• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.3
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• pp.300-309
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• 2011

Purpose: The purpose of this study was to investigate facilitators of evidence-based practice (EBP) in Clinical Nurses. Method: The instruments used in study were the EBP facilitator scale developed by Nagy et al. and a questionnaire on EBP-related characteristics. Data were collected from 230 nurses at a tertiary hospital and analyzed by descriptive statistics. Results: Compared to previous studies, this study showed that nurses had more experience related to research courses and clinical research. However, the proportion of nurses who reviewed relevant articles still remained low. The respondents had positive perceptions of organizational supports for EBP and belief in the value of EBP, whereas they had negative perceptions of skills in locating and evaluating research reports, knowledge of research terms and statistics, and time to devote to EBP. Conclusion: The findings of the study provide important basic data to develop and implement an EBP programs. In future, EBP programs should cover the nurses' skills to search and review research literature as well as their knowledge of research terms and statistics. Furthermore, nurses will require help to ensure that there is adequate time to devote to EBP.

• Clinical and Experimental Pediatrics
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• v.63 no.12
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• pp.454-462
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• 2020

The Committee on Dyslipidemia of Korean Pediatric and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for dyslipidemia in Korean children and adolescents. These guidelines were formulated with the Grading of Recommendations, which include both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines are based on the 2011 National Heart, Lung, and Blood Institute Guidelines, which focus on the prevention of cardiovascular disease in children and draw from a comprehensive review of evidence. These guidelines contain the definition of and screening process for dyslipidemia and introduce new dietary methods: the Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, the CHILD-2-low-density lipoprotein cholesterol, and the CHILD-2-triglyceride. Potential drug therapies for dyslipidemia along with their main effects and doses were also included.

• Journal of Society of Preventive Korean Medicine
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• v.20 no.1
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• pp.55-64
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• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.83-90
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• 2017

Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

• Journal of Sasang Constitutional Medicine
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• v.34 no.2
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• pp.48-64
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• 2022

Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.877-883
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• 2013

Background and Objective: There has been no universally agreed standard chemotherapy regimen for patients with advanced biliary tract carcinomas (BTC). We aimed to fully display and evaluate the clinical evidence for gemcitabine or gemcitabine-cisplatin combination for advanced BTC. Methods: Systematic searches were performed to identify relevant randomized controlled trials (RCTs) and uncontrolled trials. Overall survival (OS), progression-free survival (PFS), overall response rates (ORR), tumor control rates (TCR), and toxicity were evaluated. Evidence levels of the results were evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Results of the eleven gemcitabine-cisplatin trials and ten gemcitabine trials showed both chemotherapy regimens had benefits with reference to mean OS (8.63 vs. 8.79 months), mean PFS (4.86 vs. 4.72 months), pooled ORR (25.3% vs. 19.6%) and TCR (55.2% vs. 53.1%). Two RCTs showed the gemcitabine-cisplatin combination to prolong the mean PFS (mean difference [MD] 2.57, 95%CI 1.69 3.45), substantially increasing the mean OS (MD 3.59, 95% CI 3.48 3.71), and producing a similar effect in ORR (risk ratio [RR] 1.59, 95%CI 1.04 2.43), increasing TCR (RR 1.15, 95%CI 1.02 1.31) compared with gemcitabine alone, with generally manageable grade 3 or 4 adverse events. The evidence level of OS was moderate, and other outcomes (ORR, PFS, TCR, anaemia, neutropenia) were at low evidence levels. Conclusion: Available evidence was limited with low quality, which showed that both gemcitabine-cisplatin and gemcitabine alone had clinical activity with acceptable safety profiles, and gemcitabine-cisplatin appeared to be more useful for advanced BTC patients than gemcitabine alone.

• Journal of Korean Clinical Nursing Research
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• v.30 no.1
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• pp.54-64
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• 2024

Purpose: This descriptive survey study aimed to examine the effects of grit, social support, job crafting, and evidence-based practice competency on job satisfaction among nurses. Methods: The participants of this study were 211 clinical nurses with experience of more than six months. Data were collected using through an online survey from February 1 to February 17, 2023. The questionnaires was consisted of general characteristics, grit, social support, job crafting, evidence-based practice competency, and job satisfaction. Data were analyzed using descriptive statistics(frequency, percentage, mean, and standard deviation), t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis with the SPSS/WIN 28.0 program. Results: The average scores of the main variables were 3.08±0.44 out of four for grits, 3.67±0.52 out of five for social support, 4.20±0.64 out of five for job crafting, 4.84±0.71 out of seven for evidence-based practice competency, and 3.72±0.55 out of five for job satisfaction. In the regression model, the factors affecting the nurses' job satisfaction were grit (β=0.66, p<.001) and social support (β=0.11, p=.046), which explained 78.7% of the variance in job satisfaction. Job crafting and evidence-based practice competency were correlated with job satisfaction; however, there was no statistically significant effects of these variables on job satisfaction. Conclusion: Based on the findings of this study, grit and social support showed the most significant effects on the job satisfaction of nurses. Therefore, active support is needed to develop a strategy to improve nurses' grit and to create a supportive work environment, which would be helpful to increase their job satisfaction.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.2
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• pp.292-303
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• 2013

Purpose: The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals. Methods: Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology. Results: Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'. Conclusion: The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.

• YAKHAK HOEJI
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• v.59 no.6
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• pp.245-250
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• 2015

Middle East respiratory syndrome - coronavirus infection has posed substantial threat to public health with extremely high mortality rate in 2015. Although there are no approved novel medications for coronavirus, several antiviral agents such as ribavirin and interferon have been tried to MERS patients according to the in-vitro inhibitory effect, therapeutic effect on the animal model and experience from the severe acute respiratory syndrome - coronavirus infection. The aim of this study is to evaluate the clinical evidence of the antiviral treatment for MERS-CoV infection. After systematically searching the medical literature databases, I found five studies described the clinical efficacy of antiviral treatment on MERS patients. All of them were about the combination therapy of ribavirin and interferon (IFN). Two of them were retrospective cohort studies with quality of evidence (QOE) II and the others were observational study and case reports with QOE III. As a result of critical appraisal, it is concluded that none of those studies represented confirmatory clinical evidence of the efficacy of ribavirin and interferon combination therapy on MERS patients. Although Omrani et al. represented that ribavirin and IFN treatment had significantly improved survival at 14 days, it was not enough time to conclude the effect.

• Perspectives in Nursing Science
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• v.4 no.1
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• pp.19-25
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• 2007

Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.