• 의료커뮤니케이션
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• 제13권2호
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• pp.133-140
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• 2018

Purpose: This study was performed to provide basic educational data for improvement of satisfaction in clinical practice by investigating the relationship of clinical practice satisfaction with self-efficacy, fatigue and communication skill in dental hygiene students. Methods: A survey using a self-administered questionnaire was conducted among 205 second- and third-year students enrolled in an dental hygiene program at three colleges located in A and B province from March 10 to April 10, 2018. Results: Satisfaction level of clinical practice was significantly higher in the group more satisfied with their majors, with more healthy subjective health status, more satisfied with their interpersonal relationships, with a higher self-efficacy, with a lower fatigue, and with better communication skill. Clinical practice satisfaction had a significantly positive correlation with self-efficacy and communication skill and a significantly negative correlation with fatigue. Factors affecting clinical practice satisfaction in the subjects were communication skill, self-efficacy and fatigue. The total variance explained by all three variables was 20%. Conclusion: Further studies and development of education programs including a broad range of strategies for clinical training are warranted by reflecting those related variables to improve clinical practice satisfaction in dental hygiene students.

• 중환자간호학회지
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• 제15권2호
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• pp.27-38
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• 2022

Purpose : The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals. Methods : The participants were 137 advanced practice nurses. The assessment tools were clinical decision-making in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods. Results : There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043). Conclusion : Therefore, to reduce advanced practice nurses' job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.

• 대한간호학회지
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• 제53권2호
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• pp.145-154
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• 2023

Purpose: This study investigated clinical competency, COVID-19-related anxiety, coping strategies, self-efficacy, and perceived stress among graduating nursing students during the COVID-19 pandemic. Methods: We conducted a cross-sectional survey. Participants were recruited from universities located in four major cities in South Korea. General demographic information, clinical competency, self-efficacy, perceived stress, COVID-19-related anxiety, and coping strategies were assessed using reliable questionnaires. Descriptive statistics, correlations, and multiple regression tests were used to analyze the data. Results: The mean clinical competency, self-efficacy, perceived stress, adaptive coping, and maladaptive coping were 138.16 ± 18.34, 83.85 ±14.02, 21.37 ± 5.79, 53.15 ± 4.64, and 30.98 ± 6.73, respectively. COVID-19-related anxiety was reported by 4.3% of participants. Clinical competency was significantly positively correlated with self-efficacy (r = .44, p < .001) and adaptive coping (r = .20, p = .035) and was significantly negatively correlated with maladaptive coping (r = .20, p = .035). The predictors of clinical competency were self-efficacy (β = .434, p < .001) and adaptive coping (β = .173, p < .039), which explained 23% of the variance in clinical competency. Conclusion: Self-efficacy and adaptive coping strategies are significant predictors of clinical competence during the pandemic. Planning and implementing various curricular and non-curricular activities to increase senior students' self-efficacy and adaptive coping strategies will help prepare competent nursing graduates for the pandemic when they enter the nursing workforce.

• 한국간호교육학회지
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• 제29권2호
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• pp.190-198
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• 2023

Purpose: This study was conducted to identify the effect of verbal violence, clinical practice stress, and coping with stress on the major satisfaction in nursing students during clinical practice. Methods: A cross-sectional study was used. A survey was conducted from May 3 to May 10, 2022, on 200 nursing students who were in their junior and seneior years at two universities in Gyeongsangbuk-do. Descriptive statistics, frequency analysis, independent t-test, one-way ANOVA, Scheffé's test, Pearson correlation coefficient, and hierarchical regression analysis were employed to analyze the data. Results: Major satisfaction was found to be significantly negatively correlated with verbal violence (r=-.30, p<.001) and clinical practice stress (r=-.15, p=.032) and to be positively correlated with coping with stress (r=.24, p<.001). Their satisfaction with clinical practice (β=.29, p=.037), verbal violence (β=-.23, p<.001), coping with stress (β=.16, p=.015), religion (β=.14, p=.041), and clinical practice stress (β =-.13, p=.048) explained 19.3% of the variance in nursing students' major satisfaction during clinical practice. Conclusion: A verbal violence and coping with stress program for nursing students should be developed to increase nursing students' major satisfaction during clinical practice.

• Journal of Preventive Medicine and Public Health
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• 제46권2호
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• pp.74-81
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• 2013

Objectives: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. Methods: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. Results: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. Conclusions: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

• Annals of Clinical Neurophysiology
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• 제12권2호
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• pp.55-60
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• 2010

