Purpose The purpose of this study was to identify the moderating effect of teaching effectiveness and students’ anxiety in the relationship between simulation design characteristics and clinical reasoning competence among nursing students.
Methods: The participants were 123 nursing students who underwent simulation practice. Data were collected from September 1 to October 30, 2020 using self-report questionnaires. The collected data were analyzed using descriptive statistics, independent t-test, Pearson’s correlation coefficient, and SPSS PROCESS Macro program (to study the multiple additive moderation effect).
Results: Significant positive correlations were observed between clinical reasoning competence and simulation design characteristics (r=.57, p<.001), clinical reasoning competence and teaching effectiveness (r=.49, p<.001), while negative correlations were observed between clinical reasoning competence and students’ anxiety (r=-.33, p<.001). Teaching effectiveness and students’ anxiety had a multiple additive moderating effect on the relationship between simulation design characteristics and clinical reasoning competence among the nursing students (F=15.10, p<.001).
Conclusion: The relationship between simulation design characteristics and clinical reasoning competence differed depending on the students’ anxiety. To improve the clinical reasoning competence of nursing students in simulation practice, developing interventions and techniques to manage students’ anxiety levels are important.
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Purpose This study aimed to identify the mediating effect of fatigue in the relationship between clinical nurses’ job stress and medication safety performance. Methods For this cross-sectional study, 122 registered nurses were recruited through convenience sampling. The results were collected from August to September 2020 using self-reported structured questionnaires, analyzed with IBM SPSS Statistics 25.0 and using descriptive statistics, independent t-tests, one-way analysis of variance and Pearson correlation coefficient, and hierarchical multiple regression analysis. The mediating effect was analyzed using PROCESS macro with a 95.0% bias-corrected bootstrap confidence interval (5,000 bootstraps re-sampling). Results Significant positive correlation was observed between job stress and fatigue (r=.57, p<.001). Significant negative correlations were observed between job stress and medication safety performance (r=-.27, p=.003), fatigue, and medication safety performance (r=-.55, p<.001). Fatigue has a mediating effect between job stress and medication safety performance in nurses (indirect effect=-0.11, 95% Boot confidence interval=-0.16~-0.07). Conclusion To improve the medication safety performance of clinical nurses who experience job stress and fatigue, early detection and periodic observation of nurses’ job stress and fatigue should be made. Moreover, job stress and fatigue should be considered together in devising relevant interventions.
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PURPOSE The purpose of this study was to identify the effects of an exercise program on muscle strength, Activities of Daily Living (ADL), health perception, and depression among post-stroke elders. METHODS Nonequivalent control group design with pretest and posttest was used. A total of 23 post-stroke elders who met inclusion criteria were recruited. Muscle strength in upper and lower extremities, ADL, health perception, and self-rated symptoms of depression were measured. The exercise program consisted of deep breathing, range of motion, and muscle strengthening exercises using Thera-band, 30~40 min/day, three days a week, for 12 weeks. RESULTS Muscle strength of right shoulder (U=11.50, p=.001), right leg (U=13.50, p=.002), and health perception (U=24.00, p=.010) in the experimental group was significantly higher compared to the control group at 12 weeks of post-intervention. Depression scores were significantly lower in the experimental group compared to the control group at 6 weeks (U=28.00, p=.021), at 12 weeks (U=22.00, p=.006) of an exercise program. CONCLUSION By applying this program, post-stroke elders showed increases in muscle strength and a decrease in depression as well as improvement of health perception. Further study is needed to verify the effects of the exercise program on cardiovascular physiologic variables through long-term follow-up.
PURPOSE This study was to identify the level of knowledge and performances on evidence-based infection control and influencing factors on performance among nurses in intensive care unit. METHODS A descriptive cross-sectional survey design was used. Two hundred thirty-nine nurses at intensive care units were conveniently recruited from seven hospitals located in Seoul and Kyounggi province. Data were collected with a questionnaire survey about evidence-based infection control. Data were analyzed using SPSS/WIN 17.0 program. RESULTS Both level of knowledge (mean 9.15 out of 19) on preventing ventilator-associated pneumonia and central venous catheter induced bloodstream infection, and performance on evidence-based infection control (1.94 out of 4) were moderate. Performance of evidence-based practice for infection control was related to reading research articles regularly, professional satisfaction, and taken education course. CONCLUSION These results indicate that systematic and organizational strategies for enhancing evidence-based infection control are needed to improve quality of intensive nursing care.
