• Title/Summary/Keyword: Tertiary education

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Effects of Nursing Practice Environment and Self-esteem on Critical Thinking Disposition among Clinical Nurses (임상간호사의 간호근무환경과 자아존중감이 비판적 사고성향에 미치는 영향)

  • Choi, Eunju;Hwang, Jihyeon;Jang, Insil
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.2
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    • pp.161-169
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    • 2017
  • Purpose: This study was a cross-sectional study done to determine the relevance and impact factors of nursing practice environment and self-esteem on critical thinking disposition in clinical nurses. Methods: A survey was conducted from March to May 2015 with self-report questionnaire. Participants were 281 registered nurses working in one tertiary hospital. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 21.0. Results: Factors affecting the nurses' critical thinking disposition included age (F=7.23, p<.001), educational background (F=7.82, p<.001), position (F=14.95, p<.001), clinical career (F=7.66, p<.001). Further, critical thinking disposition had a positive correlation with nursing practice environment (r=.60, p<.001) and self-esteem (r=.41, p<.001). Self-esteem and nursing practice environment accounted for 43% of the variance in critical thinking disposition. Conclusion: The study findings show that critical thinking disposition is influenced by nursing foundations for quality of care and the collegial nurse-physician relations of nursing practice environment. Therefore, it's necessary to provide continuing education for clinical nurses to reconstruct the organizational culture of nurses and physician partnerships. In addition, increasing self-esteem through various motivational programs should increase critical thinking disposition.

Developing Prevention System of Overseas Infectious Disease Based on MERS and Zika Virus Outbreak (중동호흡기증후군과 지카바이러스의 대응사례분석을 통한 해외유입 신종감염병 예방시스템 구축 방안)

  • Kim, Ja Young;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.330-340
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    • 2016
  • Objective: The outbreak of Middle East Respiratory Syndrome (MERS) started in South Korea in May 2015 and the end of crisis was declared in December 2015 by Korea Centers of Disease Control and Prevention (KCDC). However, Zika virus emerged in less than 2 months following MERS and showed higher mortality than other countries. This study is to assess the current prevention system of overseas infectious diseases, based on MERS and Zika virus outbreak and to suggest effective response system for the future. Methods: We conducted two surveys on medical specialists working at tertiary general hospitals regarding the effectiveness of responding system by KCDC against MERS and Zika virus and education in individual medical institutions using 5-Likert points. Response system was examined in three different periods as initial period, spreading period, and post disease period. Results: Although medical specialists received the notifications in initial period, no practical prevention was proven to be placed in responding stage by medical facilities (averagely 3.5/5 points in total and sub-analyses). During spreading period, there were several academic seminars conducted, which were evaluated as helpful. In post disease period, all answered that there were changes on patient treatment in all medical facilities, with mainly report system and the treatment regulations in case of suspicious patients for infection. Only 49% respondents answered positive on the possibility of initial responses. For questionnaire items regarding Zika virus, all answered that there were notifications prior to the first outbreak of the infected patient. Eighty% of respondents were aware of 'the Guideline system for traveling to dangerous areas', and answered that the system was moderately effective (averagely 3.8/5 points in total). For the effectiveness of prevention measures for foreign novel disease by KCDC, the average point was 3.0 in both of total and sub-analyses. Conclusion: There is not enough response system to prevent infectious disease in medical institutional and governmental levels in Korea. It would warrant the modification of overall medical system to improve preventive measures for initial spread of such diseases.

Effect of Comprehensive Breast Care on Breast Cancer Outcomes: A Community Hospital Based Study from Mumbai, India

  • Gadgil, Anita;Roy, Nobhojit;Sankaranarayanan, Rengaswamy;Muwonge, Richard;Sauvaget, Catherine
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1105-1109
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    • 2012
  • Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

Efforts to obtain better rice seedlings performance under nontidal swamp land agro-ecosystem in south Sumatra, Indonesia

  • Suwignyo, Rujito A.;Sakagami, J.;Ehara, H.;Sulaiman, F.;Hasmeda, M.
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.50-50
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    • 2017
  • Swampland is a potential alternative land to be used in various agricultural production activities in Indonesia, because Indonesia have 33.41 million hectares of swamp land that consists of 13.28 million hectares nontidal swamp and million hectares 20.13 tidal swamp. In the province of South Sumatra, because of unpredictable water level in the field before planting, farmers have been doing agronomic adaptation method through the delay time of transplanting and forced to apply more than one the nursery practice with the combination of a floating nursery method and a dry-bed nursery method. This study was aimed to (1) evaluate the seedling growth and tillering pattern of several popular Indonesian rice varieties, and (2) look for alternative technologies to get a better rice seedlings under two nursery methods in the nontidal swamp land. In the first experiment, the seedling growth characteristics of five rice varieties (Ciherang, Inpara 5, Inpara 9, Inpari 29, and Inpari 30) was evaluated by two methods of nursery, i.e. floating nursery and dry-bed nursery. In the second experiment, rice variety of Inpari 30 was treated with Zn seed priming and foliar fertilizer of 2,300 ppm N at the nursery stage. Those treatments were combined with the time of seedling under floating and dry-bed nursery. The results of the first experiment showed that of the five varieties tested, dry-bed nursery method showed better seedling growth than floating nursery. This was indicated by high leaf number, tiller number, tillers pattern, shoot-root ratio and relative growth rate. Ciherang and Inpari 30 showed high tiller number, and they had produced tertiary tiller in the sixth week of observation. Moreover, shorter period of floating and dry-bed nursery in combination with the treatment of Zn seed priming and spraying seedling with foliar fertilizer N could improve the growth of seedlings.

