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Volume 41(1); February 2011
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Original Articles
Concept Analysis of Patient Safety
Mi Ran Kim
J Korean Acad Nurs 2011;41(1):1-8.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.1
AbstractAbstract PDF
Purpose

This study was conducted to investigate the clear concept of patient safety and obtain theoretical evidences.

Methods

Research was conducted using Walker & Avant's conceptual analysis process.

Results

Patient safety was defined as an activity that minimizes and removes possible errors and injuries to patients. It includes a basic desire to secure the patient's right to safety, and the legal regulations and duties of medical teams. The results of the establishment of a safety culture are patient-centered medical treatment and caring. Antecedents were found to be open and clear communications, continuous education and training for health care personnel, sufficient allocation of qualified personnel, cooperation among departments, improvements in the recognition of patient safety. Consequences were found to be the provision of high quality medical care and treatment, and increase in patient satisfaction.

Conclusion

Patient safety as defined by the results of this study will contribute to the foundation of institutionalization of the pursuit of patient safety and creation of a hospital culture focusing on patient safety as a first priority.

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Development and Evaluation of 「Hospice Smart Patient」 Service Program
Chai-Soon Park, Yang-Sook Yoo, Dong-Won Choi, Hyun-Jeong Park, Ji-In Kim
J Korean Acad Nurs 2011;41(1):9-17.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.9
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness.

Methods

It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone 「Hospice Smart Patient」 Service at least once a week for 5 months.

Results

There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life.

Conclusion

We have concluded that the 「Hospice Smart Patient」 Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

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Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis
Jia Lee, Eun Sun Ji
J Korean Acad Nurs 2011;41(1):18-25.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.18
AbstractAbstract PDF
Purpose

This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis.

Methods

A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks.

Results

Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035).

Conclusion

The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

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A Comparison between Effects of Aroma Massage and Meridian Massage on Constipation and Stress in Women College Students
Miyoung Chung, Euysoon Choi
J Korean Acad Nurs 2011;41(1):26-35.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.26
AbstractAbstract PDF
Purpose

This study was done to compare the effects of abdominal aroma massage and meridian massage on constipation and stress in college women with functional constipation.

Methods

The participants were 38 college women, 18 were in the aroma group and 20 in the meridian group. The aroma massage was given using aroma oil which was a mixture of lemon, lavender, rosemary, and cyprus. The meridian massage was given at 9 accupoints which influence intestinal functions. The treatment was given 5 days a week for 4 weeks. A constipation severity score, weekly defecation frequency, and a stress response score were measured before and every week of 4 weeks of the experiment.

Results

While there was no significant difference between two groups, there was a significant difference within the groups in the constipation severity (aroma group: 1st week, meridian group: except 4th week), defecation frequency (aroma group: 3rd week, meridian group: 2nd and 3rd week), and stress (aroma group: all weeks, meridian group: except 4th week) after different duration of experiment.

Conclusion

Based on these results, both abdominal massages relieved constipation and stress. Resorting to either types of massage will contribute to the reduction of use of stool softeners, suppositories, or enemas.

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Development and Effects of an e-Learning Program in Operating Room Nursing for Nursing Students
Eun Hee Park, Seon Young Hwang
J Korean Acad Nurs 2011;41(1):36-46.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.36
AbstractAbstract PDF
Purpose

This study was conducted to develop an e-Learning program that assists nursing students' clinical practice in operating room nursing and to examine the learning effects.

Methods

Based on content and need analysis, 9 learning modules were developed for nursing care in operating rooms and with operating equipment. To verify the effects of the program, a quasi-experimental pretest-posttest control group design was employed. The participants in this study were 74 third-year nursing students (34 in the experimental and 40 in the control group) from a junior college in G-city, Korea, who were engaged in a one week clinical practicum in an operating unit. Frequencies, χ2-test and t-test with the SPSS program 17.0 were used to analyze the data.

Results

Knowledge was significantly higher in the experimental group compared to the control group (p=.018). However, there was no significant difference between the two groups in self-directed learning. The experimental group had significantly higher motivation toward learning, which was examined posttest only (p=.027).