PURPOSE The purpose of this study was to determine the effect of a 2-week somatosensory stimulation program on cognitive function and ADL of patients with brain damage. METHODS The sample consisted of two groups of patients with stroke: 10 patients with a mean age of 59.0 years who were treated with somatosensory stimulation, and 9 patients with a mean age of 51.78 years, who were not treated with somatosensory intervention. A nonequivalent control group non-synchronized design was used to assess the functional recovery after stroke. Instruments used in this study were MMSE-K for cognitive function and FIM for ADL. RESULTS The hypothesis 1 that "Patients with stroke who were treated with the somatosensory stimulation program will show higher MMSE-K score than that of the non-treatment group" was supported(Z = -2.390, p = .017). The hypothesis 2 that "Patients with stroke who were treated with the somatosensory stimulation program will show higher FIM score than that of the non-treatment group", however, was partially supported(social cognition: Z = -2.204, p = .045). CONCLUSION Somatosensory stimulation was effective to patients with stroke in improving their cognitive function. These findings suggest that somatosensory input can be adopted to nursing intervention for functional recovery after stroke.
PURPOSE 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. METHOD Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). RESULTS 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. CONCLUSION On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.
PURPOSE This descriptive study was undertaken to explore the distribution of stages of mammography adoption and identify benefits and barriers perceived by women according to the stage of mammography adoption. METHODS: A total of 227 women aged between 30-60 was selected by the convenient sampling in W city. The instrument developed by the researcher based on the scales of Champion(1993), Champion & Skinner(2003), and Rakowski et al (1992) was used. RESULTS: The distribution of stages of mammography adoption was as following; precontemplation 30.7%, contemplation 23.8%, relapse 20.2%, action 14.4%, and maintenance 10.8%. Women in maintenance and actors showed high scores in benefits and low scores in barriers. Those in relapse reported high scores in both benefits and barriers, while precontemplators and contemplators showed high score in barriers and low scores in benefits. CONCLUSION: Despite the rate of mammography participation has increased, the proportion of maintenance stage is still low and that of relapse is high. For those in relapse, strategies to eliminate barriers hindering regular and continuous mammography are necessary. For precontemplators and contemplators, detail information including purpose, procedure and benefits of mammography should be given primarily.
PURPOSE To identify perceived importance and performance frequency of nursing interventions with nursing activities of 5 nursing interventions from the physiological domains of NIC used in the home health care nursing. METHOD: Five nursing interventions in the physiological domain of NIC were selected based on the previous finding. Data were collected from 85 nurses working in 54 home health care centers between August and October, 2004 using mailing survey(return rates : 41.5%). The questionnaire consisted of 96 nursing activities in 5 interventions with definitions, asking perceived importance and performance frequency of them. RESULT: Skin surveillance was perceived as the most important(3.52+/-0.36) intervention and also performed most frequently(4.43+/-0.45). All the nursing activities in skin surveillance appeared to be used frequently, which was rated over 4 out of 5 point Likert, while only 4 nursing activities in exercise therapy: joint mobility did. Correlations between perceived importance and performance frequency of 5 interventions were all significant (r=0.591-0.718, p=0.000). CONCLUSION: Identifying the use of particular interventions and nursing activities will help nurses simplify documentations and to deliver better care to the patients in home health care nursing.
PURPOSE The purpose of this study was 1) to classify the stage of adoption 2) to compare the decisional balance and confidence by stage of adoption 3) to identify factors influenced the stage of adoption for breast self exam. METHOD: A comparative study using a survey method with convenience sample of 143 women was used. Decisional balance and confidence was measured using the CHBMS-K. Stage of adoption for BSE was measured by a single item modified by the researchers based on the Rakowski et al (1992). RESULT: 1) The number of women in each stage of adoption for BSE was as follows; maintenance phase, 7.7% (n=11), action phase, 49.0% (n=70), contemplation phase, 35.0% (n=50) and pre- contemplation phase, 8.4%(n=12). 2) The mean difference in the decisional balance (F=4.32, p=.006) and confidence (F=13.85, p=.000) according to the stage of BSE adoption was statistically significant. 3) Prevention education and confidence accounted for 32% of variance in BSE. CONCLUSION: Assessment of decisional balance and stage of adoption for BSE can guide planning for cancer prevention education. We must educate women to have confidence in BSE. Further, it is important to urge women to continually practice BSE.
PURPOSE The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.
PURPOSE The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%). CONCLUSION Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.
PUPPOSE: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. METHOD This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. RESULT The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. CONCLUSION The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.