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Space-time cluster research of R&D industry in Seoul, Korea (서울시 R&D 산업체의 시공간 클러스터 분석)

  • Park, Sun-Young;Kim, Youngho
    • Journal of the Economic Geographical Society of Korea
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    • v.16 no.3
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    • pp.492-511
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    • 2013
  • According to IASB(International Accounting Standards Board), R&D(Research and Development) is defined as a tertiary sector industry combining research and development. Many studies investigated R&D industry clusters in the form of high-tech cluster(Coe et al., 2007). However, these studies only generalized various spatial cluster of R&D industries. In particular, the studies could not considers cluster formation process over time lacking statistical significance in space-time perspectives. This study, therefore, indicates the limitation of recent R&D cluster literature which only considers either time or space. In addition, this study explores space-time clusters in R&D industry together with textile and cloth industry for comparison. Discovering the existence and location of clusters, this study utilized space-time K function and space-time scan statistics. The result shows that R&D industry presents significant clusters only in spatial dimension. No significant clusters were found in space-time dimension. However, textile and clothing industry presents significant clusters in both spatial and space-time dimensions.

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Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis

  • Rao, Abha;Sunil, Bhuvana;Ekstrand, Maria;Heylen, Elsa;Raju, Girish;Shet, Arun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1779-1784
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    • 2016
  • Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

Caregiver's Burden and Quality of Life of Male Spouses with Stroke Wives (뇌졸중 환자인 부인을 돌보는 남성노인 배우자의 부담감과 건강 관련 삶의 질)

  • Han, Jung-Hee;Park, Yeon-Hwan
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.615-626
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    • 2012
  • Purpose: The purpose of this study was to investigate caregiver burden and health related quality of life (HRQoL) among male spouses who cared for partners with a stroke. Methods: The subjects were spouses of 121 female patients who visited the neurology outpatients department in one tertiary hospital located in Seoul between February and April in 2011. Results: The mean age of the male caregivers was $71.25{\pm}5.51$ years. The mean score of caregiver's burden was moderate ($63.28{\pm}9.85$). The average reported caregiving time was $58.48{\pm}5.51$ min/day with the male spouses spending more time in house-working than with caregiving activities. The reported depression and care giving time, plus the cognitive status and functional dependencies of the spouse were significantly related to male caregiver's burden. The mean scores of 'physical health' and 'mental health' for quality of life for the male caregivers was moderate (47.49 and 47.33 respectively). Overall, caregiver's burden has a negative effect on the HRQoL of male spouses. Conclusion: Caregiver's burden and HRQoL are important problems which are in need of nurses' attention. It is suggested that intervention programs for male spouses be developed with a focus on emotional and social support as well as education about the caregiving role.

The Change of Characteristics in Clinical Decision Making in Novice Critical Care Nurses (중환자실 신규간호사의 임상의사결정 특성의 변화)

  • Kim, Dong-Oak;Kim, Mae-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.301-314
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    • 2001
  • The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

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Importance, Satisfaction and Contribution of Advanced Practice Nurses' Role Recognized by Health Care Professionals (전문간호사 역할의 중요도, 만족도 및 기여도에 대한 의료인의 인식 - 전문의, 간호사, 전문간호사를 대상으로 -)

  • Cho, Myung-Sook;Cho, Young-Ae;Kwon, In-Gak;Seo, Min-Jeong;Baek, Hye-Jin
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.2
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    • pp.168-179
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    • 2011
  • Purpose: The purpose of this study was to identify level of recognition of the importance, satisfaction and contribution of APNs' role by physicians, nurses, and advanced practice nurses. Method: Perceived importance and satisfaction were measured with a 23-item questionnaire on APN role with 5 subcategories. APNs' contribution was investigated using a 13-item outcome questionnaire developed by the researchers. Between August 15 and October 31, 2009, the researchers collected data from 68 physicians, 265 nurses, and 23 APNs all working in a single tertiary hospital. Data were analyzed using descriptive statistics, Kruskal-Wallis Test with Bonferroni's Correction and scatter plot. Result: The importance (3.24~3.39, 4 point scale), satisfaction (3.02~3.13, 4 point scale), and contribution of APNs' role (3.39~4.12, 5 point scale) were well recognized by the health care professionals. All the three health care professional groups rated APNs' contribution high in medical service management, continuity of care, patient accessibility, improvement in patient satisfaction, and patient and family education. 'Importance-Satisfaction Analysis' showed that patient data management by APNs needed greater effort. Conclusions: The findings show that the importance, satisfaction, contribution of APNs' role are recognized, and indicate a need for further development of APNs' role through efforts to overcome the gaps identified through this research.

Development of Roles and Organizational Policy of Advanced Practice Nurses in an Acute Hospital Setting (일 종합전문병원에서의 전문간호사 역할 및 운영방안 개발)

  • Lee, Tae-Wha;Ko, Il-Sun;Kim, In-Sook;Kim, Hyun-Ok;Park, Young-Woo;Kim, In-Ja;Park, Jung-Sook;Choi, Mi-Ok;Son, Mi-Jung;kil, Yoon-Kyung;Kim, Eun-Hyeon
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.3
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    • pp.352-361
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    • 2007
  • Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.

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