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The Effect of Problem-Based Learning for Patient Safety on Self-Leadership, Patient Safety Competencies, and Reflective Thinking of Nursing Students

  • Park, Jung-Ha;Yun, Ji-Ah;Park, Kyoung-Duck
    • International journal of advanced smart convergence
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    • v.11 no.2
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    • pp.194-204
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    • 2022
  • This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

The Influence of Nurses' Communication Competency, Critical Thinking Disposition, and Perception of Patient Safety Culture on Patient Safety Competency in Armed Forces Hospitals (군 병원 간호사의 의사소통능력, 비판적 사고성향, 환자안전문화 인식이 환자안전역량에 미치는 영향)

  • Yoon, Sookhee;Lee, Taewha;Maeng, Soonju;Kwon, Jae-eun
    • Korean Journal of Occupational Health Nursing
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    • v.29 no.2
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    • pp.123-132
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    • 2020
  • Purpose: This study examined the influence of nurses' communication competency, critical thinking disposition, and perception of patient safety culture on patient safety competency in armed forces hospitals. Methods: A crosssectional design was employed with a convenience sample of 204 nurse officers from four armed forces hospitals in South Korea. Data were collected through a self-administered questionnaire from August 10~23, 2019, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression. All analyses were conducted using SPSS for Windows 21.0. Results: Patient safety competency scores were 4.35±0.40 for patient safety attitudes, 3.63±0.64 for patient safety knowledge, and 3.94±0.51 for patient safety skill. Communication competency, critical thinking disposition, and perception of patient safety culture were positively correlated with patient safety competency. Communication competency (β=.30, p=.002) and perception of patient safety culture (β=.24, p=.001) were identified as particularly important factors influencing patient safety competency. Conclusion: This study's results suggest that education programs to enhance communication competency and patient safety culture could increase patient safety competency among nurses in armed forces hospitals.

Patient Safety Teaching Competency of Nursing Faculty (간호대학 교수의 환자안전 교육역량)

  • Ahn, Shinae;Lee, Nam-Ju;Jang, Haena
    • Journal of Korean Academy of Nursing
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    • v.48 no.6
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    • pp.720-730
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    • 2018
  • Purpose: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. Methods: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. Results: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was $3.52{\pm}0.67$ out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (${\beta}=.39$) during clinical practicum, their perceived importance of patient safety education during lectures (${\beta}=.23$), and the teaching subject (${\beta}=.15$). Conclusion: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.

Relationship between Perceived Health Status and Patient Satisfaction in Outpatient Settings - Korean National Health and Nutrition Examination Survey 2015

  • Park, Eun-Joo;Park, Seung-Guk;Kwon, Ji-Hye;Cheon, Seung-Won;Kim, Hyo-Eun;Yoo, Sun-Mi
    • Health Communication
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    • v.13 no.2
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    • pp.159-166
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    • 2018
  • Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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A Clinical Study about Soyangin Edema Patient (소양인(少陽人) 부종(浮腫) 환자(患者) 치험례(治驗例))

  • Ahn, Taek-Won;Bae, Na-Young
    • Journal of Sasang Constitutional Medicine
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    • v.17 no.3
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    • pp.163-171
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    • 2005
  • 1. Objectives The purpose of this study is to evaluate the effectivity of the Korean herbal medicine therapy which is based on the Sasang constitutional medicine for the Soyangin Edema Patient 2. Methods Patient who diagnosed as Soyangin by physical characteristic, posture and symptoms is evaluated with length of patient' Lt. calf, ankle, foot circumference after medication 3. Results After medicine, 1) Length of patient' Lt. calf was on the decrease from 37.2cm to 34.4cm 2) Length of patient' Lt. ankle was on the decrease from 27.8cm to 25.4cm 3) Length of patient' Lt. foot was on the decrease from 28.0cm to 25.7cm Edema of a Soyangin patient responded well to the treatment with Dojeokgangki-tang 4. Conclusions The case study shows an efficient results by using Dojeokgangki-tang in treatment of Soyangin edema patient.

