• Title/Summary/Keyword: critical care nursing

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Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients

  • Minhee Cho;Hyunjoo Na
    • Journal of Hospice and Palliative Care
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    • v.27 no.1
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    • pp.11-20
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    • 2024
  • Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

A comparative study Program Outcome between nursing college students before and After Integrated Clinical Practice (간호대학생의 통합임상실습 전·후 학습성과의 차이)

  • Lee Oi Sun;Noh Yoon Goo
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.4
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    • pp.23-30
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    • 2023
  • This study was attempted to be used as basic data for efficient clinical practice education operation by identifying differences in program outcomes before and after integrated clinical practice of nursing students. Data collection was conducted before and after 6 weeks of integrated clinical practice for 38 nursing college students from July 19 to September 10, 2021 with a single group pre- and post-design. The collected data were analyzed by frequency, Wilcoxon sign rank, and Pearson correlation using SPSS/Win 23.0. After the integrated clinical practice, 1st program outcomes(Care integration)(Z=-4.63, p<.001), 2nd(Core practice)(Z=-3.99, p<.001), 6th(Critical thinking)(Z=-3.60, p<.001) and 11th(Research practice)(Z=-2.76, p=.005) increased significantly compared to before practice. Since integrated clinical practice was found to be an effective practice to improve program outcomes, it is suggested to actively utilize it as a strategy for improving program outcomes.

Risk Factors and Features of Critically Ill Patients with Deep Vein Thrombosis in Lower Extremities (하지 심부정맥혈전증을 가진 중환자의 특성 및 발생 영향 요인)

  • Kim, Hwa-Soon;Cho, Ok-Min;Cho, Hyo-Im;Kim, Ju-Yeun
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.396-404
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    • 2012
  • Purpose: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. Methods: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. Results: The mean age was 62.24 (${\pm}17.28$) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(${\pm}2.94$) and they had on average 4.01(${\pm}1.35$) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. Conclusion: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

Mental Health and Medical Error among Nursing Staffs at Korean Medicine Clinics: a first survey in South Korea

  • Soo-Hyun Nam;Chan-Young Kwon
    • Journal of Pharmacopuncture
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    • v.27 no.3
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    • pp.253-263
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    • 2024
  • Objectives: Nurses face mental health issues like emotional labor, stress, and depression, increasing the risk of medical errors. This study assesses the mental health and medical errors among nurses in Korean medicine clinics in South Korea. Methods: The cross-sectional analysis involved 83 nurses, examining relationships between emotional labor, stress, depression, cognitive failure, Hwa-byung (HB) (a syndrome of suppressed anger in Korean culture), and medical errors. It identified factors associated with HB and medical errors using multiple regression analysis, presenting their odds ratios (ORs) with 95% confidence intervals (CIs). Results: The findings revealed a current HB prevalence of 19.28% and a 6-month medical error prevalence of 16.87% among participants. The regression analysis showed that higher levels of depression (OR = 1.368, 95% CI = 1.098 to 1.703, p = 0.005), cognitive failure (OR = 1.072, 95% CI = 1.011 to 1.136, p = 0.020), and HB trait (OR = 1.136, 95% CI = 1.005 to 1.284, p = 0.041) significantly correlated with HB presence. Conclusion: This groundbreaking study on this previously under-researched nurse workforce highlights the critical need for comprehensive mental health care, with the objective of significantly enhancing their mental well-being and improving their overall work environment.