Background: The aim of this study is to identify the correlation between ultrasonographic findings of median nerve and clinical scale and electrophysiologic data in carpal tunnel syndrome. Methods: Forty three patients (79 hands) with electrophysiologically confirmed carpal tunnel syndrome were evaluated. Clinical symptoms were examined by Historical-Objective (Hi-Ob) scale. Electrophysiologic data and Padua scale were used for severity of electrophysiology. In ultrasonographic study, cross sectional area and flattening ratio of median nerve were measured at distal wrist crease level (DWC), 1cm proximal to distal wrist crease level, and 1cm distal to distal wrist crease level. The correlation between Hi-Ob scale, electrophysiologic data and ultrasonography was measured with Spearman rank test. Results: The mean Hi-Ob scale was 2.4. Mean Padua scale was 4.0. In ultrasnonographic study, cross sectional area and flattening ratio were $0.112\;cm^2{\pm}0.025$ and $3.0{\pm}0.6$ at 1cm proximal to DWC level, $0.118{\pm}0.026\;cm^2$ and $2.9{\pm}0.4$ at DWC level, and $0.107{\pm}0.032\;cm^2$ and $3.0{\pm}0.4$ at 1 cm distal to DWC level. Hi-Ob scale was not correlated with cross sectional area and flattening ratio of median nerve. Hi-Ob scale was correlated with Padua scale positively (r=0.44) and correlated with amplitudes of CMAP and SNAP, negatively (r=-0.33; r=-0.30). Cross sectional area of median nerve was significantly correlated with Padua scale, amplitudes and latencies of CMAP and amplitudes of SNAP. Conclusions: Ultrasonographic findings of median nerve and electrodiagnostic data had statistically significant correlation. Consequently, ultrasonography could be an adjunctive method in diagnosis of carpal tunnel syndrome.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1281-1289
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• 2022

Objective: Radiomic modeling using multiple regions of interest in MRI of the brain to diagnose juvenile myoclonic epilepsy (JME) has not yet been investigated. This study aimed to develop and validate radiomics prediction models to distinguish patients with JME from healthy controls (HCs), and to evaluate the feasibility of a radiomics approach using MRI for diagnosing JME. Materials and Methods: A total of 97 JME patients (25.6 ± 8.5 years; female, 45.5%) and 32 HCs (28.9 ± 11.4 years; female, 50.0%) were randomly split (7:3 ratio) into a training (n = 90) and a test set (n = 39) group. Radiomic features were extracted from 22 regions of interest in the brain using the T1-weighted MRI based on clinical evidence. Predictive models were trained using seven modeling methods, including a light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, with radiomics features in the training set. The performance of the models was validated and compared to the test set. The model with the highest area under the receiver operating curve (AUROC) was chosen, and important features in the model were identified. Results: The seven tested radiomics models, including light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, showed AUROC values of 0.817, 0.807, 0.783, 0.779, 0.767, 0.762, and 0.672, respectively. The light gradient boosting machine with the highest AUROC, albeit without statistically significant differences from the other models in pairwise comparisons, had accuracy, precision, recall, and F1 scores of 0.795, 0.818, 0.931, and 0.871, respectively. Radiomic features, including the putamen and ventral diencephalon, were ranked as the most important for suggesting JME. Conclusion: Radiomic models using MRI were able to differentiate JME from HCs.

• 간호행정학회지
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• 제11권1호
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• pp.13-21
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• 2005

Purpose: The Purpose of this study was to identify the relationship between leadership styles and self-esteem, satisfaction of clinical practice in nursing students. Method:The subjects were 386 nursing students who were in college and university located around Seoul, Kyounggi, Chungchung, Kangwon province. The data were collected from July 26 to September 18, 2004 by the structured questionnaires. For data analysis, descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS package were used. Results: 1. The score of the nursing students' transformational leadership were higher than that of the nursing students' transactional leadership. 2. The mean of satisfaction of clinical practice perceived by nursing students was 3.07, and its subcategories were practice contents 3.28, practice evaluations 3.11, practice hours 3.00, practice environments 2.99, practice directions 2.98. 3. 'Transformational leadership', 'charisma', 'intellectual stimulation' and 'individual consideration' were positively related to 'self-esteem', 'satisfaction of clinical practice' of nursing students. 4. 'Contingent reward' was positively related to 'self-esteem'. And 'Management by exception' was negatively related to 'self-esteem'. 5. 'Transactional leadership', 'Contingent reward' were positively related to 'satisfaction of clinical practice' of nursing students. 6. As a result of multiple regression analysis, the key determinants of 'self-esteem' were 'charisma' and this explained 27.41% of the total variance of it. And the key determinants of 'satisfaction of clinical practice' were 'charisma' and this explained 10.94% of the total variance of it.

• 대한미생물학회지
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• 제20권1호
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• 한국간호교육학회지
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• 제14권2호
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• pp.205-215
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• 2008

Purpose: This study was to identify the relationship between the degree of family support and the degree of satisfaction in clinical practice by nursing students. Method: This study was designed to measure the level of satisfaction according to the content, guidance, circumstance, hours, and the evaluation of clinical practice. Four hundred sixty-five nursing students from 4 nursing colleges, and 1 baccalaureate program in G area were randomly sampled. An instrument consisting of 64 questions, developed by the researcher and a nursing professor, was used to gather data from March 10 through 31, 2008. The data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson Correlation, using the SPSS 14.0 program. Result: The results were summarized as follows : Family support of nursing students showed a significant difference by religion (t=2.104, p=0.036) and satisfaction of major (F=8.010, p<0.001). The satisfaction degree of clinical practice by nursing students showed a significant difference by university or college (t=2.636, p=0.012), residence type (t=2.098, p=0.036), and satisfaction of major (F=5.779, p=0.003). The relationship between generally perceived family support correlated with the degree of satisfaction in clinical practice of nursing students (r=.199, p<0.001). Conclusion: It was found that a higher degree of satisfaction in clinical practice depends on a higher degree of family support. Therefore, nursing faculty should plan interventions to inspire satisfaction level of clinical practice by family support.