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The Effect of Patient's Psychological Distress on Social Support in Physical Therapists : Focused on patient's regulatory focus (물리치료사의 사회적 지지가 환자의 심리적 디스트레스에 미치는 영향 : 환자의 조절초점을 중심으로)

  • Kim, Cheol-Yong
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.3
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    • pp.331-339
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    • 2011
  • Purpose : The purpose of this study is to examine the impact of patient's psycological distress on social support in the view of patient's regulatory focus. Methods : For this study 300 questionnaires were distributed to medical institution, Busan from July 19 through August 4, 2010. The contents item divided the general characteristics, social support, psychological distress, and regulatory focus. The collected data were analyzed by t-test and multi-regression analysis. Results : The results show that patient's psychological distress is significantly influenced by physical therapist's emotional support and informational support. Also, there were difference with the effect of psychological distress on social supports in the physical therapists according to patient's regulatory focus. Conclusion : The instrumental support is more important to patient with promotion-focus than patient with prevention-focus. The implication of this research confirmed that physical therapist's social support plays important role in decreasing patient's psychological distress.

Long-term Experience with the Bjork-Shiley Monostrut Valve (Bjork-Shiley monostrut 판막의 임상 치험)

  • 김영태
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1337-1345
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    • 1992
  • One hundred and fourty-one Bjork-Shiley Monostrut valves were implanted in 105 consecutive patients from November 1983 to February 1990. There were 61 male and 44 female patients with a mean age of 33.6 years at the surgery. The cummurative follow-up was 370.3 patient-years with a mean of 44.0 months per patient. The operative mortality rate was 3.8%, and the linealized late mortality was 1.18%/patient-year. The incidence of major complications were 4.59%/patient-year, and the actuarial rate of freedom from valve-related morbidity was 80.2$\pm$4.4% at 7 years. The 7-year survival rate was 90.5$\pm$4.1%, and the actuarial rate of freedom from thromboembolism at 7 years was 93.3$\pm$2.3%. The linealized annual rates of complication were ; structural valve failure 0.27% /patient-year, non-structural valve failure 0.54% /patient-year, thromboembolism 1.62% /patient-year; bleeding 1.62% /patient-year; endocarditis 0.54% /patient-year. On the basis of our experience, we judged the Bjork-Shiley Monostrut valve reliable, with similar incidence of valve-related morbidity of other mechanical prosthetic valves.

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An Explanatory Model for Patient Adherence of Rehabilitation in patients with Spinal Cord Injury (척수손상 환자의 재활 치료 지속이행 설명모형)

  • Kim, Aee-Lee
    • Korean Journal of Adult Nursing
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    • v.22 no.1
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    • pp.90-102
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    • 2010
  • Purpose: The purpose of this study was to identity factors affecting patient adherence and to develop an explanatory model for patient adherence in patients with spinal cord injury. 8 Variables that were based on the previous research and a review of literature were used to construct hypothetical model. Social support, economic status, perceived barrier, patient provider relationship and rehabilitation related knowledge were the exogenous variables, depression, self-efficacy and patient adherence were the endogenous variables. Methods: Data form 117 patients with SCI were analysed to test the hypothetical model, using SAS and LISREL 8.53 program. Results: The overall fitness of the model was good (GFI=.991, AGFI=.915, NNFI=1.299, NFI=.953, p=.632) Depression, powerlessness, economic status were the strong factors influencing patient adherence. Powerlessness was significant factors for self-efficacy. Conclusion: To improve of patient adherence should focus on nursing intervention for depression, powerlessness and economic status.

Stress and Psychological Status between a Stroke and a Fracture Patient's Caregivers (뇌졸중환자와 골절환자 보호자의 스트레스 및 심리상태)

  • Jung, Jaehun
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.4
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    • pp.213-222
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    • 2019
  • Purpose : The purpose of this study was to compare stress and psychological status between a stroke and a fracture patient's caregivers. Methods : Data was collected from September to December 2018 and participants of this study were 60 stroke and 61 fracture patient's caregivers. Stress was evaluated with the Global Assessment of Recent Stress scale-Korean Version and psychological status was measured with the Symptom check List-90-Revision. Results : The stroke patient's caregivers scored significantly higher than the fracture patient's caregivers in stress relevant to interpersonal, change in relationship, sickness or injury, financial, change/no change in routine (p<.05). The stroke patient's caregivers scored significantly higher in somatization, interpersonal sensitivity, depression, anxiety, paranoid ideation, and psychoticism than the fracture patient's caregivers (p<.05). Conclusion : It was found that the severity of mental health in the stroke patient's caregivers is necessary to develop a customized mental health improvement program for stroke patient's caregivers.