An Integrative Review on Nursing Studies Related to Humor (유머와 관련된 국내 간호연구의 통합적 고찰)

  • Kim, Shin-Jeong;Kim, Sung Hee;Lee, Jung-Eun;Kim, Hye-Young;Yoo, So Young;Oh, Jina
    • Child Health Nursing Research
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    • v.20 no.1
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    • pp.58-66
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    • 2014
  • Purpose: The purpose of this paper was to describe the attributes of nursing with humor based on an integrative review and to present basic information for developing humor intervention programs for children. Methods: Using combinations of the terms 'nursing' and 'humor' as key words, the researchers searched four electronic databases to relevant identify studies. Thirteen studies were selected through full text screening of related research published in academic journals from January 1993 to April 2013. Results: Through in-depth discussion and investigation of the relevant literature, three components emerged; 1) using instruments of coping for stress relief, 2) symptoms relief through pleasant feeling, and 3) job satisfaction and work improvement of nurse using humor. Conclusion: The results of this study suggest that humor is valuable as a nursing intervention for children and the possibility of bringing about positive results in nursing care if nurses utilize the sense of humor as fully as they can. Therefore, it is critical for nurses to develop a diversity of humor interventions for children as well as measurements to test quality and quantity of humor used in clinical pediatric settings.

Evaluation of Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (신경계 중환자에게 적용한 중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가)

  • Kim, Hee-Jeong;Kim, Jee-Hee
    • Proceedings of the KAIS Fall Conference
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    • 2012.05a
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    • pp.22-24
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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PATERNAL INFANT BONDING : A CRITICAL REVIEW (부아(父兒)애착 : 문헌고찰 및 비평)

  • Kim, Hea-Sook
    • 모자간호학회지
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    • v.2 no.1
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    • pp.34-44
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    • 1992
  • 지난 10년 동안 구미에서는 부모-아동 관계 영역에 혁신을 가져왔다. 특히 부모-아동 애착이론의 획기적인 변화로 가족 중심 출산 경험을 강조하고 있다. 과거에는 남편이 아내의 출산에 참여하던 것이 타부시되어 왔지만 애착의 개념이 대두되면서 남편도 출산에 함께 참여하도록 고려하여 임신에서부터 부부가 함께 이 과업을 완수하도록 모든 환경을 변화시키고 있다. 애착이론은 다양하여 정신분석이론, 학습이론, 인지발달이론과 동물 행동학적 측면에서 이해되고 있다. 다양한 이론적 배경과 개념들을 가지고 아버지-아동의 애착 및 유대관계에 대한 연구가 지난 10여년 이상 되어오고 있다. 가장 관심의 촛점이 되어 연구 되어온 것으로는 애착형성을 위해 중요하다고 하는 민감한 시기(Critical period)를 중심으로 애착의 특성인 시각, 청각, 촉각, 상호호혜적 관계, 긍정적 애정을 바탕으로 연구되어졌다. 이 연구는 부아 애착(Paternal Infant Attachment)의 연구를 연구방법, 측정도구 및 방법상문제와 변수들을 중심으로 재정리하여, 이 분야에 있어서 앞으로의 연구 방향을 살펴보았다. 17편의 연구들을 각각 년도, 표본수, 방법 및 측정, 결과 및 비고난을 비교 분석하여 도표를 작성하였다. 이론적 기틀과 문헌고찰에 근거하여 다음과 같은 적용과 제언을 한다. 1. 출산전 아버지의 특성에 대한 사정이 필요하다. 2. 연구자가 집단간 비교를 용이하게 하기 위해 연구전에 표본의 특성을 정확히 기술해야 한다. 3. 부모와 아버지의 과거력에 대한 상세한 정보수집이 강조되어야 한다. 4. 앞으로의 연구는 이론적 모델에 근거하여 이루어져, 대중교육 뿐 아니라 정책 결정에 기여해야 한다. 5. 연구결과 평가와 해석을 위해 정확한 이론적 근거가 필요로 된다. 6. 간호연구는 부적절한 부아 애착 형성에 있어서 아버지의 특성을 확인하고 부아유대와 애착 증진의 요소를 파악해야한다. 7. 부아 유대에 대한 위협요소 확인을 위한 도구개발과 그들에 대한 효과적인 간호전략이 필요 된다. 8. 가족에 있어서 모든 부모행위가 하나의 독립변수로서 연구되어야 하고 부아유대 증진에 관한 연구가 시도되어야겠다. 오늘날 부모들은 임신기간동안 많은 정보에 접하기를 원한다. 산전, 산후의 교육과 지식은 긍정적인 부아 관계를 증진시키고, 이것은 아동의 발달에 크게 기여할 수 있다. 긍정적으로 이러한 관계는 가족단위를 강하게 통합시키게 되므로 건강관리자(Health care workers)들은 애착에 대해 높은 관심을 갖어야 하겠다.