PURPOSE This study was to investigate symptom occurrence related to the disease characteristics of patients with cancer. METHOD A total of 301 patients with cancer participated in this study. The participants were recruited from University Hospitals located in Seoul, Wonju, Kwangju, Daegu, and Pusan. Data collection was performed by using a questionnaire on symptom occurrence. The obtained data was analyzed using SPSS computer program that included descriptive statistics, Pearson correlation, one-way ANOVA, and t-test. 1) Yonsei University (Wonju College of Medicine) 2) Ajou University 3) Home Health-Hospice Research Institute at Yonsei University 4) Research Institute of Nursing Science at Chonnam National University 5) The Institute of Nursing Science at Kyungpook National University 6) Research Institute of Wholistic Nursing Science at Kosin University. RESULT The mean score of fatigue was the highest (3.24), followed by loss of appetite, lack of concentration, change in appearance, pain, insomnia, change in bowel pattern, nausea/ vomiting, coughing, and dyspnea. Most symptoms were significantly correlated with each other. The level of symptom occurrence in patients with lung cancer or cervix cancer was significantly higher than the level in patients with stomach cancer. Patients receiving radiation therapy or a combined therapy of radiation therapy and chemotherapy experienced significantly higher level of symptom occurrence than those receiving chemotherapy only. Also, female patients experienced higher level of symptom occurrence than male patients did. CONCLUSION The sites of cancer, types of treatment, and gender influence the level of symptom occurrence of patients with cancer. Thus, these variables should be considered when assessing and planing for symptom occurrence of patients with cancer.
PURPOSE To explore what particular types of information were important to patients diagnosed with cancer. METHODS Seventy three patients with cancer at an outpatient clinic and hospitalized patients in W Christian Hospital Korea, responded. The structured questionnaire developed by the investigator based on previous studies. RESULTS There was a significant negative relationship between age and the score of informational need (r=-.307, p<.05). Level of education, and level of monthly income were related to level of informational need. The top three informational priorities according to the time since diagnosis were 'Self care during treatment', 'Health food and diet', 'Likelihood of recurrence', 'Follow up care' and 'Side effects'. The top three informational priorities for patients with breast cancer were 'Likelihood of recurrence', 'Metastasis possibility', 'Treatment options', and 'Side effects. For patients with stomach cancer, they were 'Follow up care', 'Healthy food and diet', 'Likelihood of recurrence', and 'Metastasis possibility', and for patients with colon/rectal cancer, they were 'Side effects', 'Healthy food and diet', 'Likelihood of recurrence', and 'Self care during treatment'. CONCLUSION The assessment of information needs based on demographic factors and disease-related factors is critical in helping patients with cancer to manage their illness.
Nurses play an important role in patient education, including providing patients with useful and appropriate information. The purpose of this study was to explore what particular types of information were important to women diagnosed with breast cancer. Sixty seven women with breast cancer an outpatient clinic in W Christian Hospital responded to the structured questionnaires developed by the investigator. Interviews and mail surveys were used in this study. The findings in this study showed that six kinds of information needs arose, ranked as the signs and symptoms of recurrence, the possibility of recurrence, the possibility of metastasis, treatment, diet and physical activities in daily living. Marital status, level of education, and level of monthly income were not related to level of informational need. Younger women rather than older women had a greater need to seek information(r=-.471, p<.01). There was a significantly negative relationship between duration of disease and the score on information needs(r=-.32, p<.05). The findings have implications that the opportunity to ask questions and have accurate information on the recurrence should be provided to women with breast cancer.
