Purpose: The purpose of this preliminary study was to describe the physical and psychosocial distress of critically ill patients undergoing noninvasive ventilation(NIV). Method: Open-ended question interviews were conducted with four patients using NIV. Considering the outcomes of the interviews, literature, and experts'opinions, a survey questionnaire was developed. Twenty patients in medical and surgical intensive care units answered the questions. Results: Through open-ended question interviews and survey, the patients using NIV reported feeling heavy, impotent feeling, pain, loss in feeling, loss in communication, and lack of sleep as physical distress and a loss in sense of time, pain, anxiety, mind of desiring to die, worry about family, and a sense of burden for medical-cure expenses as psychosocial distress. Conclusion: Critically ill patients undergoing NIV experience physical and psychosocial distress to artificial respiratory ventilation treatment. Further research should be performed with a large sample for generalization of the study result.
Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.
To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.
Purpose: The purposes of this study were to determine the intertester and intratester reliabilities of the Lateral Scapular Slide Test (LSST) method, and to examine if significant differences existed in scapular positions among the pain groups (right-shoulder pain group, left-shoulder, pain group and both-shoulders pain group). 27 female subjects (mean age = 51.6, mean height = 157.7 cm, mean weight = 57.5 kg) with shoulder pain were recruited for this study. Methods: The bilateral distances between the root of the scapular spine and T3/4 (RSS), and between the inferior scapular angle and T7/8 (IA), were recorded. Subjects were tested at three positions: the with arms with abducted at 0, 45 and 90 degrees in the coronal plane. The LSST measurements were performed by two testers, selected randomly. Results: The results were as follows: Intraclass correlation coefficients (ICCs) for the intertester reliability were excellent (ICC 0.78-0.94). And the ICCs for the intratester reliability were excellent (ICC 0.83-0.99). In the right-shoulder and both-shoulders pain groups, the right-side RSS and IA values of right side were significantly greater than of the left-side RSS values left side for the arms abducted at 0 degrees of right shoulder pain group and both shoulder pain group (p<.05). However, the side-to-side difference was less than 1.5 cm. Conclusion: Our results suggest that the LSST is highly reliable in identifying the abnormal scapular position of patients with shoulder problems. Future research should be continued to clarify the clinical usefulness of this method.
Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.
Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.
Purpose: To evaluate reliability of Q-ray view (Aiobio Inc,. Seoul, Korea) for assessing retention status of pit and fissure sealants. Methods: Pit and fissure sealants of 58 permanent molars from 15 third-grade students were examined. Posterior teeth with ≥1 pit and fissure sealants applied to the occlusal surface for >6 months were examined. The teeth were examined using traditional visual-tactile assessments and combined Q-ray view. Pit and fissure sealants were evaluated by assessing marginal plaque, marginal discoloration, marginal integrity, retention, and presence of caries. Fleiss kappa and Cohen's kappa values were calculated to compare inter- and intrarater agreements between visual-tactile and combined Q-ray view assessments. Results: Regarding interrater agreement in visual-tactile assessments, K values of Cohen's kappa for marginal plaque, marginal discoloration, and presence of caries were 0.22-0.57, 0.36-0.57, and 0.43-0.61, respectively, and agreements ranged from slight to moderate. When combined with Q-ray view, the values were 0.81-0.89, 0.69-0.88, and 0.80-0.90, respectively, and agreements ranged from substantial to nearly perfect level, indicating statistical significance. Marginal plaque (0.81-0.83), marginal discoloration (0.57-0.89), and presence of caries (0.69-0.91) showed higher agreements in combined Q-ray view than in visual-tactile assessments, and kappa values of marginal plaques were significantly higher in combined Q-ray view than in visual-tactile assessments. Conclusion: Evaluating retention status of pit and fissure sealants using Q-ray view showed higher reliability than using visual/tactile assessments for marginal plaque, marginal discoloration, and presence of caries. Therefore, Q-ray view may be used to assess the retention status of pit and fissure sealants.
Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis. Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians. Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2). Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters' inconsistency.
The purpose of study was to examine the effect of nonnutritive sucking(NNS) on behavioral state in preform infants. Fourteen infants (gestational age 28-35 weeks, M=31.86 ; birth weights 1095-2275g, M=1694g) admitted to NICU, serving as their controls were randomly administered 5 min of nonnutritive sucking and a control condition. Behavioral state was measured using the Anderson Behavioral State Scale(ABSS). Heart rates were obtained for each infant before and during NNS and bottle feeding. Data collecction was done by 3 experienced nurses in NICU 2 times a day for conseculive 4 days for each subject. Interrater reliability were .80-.90. The findings were as follows : 1. Preform infants averaged active restless states 58.93% in the prointervention phase and 27.32% in the NNS phase. Inactive awake states were 3.57% in the preintervention phase and 34.64% in the NNS phase. 2. There were significantly more positive changes to inactive awake states for the NNS intervention, Z=-2.35, p=.01. 3. There was no statistically significant difference in heart rate change between NNS intervention and control condition, z=-1.15, p=.24. 4. The rates of feeding success determined by finishing prescribed amount of milk by bottle feeding within 15 minutes were 83.94% in NNS intervention and 89.29% in control condition. The findings from this study confirmed that NNS is effective for behavioral state modulation and inducing optimal state for feeding in preform infant. The NNS intervention in nursing practice may help the transition of preform infants for nipple feeding.
Purpose: The aim of this study was to share the experience of clinical performance examinations (CPXs) using standardized patients, which was to test comprehensive clinical competence of fourth-year nursing students for four years. Methods: The assessment strategies for CPXs were developed. It included clinical scenarios, the roles of standardized patients, and appraisal criteria in the areas of fundamental and comprehensive nursing care. The CPXs were implemented to about 60-70 fourth-year nursing students of C University in G-city, South Korea, during every second semester from the year of 2006 to 2009. Results: The effects of CPXs were measured by 10 or 25-item rating checklist. Internal reliability of the checklists was distributed from .511 to .956 and interrater agreement between faculties and standardized patients was moderate (r=.250-.949). Students' satisfaction level was 4.27 out of 5 points for four years. Conclusion: The use of CPXs was an innovative educational strategy to evaluate nursing students' comprehensive performance ability including knowledge, skills and attitude. Further studies are needed to evaluate the levels of critical thinking and problem solving skills of clinical nurses who were taken CPXs as well as employers' satisfaction.
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