Purpose: This study was a descriptive methodological study to develop protocols for school health practice to manage health problems of primary school students effectively. Methods: The protocols were verified by 12 experts and 10 health teachers, respectively, to secure a two-step content validity. Results: The main 8 health problems of primary school students were headache, abdominal pain, musculo-skeletal, respiratory, circulatory, ophthalmic, and oral-dental problems, and fever. The developed protocols consist of 8 algorithms, which are to help decision making in the course of assessing health problems and to identify and link related factors and associated symptoms, 8 school nursing records based on the Omaha classification system, and the list of 441 links between nursing assessment and nursing intervention. Conclusion: The use of the protocols is expected to make it easier for health teachers to apply the nursing process in solving the health problems of primary school students and supporting the rational decision making process, eventually improving the quality of primary school health. Repeated studies for protocol standardization as well as studies dealing with various health problems not included in the protocols should be performed for the development of school health practice protocols.
Purpose: This study was conducted to investigate the effects of foot reflexzone massage on state - anxiety and discomfort of ovarian cancer patients receiving chemotherapy. Method: A quasi experimental design with a non equivalent control group and non synchronized design was used. The experiment was conducted from October 1, 2003 to September 30, 2004. The subjects consisted of 40 patients admitted to C University Hospital. Twenty subjects were assigned to the experimental group and received foot reflexzone massage everyday for 3 days. The other 20 subjects were in the control group and received routine care. Foot reflexzone massage was done on both feet of the subjects for 30 minutes for 3 days using standard protocol. The 'State-Anxiety Inventory' developed by Spielberger was used to measure the degree of state-anxiety. Discomfort was assessed using the 'Symptom Distress Scale' of McCorkle and Young. Data was analyzed by a SAS program using t-test, Wilcoxon signed rank sum test and Wilcoxon rank sum test. Results: State-anxiety and discomfort of subjects receiving foot reflexzone massage were significantly lower than those of the control group. Conclusion: These findings indicate that foot reflexzone massage could be an effective nursing intervention for relieving state-anxiety and discomfort in ovarian cancer patients.
Purpose: This study was to examine the effects of hand massage and hand holding as nursing interventions on the anxiety in patients with local infiltration anesthesia. Method: The design of this study was a nonequivalent, control group, non- synchronized design. The subjects of this study consisted of 15 patients for the hand massage group, 15 patients for the hand holding group and 17 patients for the control group awaiting surgery in the operation room of a general hospitalin Daegu. As an experimental treatment, hand massage was carried out by the Hand Massage Protocol developed by Snyder(1995) and interpreted by Cho(1998) and hand holding developed by Cho(1998). The data were analyzed by SPSS/WIN, T-test, ANOVA, Cronbach's a, and the Scheffe test. Results: The hand massage group and hand holding group were more effective than the control group in reducing anxiety, VAS score, systolic blood pressure and pulse rate. Conclusion: Hand massage and hand holding are effective nursing interventions that alleviates the psychological and physiological anxiety of patients with local infiltration anesthesia. In particular, the simple contact of hand holding is regarded as an effective and easily accessible nursing intervention in the operating room.
Purpose: The purpose of this study was to identify the current status of evidence-based research, education, and practice, and to suggest a directions for the future development of evidence-based nursing. Methods: To examine the current status of evidence-based nursing research, experimental research among studies published in the Journal of Korean Academy of Nursing from 2008 to 2010 were analyzed. We suggested a direction for the future development of evidence-based research based on the analysis and literature reviews. We also suggested a direction for the future development of evidence-based education and practice based on literature reviews. Results: The results showed that designs and methods of studies were insufficient to use evidences derived from the studies in terms of evidence-based research, and experimental studies consistent with themes were found to be deficient. In the future, the methods and rationale for the design of experimental studies need to be clearer In addition, a test for intervention effects through repetitive studies and a connection between the intervention effects and a protocol for clinical practice will be required. In terms of evidence-based education, curriculum revision and development of teaching methods including contents related to evidence-based practice and research methodology in undergraduate and graduate programs will be required. Evidence-based practice in Korea was less actively done than with that of foreign countries. Some large hospitals have recently attempted systemic activities to promote evidence-based nursing practice in clinical settings. To activate evidence-based practice, the perception of nurses for evidence-based practice needs to be changed and support for education and administration of the program is required. Also, evidence-based practice guidelines, protocols, and assessment tools need to be developed. Conclusion: Evidence-based nursing in Korea is in the process of evolving. To realize evidence-based nursing, we need to develop nursing science based on evidences of closer communication and cooperation in terms of nursing research, education, and practice.
The purpose of this study was to identify transition conditions, health behavior and indicators of healthy transitions among middle-aged women based on Schumacher & Meleis(1994) transition model for developing intervention program for their health promotion. A convenience sample of 221 women aged 40-60 was obtained in Jung-Gu, Seoul and they were asked to complete the questionnaires, which consisted of modified health-promoting lifestyle profile(HPLP), knowledge of menopause, physical well-being, emotional well-being, modified women's role integration protocol (WRIP), Beck's Depression Inventory(BDI), and indicators of healthy transition with subcategories such as subjective well-being, role mastery and well-being of interrelationship. The results were as follows: 1. Women had a mean age of 47.53 years. More than half(53.39%) of the women had jobs and 88.69 % had their spouses, Of 221 women, 51.13 % were premenopausal, 19.91% were perimenopausal, and 28.96% were postmenopausal. 2. Women scored lower on health responsibility and exercise than on self actualization, nutrition and interpersonal support among subcategories of health behavior measured the modified HPLP. Only 11.98% of respondents had breast-self examination and 42.66% had pap smear for screening cancer. 3. In transition conditions, women had poor knowledge about menopause and median level of physical well-being, emotional well-being and stress. 15.45% of the women had clinical depression. 4. As for the outcome index of the transition model, the mean of indicators of healthy transition was 3.69(possible range 1-5). 5. The levels of education and economic and the menstrual status were significantly related to physical well-being, depression and stress in the categories of transition conditions. The total score of health behavior correlated negatively with depression. The total score of indicators of healthy transition correlated with physical well-being, emotional well-being, stress, and depression in the categories of transition conditions. In conclusion, these findings suggested a profile of fragile middle-aged women and contributed to developing the community-based intervention program for health promotion.
Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.
Purpose: The present study was designed to identify cancer patients' needs when chemotherapy ends. Method: In-depth interview with focus questions was applied for the study. The participants were recruited from the patients receiving cancer chemotherapy in a university hospital. They were seven cancer patients with stomach cancer and two with liver cancer at the ending period of their chemotherapy protocol. Participants were interviewed on discharge date of last treatment and when they returned for the first outpatient follow-up. The focus question was 'what are your needs at this point?' The interviews were audio-taped and transcribed before analysis. The data were analyzed for common categories, special analytic categories, and conceptual categories. Results: Thirty two common categories, ten special analytic categories, and six conceptual categories were identified as patient's needs. The six conceptual categories were comfort needs, social needs, information needs, humanism needs, environmental needs, and self-efficacy needs. Conclusion: There were characteristic specific patients' needs when chemotherapy ends. There are needs to develop and to apply nursing intervention for cancer patients.
Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.
Purpose: This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease. Methods: Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association(AHA) and Scottish Intercollegiate Guidelines Network(SIGN). Results: The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain. Conclusion: Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.
Purpose: This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system. Methods: The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using ${\chi}^2$-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression. Results: Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference. Conclusion: For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.
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