Conclusion

These results indicate that the implementation of an e-Learning program needs to be continued as an effective educational tool, but more research on the best way to implement e-Learning in students' practicum is needed.

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Development and Evaluation of a Web-based Education Program to Prevent Secondary Stroke
Chul-Gyu Kim, Hyeoun-Ae Park
J Korean Acad Nurs 2011;41(1):47-60.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.47
AbstractAbstract PDF
Purpose

This study was conducted to develop and evaluate a web-based education program for secondary stroke prevention.

Methods

A web-based secondary stroke prevention education program was developed using the system's life cycle methods and evaluated by comparing the effects of education among three groups, a web group, a booklet group and a control group.

Results

Knowledge level of both patients and family, as well as some health behavior compliance in the web-based and booklet education groups were significantly higher than those of the control group. Family support in the web-based and booklet education groups was significantly higher than that of the control group after 12 weeks. The urine cotinine level in the web-based education group was significantly lower than that of the control group after 12 weeks. Medication adherence, blood pressure and perceived health status were not statistically different among the three groups at any time.

Conclusion

Web-based and booklet education programs were equally effective regarding the level of knowledge of patients and their families, family support, health behavior compliance, and urine cotinine level. These results demonstrate the potential use of a web-based education program for secondary stroke prevention.

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A Phenomenological Study of Suicide Attempts in Elders
Mi Young Im, Yun Jeong Kim
J Korean Acad Nurs 2011;41(1):61-71.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.61
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the meaning and essence of suicide for elderly people who had previously attempted suicide as an older person.

Methods

Giorgi's descriptive phenomenology was used for analysis. The researchers carried out in-depth interviews, recordings and memos individually with four elders. The elders were individuals who had attempted suicide sometime in the past 5 yr. They were interviewed from 5 to 10 times using open-ended questions and a semi-structural format. Demographic data were also collected.

Results

The meaning of suicide before a suicide attempt in older people had four core components: conflict with family, powerlessness and despair in their life with a drop in self-esteem, using internal and external resources to resolve their troubles and awareness of imminent crisis.

Conclusion

These results of this study will increase understanding of suicide in older people by defining their subjective experience of suicide attempts and applying grounded data in the development of programs that provide concrete intervention strategies to prevent suicide in elderly people.

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Factors Influencing Yangsaeng in Elders (Yangsaeng; Traditional Oriental Health Promotion)
Yeong Sook Park, Duk Sun Seo, Yunhee Kwon
J Korean Acad Nurs 2011;41(1):72-79.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.72
AbstractAbstract PDF
Purpose

The study was done to identify factors influencing Yangsaeng in elders.

Methods

Data were collected by questionnaires from 907 elders in D metropolitan city. Measures were Yangsaeng, perceived health status, self-efficacy, and self esteem. Data were analyzed using frequencies, means and standard deviation, t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS/WIN 13.0 version.

Results

The mean score for Yangsaeng the participants was 3.56, out of a possible 5. There were significant differences in Yangsaeng according to age, education level, monthly income, marital status, family structure, and periodic health examination. Yangsaeng correlated positively with perceived health status, self-efficacy and self-esteem. According to the research, factors influencing Yangseng in elders were self-esteem, perceived health status, self-efficacy, family structure, and marital status.

Conclusion

The positive correlation between Yangsaeng and health promotion behavior and perceived health status, self-efficacy, and self-esteem identified in this study can have an impact on strategies to improve the health of Korean elders. Therefore, the results can be used as a reference for future studies.

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Effects of Community Health Promotion Project for Garlic Cultivating Farmers Based on Self-efficacy Theory and Community Capacity Building Framework
Hyang-Sook Kim, Mee Ock Gu
J Korean Acad Nurs 2011;41(1):80-91.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.80
AbstractAbstract PDF
Purpose

This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework.

Methods

A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0.

Results

For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group.

Conclusion

The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.

