Journal of Korean Academy of Nursing

In Gak Kwon

6 Articles

Identification and Validation of Symptom Clusters in Patients with Hepatocellular Carcinoma: Myung Sook Cho, In Gak Kwon, Hee Sun Kim, Kyunghee Kim, Eunjung Ryu; J Korean Acad Nurs 2009;39(5):683-692. Published online October 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.5.683

Purpose

The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma.

Methods

This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters.

Results

Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression.

Conclusion

Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

Citations

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Symptoms and symptom clusters in patients with hepatocellular carcinoma and commonly used instruments: An integrated review
Thitiporn Pathomjaruwat, Yaowarat Matchim, Jane M. Armer
International Journal of Nursing Sciences.2024; 11(1): 66. CrossRef
Symptom clusters and network analysis of patients with intermediate and advanced liver cancer treated with targeted immunotherapy
Mei Chen, Shan Li, Guangzhi Jin, Rui Li, Zhi Qi, Yalun He
Supportive Care in Cancer.2024;[Epub] CrossRef
Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis
Mohammad Zamani, Shaghayegh Alizadeh-Tabari
BMJ Supportive & Palliative Care.2023; 13(e2): e235. CrossRef
Symptom Clusters in Patients with Non-Hodgkin’s Lymphoma Receiving Chemotherapy
YuJeong Kim, In Gak Kwon
Asian Oncology Nursing.2022; 22(2): 93. CrossRef
Symptom clusters of ovarian cancer patients undergoing chemotherapy, and their emotional status and quality of life
Kyung-Hye Hwang, Ok-Hee Cho, Yang-Sook Yoo
European Journal of Oncology Nursing.2016; 21: 215. CrossRef
Effects of Acupressure on Fatigue and Depression in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization: A Quasi-Experimental Study
Su-Chen Lan, Yueh-E Lin, Shu-Ching Chen, Yu-Fang Lin, Yu-Jen Wang
Evidence-Based Complementary and Alternative Medicine.2015; 2015: 1. CrossRef
Quality of Life in Colorectal Cancer Patients according to the Severity of Symptom Clusters Classification
Gyeonghui Jeong, Kyunghee Kim, Yeunhee Kwak
Asian Oncology Nursing.2014; 14(2): 74. CrossRef
Development and Evaluation of Learning Program for Oncology Unit-based Core Nursing Practice - Outcomes based Cancer Patients Pain Management Learning Program -
Yeon Hee Kim, Young Sun Jung, Soon Haeng Lee, Kyoung Ok Kim, Young Nam Jeong, Hye Ryun Jung, Kyunghee Kim
Asian Oncology Nursing.2013; 13(4): 231. CrossRef
Symptom Clusters and Quality of Life in Korean Patients With Hepatocellular Carcinoma
Eunjung Ryu, Kyunghee Kim, Myung Sook Cho, In Gak Kwon, Hee Sun Kim, Mei R. Fu
Cancer Nursing.2010; 33(1): 3. CrossRef

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Hospital Nurses' Experience of Do-Not-Resuscitate in Korea: Myungsun Yi, Sang Eun Oh, Eun Ok Choi, In Gak Kwon, Sungbok Kwon, Kyung-mi Cho, Youngah Kang, Jeonghui Ok; Journal of Korean Academy of Nursing 2008;38(2):298-309. Published online April 30, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.2.298

Abstract PDF

Purpose

The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses.

Methods

Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data.

Results

Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR.

Conclusion

Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

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Comparison of attitudes towards death and perceptions of do‐not‐resuscitate orders between older Korean adults residing in a facility and at home
Soon Young Park, Ok Sun Kim, Nam Hyun Cha, Sohyune R Sok
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Application of Animation Mobile Electronic Informed Consent in Inpatient of Long-term Care Hospital: Focused on DNR Informed Consent
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Ethical Attitudes, Perceptions of DNR and Advance Directives of General Population
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Nurses' Experiences of Do-Not-Resuscitate (DNR) by the Narrative Inquiry
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Family factors affecting on withdrawal of life‐sustaining treatment in Korea
Kae‐Hwa Jo, Gyeong‐Ju An, Kyung Su Han
International Journal of Nursing Practice.2012; 18(6): 552. CrossRef
Development of Implementation Strategies for u-Health Services Based on the Healthcare Professionals' Experiences
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Factors Influencing Nurses' Clinical Decision Making: Focusing on Critical Thinking Disposition: Seungmi Park, In Gak Kwon; Journal of Korean Academy of Nursing 2007;37(6):863-871. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.6.863

Abstract PDF

PURPOSE: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. METHODS: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. RESULTS: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted R2=33%). CONCLUSION: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.

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The Roles of Critical Care Advanced Practice Nurse: Young Hee Sung, Young Hee Yi, In Gak Kwon, Yong Ae Cho; Journal of Korean Academy of Nursing 2006;36(8):1340-1351. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.8.1340

Abstract PDF

Purpose

To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs.

Method

This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6).

Results

Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different.

Conclusion

Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

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The roles and responsibilities of advanced practice nurses in intensive care units: A scoping review
F. Jafari Pour, R. Watson, E. Jafaripour, R. Jafarian
Enfermería Intensiva (English ed.).2024; 35(4): e31. CrossRef
The roles and responsibilities of advanced practice nurses in intensive care units: A scoping review
F. Jafari Pour, R. Watson, E. Jafaripour, R. Jafarian
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Development of an e-Learning Program about Medication for New Nurses: Young Hee Sung, In Gak Kwon, Ji Won Hwang, Ji Young Kim; Journal of Korean Academy of Nursing 2005;35(6):1113-1124. Published online October 31, 2005; DOI: https://doi.org/10.4040/jkan.2005.35.6.1113

Abstract PDF

Purpose

The purpose of this study was to develop an e-Learning program about medication for nurses to enhance nurses' medication performance ability and to analyze learners' responses after studying with this program.

Method

For the development of the e-Learning program, the NBISD(Network Based Instructional Systems Design) model, suggested by Jung(1999) was applied as a basic model and the instruction design theory of Gagne & Briggs(1979) and ARCS theory of Keller(1983) were applied. After the operation of this program for one month to 34 new nurses, learners' responses were analyzed.

Result

Learners' knowledge of medication was greatly improved after this program. In addition learners' satisfaction with the overall education program, help in field applicability, ease of screen shift and exploration, and tutor activities were high and the contents were regarded suitable for e-Learning. Many things were advantageous such as easy accessibility, easy understandability with pictures and flash animation, practical cases and feedback from a tutor. Provision of a supplementary handout and improvement of a tight time schedule were pointed out as things to be improved.

Conclusion

This e-Learning program can be used effectively for medication education for registered nurses, student nurses, and new nurses.

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Web course on medication administration strengthens nursing students' competence prior to graduation
Sari Mettiäinen, Katja Luojus, Satu Salminen, Meeri Koivula
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Effects of Hand Reflexology on Physiological Emotional Responses and Immunity in the Patients with Chronic illness; Chronic renal failure patients and Cancer patients: Chung Hee Lee, Sei Young Oh, Ok Soon Park, In Gak Kwon, Mi A Jeong, Eun A Lee; Journal of Korean Academy of Nursing 2002;32(5):716-726. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.716

Abstract PDF

PURPOSE: The purpose of this study was to explore the effects of hand reflexology on the physiological?emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. METHOD: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. RESULT: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR and BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell and CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. CONCLUSION: We have found that the hand reflexology helps the chronic patients to improve physiological emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.

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