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Effects of a Case-Based Sepsis Education Program for General Ward Nurses on Knowledge, Accuracy of Sepsis Assessment, and Self-efficacy

  • Kim, Bohyun;Jeong, Younhee
    • Journal of Korean Biological Nursing Science
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    • v.22 no.4
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    • pp.260-270
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    • 2020
  • Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

Knowledge and Opinions Regarding Oral Cancer among Yemeni Dental Students

  • Al-Maweri, Sadeq Ali;Abbas, Alkasem;Tarakji, Bassel;Al-Jamaei, Aisha Saleh;Alaizari, Nader Ahmed;Al-Shamiri, Hashem M
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1765-1770
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    • 2015
  • Background: Oral cancer presents with high mortality rates, and the likelihood of survival is remarkably superior when detected early. Health care providers, particularly dentists, play a critical role in early detection of oral cancers and should be knowledgeable and skillful in oral cancer diagnosis. Purpose: The aim of the present study was to assess the current knowledge of future Yemeni dentists and their opinions on oral cancer. Materials and Methods: A pretested self-administered questionnaire was distributed to fourth and fifth year dental students. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Results: The response rate was 80%. The vast majority of students identified smoking and smokeless tobacco as the major risk factors for oral cancer. Most of the students (92.6%) knew that squamous cell carcinoma is the most common form of oral cancer, and 85.3% were aware that tongue and floor of the mouth are the most likely sites. While the majority showed willingness to advise their patients on risk factors, only 40% felt adequately trained to provide such advice. More than 85% of students admitted that they need further information regarding oral cancer. As expected, students of the final year appeared slightly more knowledgeable regarding risk factors and clinical features of the disease. Conclusions: The findings of the present study suggest that here is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education, particularly in its prevention and early detection.

A Childhood Attachment and Adolescent's Self Esteem as Predictors of Health Efficacy in Adolescents (애착과 자아존중감이 청소년의 건강효능감에 미치는 영향)

  • Tak Young-Ran;Lee Eun-Young
    • Child Health Nursing Research
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    • v.10 no.1
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    • pp.89-97
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    • 2004
  • Purpose: Adolescence is viewed as a critical period in the formation of health behavior and many health behaviors developed during this era persist into adulthood. Social-cognitive theory, self-efficacy as a central construct, has been used to predict and intervene the health behavioral patterns in adolescent. Previous research demonstrated that the attachment in childhood and self-esteem as psychosocial factors are predictors of the health efficacy in adolescent and it is viewed as solely an antecedent for the lifelong health behavior. Method: To investigate the path pattern of attachment in childhood, self-esteem and health efficacy in adolescents, 381 adolescents in high school from two urban cities in Korea were recruited for cross-sectional sample. Attachment in childhood was measured using Mother-Father-Peer Scale. Self esteem was measured with Hare self esteem. Perceived self efficacy in Health was measured by the School Health Efficacy Questionnaire. The path analysis revealed a significant relationship between attachment in childhood and self-esteem, self-esteem and health efficacy in adolescents. Self esteem was the strongest contributing factor for health efficacy in adolescent. The results suggest that attachment in childhood may aid in formulating positive self -esteem in adolescents and self-esteem played a major role in predicting health efficacy in adolescents. Conclusion: Therefore, self-esteem enrichment should be incorporated with adolescent health promotion and certainly should be a component in any health education program in school health program and interventions. These results have implications of psychosocial and family related factors on health promotion and health education for the health care provider with regard to primary and secondary prevention in adolescent population.

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