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Verification of Validity of MPM II for Neurological Patients in Intensive Care Units
Heejeong Kim, Kyunghee Kim
J Korean Acad Nurs 2011;41(1):92-100.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.92
AbstractAbstract PDF
Purpose

Mortality Provability Model (MPM) II is a model for predicting mortality probability of patients admitted to ICU. This study was done to test the validity of MPM II for critically ill neurological patients and to determine applicability of MPM II in predicting mortality of neurological ICU patients.

Methods

Data were collected from medical records of 187 neurological patients over 18 yr of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009. Collected data were analyzed through χ2 test, t-test, Mann-Whiteny test, goodness of fit test, and ROC curve.

Results

As to mortality according to patients' general and clinically related characteristics, mortality was statistically significantly different for ICU stay, hospital stay, APACHE III score, APACHE predicted death rate, GCS, endotracheal intubation, and central venous catheter. Results of Hosmer-Lemeshow goodness-of-fit test were MPM II02=0.02, p=.989), MPM II242=0.99 p=.805), MPM II482=0.91, p=.822), and MPM II722=1.57, p=.457), and results of the discrimination test using the ROC curve were MPM II0, .726 (p<.001), MPM II24, .764 (p<.001), MPM II48, .762 (p<.001), and MPM II72, .809 (p<.001).

Conclusion

MPM II was found to be a valid mortality prediction model for neurological ICU patients.

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A Comparison on General Education Curriculum of 4-year and 3-year Nursing Schools in Korea
Sook-Young Kim, Sun-Ei Joung, Chung-Il Hwang
J Korean Acad Nurs 2011;41(1):101-109.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.101
AbstractAbstract PDF
Purpose

This study was done to comparatively analyze the general education curriculum of 4-yr and 3-yr nursing schools in Korea.

Methods

Ten university 4-yr nursing schools were selected based on universities in Korean Accreditation Board of Nursing 2010 or "2009 Korea's Best Universities-Top 10" published by Joong-Ang Daily. Ten college 3-yr nursing schools were selected based on colleges in Korean Accreditation Board of Nursing 2010.

Results

1) Generally 4-yr nursing schools maintained the relationships between organizational philosophy/purposes and subjects in the general education curriculum. But 3-yr nursing schools did not. 2) In 4-yr nursing schools there was a relatively higher credits ratio of general education curriculum and selective courses than in 3-yr nursing schools. 3) In 4-yr nursing schools variety of courses was relatively higher than 3-yr nursing schools. 4) In 4-yr nursing schools, operating conditions were relatively better (number of tenure professors, ratio of professors to students, Identification of exclusive organization in charge of the general education curriculum) for the general education curriculum than 3-yr nursing schools.

Conclusion

The results identify significant differences in the general education curriculum of 4-yr and 3-yr nursing schools in Korea, indicating that 3-yr nursing schools should make efforts to improve the good quality of general education curriculum.

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Effects of Self-Foot Reflexology on Stress, Fatigue, Skin Temperature and Immune Response in Female Undergraduate Students
Young-Mee Lee
J Korean Acad Nurs 2011;41(1):110-118.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.110
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effects of self-foot reflexology on stress (perceived stress, urine cortisol level, and serum cortisol level), fatigue, skin temperature and immune response in female undergraduate students.

Methods

The research design was a nonequivalent control group pretest-post test design. Participants were 60 university students: 30 in the experiment group and 30 in the control group. The period of this study was from April to June 2010. The program was performed for 1 hr a session, three times a week for 6 weeks. The data were analyzed using the SPSS/WIN 17.0 program.

Results

The results showed that self-foot reflexology was effective in reducing perceived stress and fatigue, and raised skin temperature in female undergraduate students. But cortisol levels and immune response were not statistically significant different.

Conclusion

The results of this study indicate that self-foot reflexology is an effective nursing intervention in reducing perceived stress and fatigue and, in improving skin temperature. Therefore, it is recommended that this be used in clinical practice as an effective nursing intervention for in female undergraduate students.