The purpose of this study was to identify the degree knowledge of myocardial infarction(MI) among the general population and to provide a direction for developing public health education programs. The subjects for this study were 187 people who lived in Seoul or Wonju City, Korea. The data were collected by questionnaire from Nov. ito Dec.5, 1997. The questionnaire was developed by the researcher based on a literature review, It consisted of 34 items of which nine items were on .iology, ten items on preventive measures, ten items signs & symptoms, five items on pain area. Analysis the data was done using descriptive statistics, t-test and ANOVA with the SPSS PC program. The results of the study are as follows: 1. The scores for knowledge of etiology(5.94), preventive measures(7.13), signs & symptoms(5.33) and area of pain(1.62). The highest score for knowledge about MI was preventive measures. the lowest score was for area of pain. Almost half of the subjects were not aware that 'hyperglycemia'and 'fatigue'can cause a MI. Also more than half of the subjects were not aware that 'reduced high carbohydrated diet'can prevent ML So this study showed that the general population has a need for more information about the relationship of hyperglycemia to MI. Less than half of the subjects knew that 'alteration in sleep pattern(49.4%)'. 'nausea, vomiting. indigestion(36.4%)''pain in the area of radiation and not in the chest(24.2%)' are sign & symptom of MI. Most of the people are aware that pain will be College of Nursing, Yonsei University Department of Nursing, Wonju College of Medicine. Yonsei University Department of Nursing. College of Medicine. Dankook University slightly to the left of the sternum(733%) but were not aware that pain may also radiate to the shoulder or arm(74.8%), neck or teeth(90.6%) Also 35% of the subjects think there is no treatment for an MI after it has occurred. 2. In the relationship between social demographic characteristics and degree of knowledge, there were significant differences due to sex, education level, and marital status. 3. This study showed hat most subjects got their in formation about MI from T.V. and radio(62.7%), but the score for knowledge was not high. The following are suggested based on the above results 1) It is necessary to reinforce information about signs & symptoms, area of pain and treatment of MI in public education programs, because people who do not know that their symptoms represent a heart at tack will delay seeking care and medical attention, 2) Because there are significant differences between knowledge and demographic characteristic(sex. education level, marital status), it is necessary to develop effective health education programs to consider these characteristics. Also we need behavioral strategies to change lifestyle and prevent more people from entering the MI high risk group. 3) Patients are almost always frightened and fearful which can cause a fatal delay. Education should focus on the emotional reasons behind people's resistance to calling the emergency medical system. 4) Educational programs need to target the potential witnesses rather than the individuals who suffer cardiac symptoms, focusing on the independent role that family members should take in the face of cardiac symptoms. Families of high risk group members, particularly their spouses, should receive special education about handling changes in cardiac symptoms. 5) Further studies are needed to identify factors which can cause patients to delay seeking treatment and to investigate the adaptive coping strategies of MI patients & their families when they have signs & symptoms.
This study was done to identify the relationships among family support, role conflict end Lii quality of life of patients with arthritis. And it was investigated the effects of family support on role conflict and the quality of their lives. The subjects were 98 patients with arthritis. The instruments used in this study were used Family Support Scale by Kang( 1985), Modified Quality of Life Scale by Ro(1988), and Role Conflict Scale developed by the researcher. The results of study were as follows : 1. Disease characteristics related to role conflict were pain iritensity( r = .35, p< .001) and limitation of activities of daily living(ADL)(r =37, p< .001). That related to quality of life was pain(r= -.27,p<.01). 2. There were no significant variations family support, role conflict and quality of life between rheumatoid arthritis and osteogenic arthritis patients. The patients with rheumatoid arthritis had more than twice the number of. affected joints as comparing to osteogenic arthrrt:s. But there were no differences the pain intensity and limitation of activity of ADL. 3. As applying to arthritis patients in general : There was a significant negative relationship between family support and role conflict(r=-.28, p<.01). There was a significant negative relationship between role conflict and quality of life(r= -.46, p<.01). There was a sigmfrcant positive re lationship between family supprt and quality of life(r=.58, p<.01). Family support, as an intervening variabe, had an impact on quality of life and role conflict. In conclusion, family support is an important variable in improving the quality of life of patients with arthritis. And especially role conflict has a significant influence on the quality of their lives, Therefore, we have to devehope nursing interventions for higher levels of family support through family education and support programs. In future studies, it would be well to investigate for effects and qualities of role conflict in the lives of patients with arthritis.
The purpose of the study was to identify the nursing diagnoses for aged persons in gerontological clinical practice of nursing students. In this study, a total of 101 cases including 36 cases of hospitalized elder, 33 cases of institutionalized elders, and 32 cases of community dwelling elders were used in case studies reported by nursing students. Descriptive statistics was employed to determine 370 nursing diagnoses in 101 cases. There were four findings. First, 47.5% of total 370 nursing diagnoses was 'risk for injury'. The next highest percentage of nursing diagnoses was 38.9%( powerless/hopelessness/self-esteem disturbance). Second, the most nursing diagnosis for hospitalized elders was 'knowledge deficit'(41.7%), and the next was 'risk for injury'(38.9%), and 'risk for impaired skin integrity'(27.8%). Third, for both institutionalized elders and community dwelling elders, the most nursing diagnosis was 'risk for injury', and the next was 'powerlessness/hopelessness/self-esteem disturbance', and 'activity intolerance/impaired physical immobility'. Fourth, the related factors of 'risk for injury' were low bone density, low balance, low visual and auditory ability, muscle atrophy, low cognitive function, danger environment, and knowledge deficit. the related factors of 'powerlessness/hopelessness/self-esteem disturbance' were low activity ability, social isolation, low motivation depression, change of daily pattern, decrease of memory, and disorientation. These findings have implications that risk for injury related to physical changes of aging is the most significant health problem of frail elders in diverse setting. In addition, emotional problems of powerless, hopelessness, and self-esteem disturbance are significant need to develop nursing intervention for frail elders in diverse setting.
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