchers should conduct studies on the cognition and health literacy related to self-care of the elderly patients with heart failure
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Purpose To explore the nature of psychological resistance to the initiation of antihypertensive medication. Methods Participants were 13 adults with hypertension who were refusing or had refused to take antihypertensive drugs from July 2016 to October 2016. The data were collected through face-to-face in-depth interviews, and analyzed according to Braun and Clarke’s 6 steps of thematic analysis. Results Analysis of the psychological resistance experience to drug therapy in hypertensive patients resulted in 5 themes and 10 sub-themes from a total of 42 free codes. Participants were “holding out as much as possible without medication” without taking antihypertensive drugs due to “psychological opposition to starting treatment” and “situational barriers related to medication”. However, they were “coming to grips with reality” that they were not taking medication but would take it someday, and they gained “momentum for change” to start taking it. Conclusion The 5 themes derived from the data analysis of the experiences of 13 participants are interrelated and suggest the direction of intervention to lower psychological resistance. In particular, we propose the development of an intervention to assist patients in self-decision regarding taking antihypertensive medication. Additional research into the role of medical staff in lowering the psychological resistance of young hypertensive patients is needed.
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PURPOSE The purpose of this study was to identify the significance and structure of the painful experience of primary decision-makers regarding the Do-Not-Resuscitate (DNR) instruction. METHODS This study was a qualitative research based on Parse's qualitative research method. Participants were 7 family members who were primary decision-makers for regarding DNR instruction for the family member from July 28, to October 6, 2018. RESULTS The core concepts of the difficulties of the participants were Distress emerging from the pitiful condition of the patient, guilt, sadness and regret, Seeking comfort for loved ones, Uncertainty of DNR decision, Planning the resumption of daily life and decision about own DNR. The painful experience of participants can be defined as the process of empowering the patient through verbal communication with them, by valuing them, and by enabling them to overcome their limitations. CONCLUSION The result of this study is expected to contribute to a deep understanding of primary DNR decision-makers' suffering and developing guidelines for nursing care for health care professionals and primary DNR decision-makers who provide end-of-life care to the patients.
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PURPOSE This study attempts to explore the experiences of Hematopoietic Stem Cell Donation (HSCD) among donors and experts of HSCD-related institutions in South Korea. METHODS In July 2017, 7 donors and 8 experts with experience of HSCD-related work were interviewed. The transcribed data were qualitatively analyzed to identify major themes and sub-themes representing the experiences of the donors and experts. RESULTS The analysis indicated that donors' HSCD-related experiences were structured into 5 themes (“Lack of understanding of HSCDâ€, “Difficulty in decision-making regarding HSCDâ€, “Major hassles involving HSCDâ€, “Meaningful experiences and hopefulness†and “More effort by government and institutions for future donorsâ€). The experts' experiences were structured into 4 themes (“Improving the donation procedure through government supportâ€, “Improving the donation procedure through campaign reinforcementâ€, “Donors' characteristicsâ€, and “Meaning of my jobâ€). CONCLUSION HSCD-related institutions must manage donors more carefully. This would involve keeping them aware of what they are likely to experience throughout the donation procedure, follow-up monitoring, and continuous support. Efforts should be taken to inform nurses involved in HSCD of research on donors' experiences, and they must be systematically trained to ease donors' difficulties.
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PURPOSE This study aimed to investigate a successful aging experience of aged on the in-home benefits of long-term care insurance. METHODS The participants included 12 aged individuals receiving such benefits. Data were collected using in-depth interviews from November of 2016 to July of 2017. The qualitative analysis process followed the grounded theory method by Strauss and Corbin. RESULTS The research results indicate that the core category was “living my life in my home using my remaining abilitiesâ€. The phenomenon was “recognizing the limitations of my bodyâ€, and causal conditions were “old and sick body†and “depressionâ€. The interaction strategies were “examining my bodyâ€, “engaging in self-reflectionâ€, “controlling my mindâ€, “taking care of my health according to the illnesses I experienceâ€, “managing my remaining abilitiesâ€, “connecting with a supportive networkâ€, and “spending timeâ€. The outcomes were “living by adapting to my limited body conditionsâ€, “leading my life with the help of othersâ€, “sharing the meaning of life with othersâ€, and “reestablishing my life valuesâ€. CONCLUSION Based on the this results, systematic health management programs such as personalized physical activity to maintain and preserve remaining function of the body should be develop to maintain the life in my home for aged.
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