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Analysis of Multi-variate Recurrent Fall Risk Factors in Elderly People Using Residential Assessment Instrument-Home Care - Comparisons between Single and Recurrent Fallers -
In-Young Yoo
J Korean Acad Nurs 2011;41(1):119-128.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.119
AbstractAbstract PDF
Purpose

This study was done to determine the risk factors for recurrent fallers (2+falls) compared to single fallers.

Methods

Participants were 104 community-dwelling people 65 yr of age or older. The data were collected from June 1, 2008 to June 30, 2009 using the Residential Assessment Instrument-Home Care.

Results

Over the past 90 days, 55.7% of the 104 participants fell once, and 44.2% experienced recurrent falls (2+falls). In comparison of recurrent fallers with single fallers, there were significant differences in scores on the following factors: gender (χ2=4.22, p=.040), age (χ2=5.74, p=.017), educational level (χ2=5.22, p=.022), living arrangements (χ2=35.02, p<.001), cardiovascular diseases (χ2=17.10, p<.001), hypertension (χ2=4.43, p=.035), diabetes mellitus (χ2=4.44, p=.035), glaucoma (χ2=13.95, p<.001), Minimal Data Set (MDS)-Pain (t=-2.56, p=.012), fear of falling (χ2=4.08, p=.034), reduced vision (t=-3.06, p=.003), MDS-activity of daily living (t=3.46, p=.001), MDS-Instrumental Activities of daily living (t=3.24, p=.002), cognition (MDS-Cognition Performance Scale) (t=3.40, p=.001), and 'difficulties entering and leaving the house' (χ2=4.53, p=.033).

Conclusion

It is important to assess the risk factors for recurrent falls and develop differentiated strategies that will help prevent recurrent falls. Additionally, utilizing a standardized tool, such as RAI-HC, would help health professionals assess multi-variate fall risk factors to facilitate comparisons of different community care settings.

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Development of a Measurement of Intellectual Capital for Hospital Nursing Organizations
Eun A Kim, Keum Seong Jang
J Korean Acad Nurs 2011;41(1):129-140.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.129
AbstractAbstract PDF
Purpose

This study was done to develop an instrument for measuring intellectual capital and assess its validity and reliability in identifying the components, human capital, structure capital and customer capital of intellectual capital in hospital nursing organizations.

Methods

The participants were 950 regular clinical nurses who had worked for over 13 months in 7 medical hospitals including 4 national university hospitals and 3 private university hospitals. The data were collected through a questionnaire survey done from July 2 to August 25, 2009. Data from 906 nurses were used for the final analysis. Data were analyzed using descriptive statistics, Cronbach's alpha coefficients, item analysis, factor analysis (principal component analysis, Varimax rotation) with the SPSS PC+ 17.0 for Windows program.

Results

Developing the instrument for measuring intellectual capital in hospital nursing organizations involved a literature review, development of preliminary items, and verification of validity and reliability. The final instrument was in a self-report form on a 5-point Likert scale. There were 29 items on human capital (5 domains), 21 items on customer capital (4 domains), 26 items on structure capital (4 domains).

Conclusion

The results of this study may be useful to assess the levels of intellectual capital of hospital nursing organizations.

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Effects of Heat Therapy Using a Far Infrared Rays Heating Element for Dysmenorrhea in High School Girls
Yeon Ran Hong
J Korean Acad Nurs 2011;41(1):141-148.   Published online February 28, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.1.141
AbstractAbstract PDF
Purpose

The purpose of this study was designed to identify the effects of heat therapy on dysmenorrhea, heat being provided using a far infrared rays heating element.

Methods

The research design for the study was a non-equivalent control group quasi-experimental design. Participants were 22 students for the experimental group, and 26 students for the control group. Data were analyzed using SAS WIN 9.1 program.

Results

The experimental group had significantly lower mean scores for menstrual pain, dysmenorrhea, and blood pressure than those in the control group. However, no significant differences were found between two groups for pulse, respiration, and temperature.

Conclusion

These findings show that thermotherapy was effective for reduction of menstrual pain, dysmenorrhea, and B/P. Therefore, this therapy could be used as a nursing intervention for students with dysmenorrhea.

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