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Volume 40(2); April 2010
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Original Articles
Effects of Teaching Method using Standardized Patients on Nursing Competence in Subcutaneous Injection, Self-Directed Learning Readiness, and Problem Solving Ability
Mi-Ran Eom, Hyun-Sook Kim, Eun-Kyung Kim, Kayeon Seong
J Korean Acad Nurs 2010;40(2):151-160.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.151
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effects of teaching method using Standardized Patients (SPs) on nursing competence, self-directed learning readiness, and problem solving ability-focusing on subcutaneous insulin injection.

Methods

This research was a nonequivalent control group non-synchronized post-test design. The subjects consisted of 62 junior nursing students at E University. Scenarios to train SPs and checklists to evaluate the students' competence were developed by our research team. The experimental group (n=31) participated in the teaching class using SPs. The control group (n=31) received traditional practice education. The collected data were analyzed with descriptive analysis, χ2/Fisher's exact test, t-test, Pearson's correlation coefficient, and Cronbach's α using SPSS WIN 14.0 Program.

Results

The mean scores of competence, self-directed learning readiness, and problem solving were significantly higher in the experimental group than the control group.

Conclusion

As confirmed by this research findings, the teaching method using SPs was more effective than the traditional method to improve junior nursing students' competence, self-directed learning readiness, and problem solving. Therefore, It is necessary to develop a various of scenarios and to testify their effectiveness.

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Geriatric Foot Problems and Related Factors in Two Provinces of Korea
Shinmi Kim, Jaehong Ahn, Sookhee Choi, Yunjung Lee
J Korean Acad Nurs 2010;40(2):161-171.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.161
AbstractAbstract PDF
Purpose

The purpose of the study was to identify the prevalence, risk factors and clinical meanings of geriatric foot problems and to suggest implications for the future.

Methods

One hundred eighty nine elderly aged 60 and over from institution as well as community were investigated for their foot conditions by means of a questionnaire including general characteristics, self care capacity, risk factors, foot problem checklist, X-ray, podoscopy and foot scan. Descriptive statistics and χ2-test was performed as appropriate utilizing SPSS version 14. Less than .05 of p-value was adopted as statistical significance level.

Results

All subjects had at least one kind of foot problem and the most prevalent ones were nail problems, foot deformities in order. Prevalence of foot pain and edema was relatively low.

Conclusion

Foot problem in elderly is prevalent and geriatric foot is expected to emerge as one of the most important problems in the geriatric field. Therefore strategies to deal with geriatric foot should be developed and practiced for better quality of life in later life.

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The Effectiveness of Error Reporting Promoting Strategy on Nurse's Attitude, Patient Safety Culture, Intention to Report and Reporting Rate
Myoungsoo Kim
J Korean Acad Nurs 2010;40(2):172-181.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.172
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the impact of strategies to promote reporting of errors on nurses' attitude to reporting errors, organizational culture related to patient safety, intention to report and reporting rate in hospital nurses.

Methods

A nonequivalent control group non-synchronized design was used for this study. The program was developed and then administered to the experimental group for 12 weeks. Data were analyzed using descriptive analysis, χ2-test, t-test, and ANCOVA with the SPSS 12.0 program.

Results

After the intervention, the experimental group showed significantly higher scores for nurses' attitude to reporting errors (experimental: 20.73 vs control: 20.52, F=5.483, p=.021) and reporting rate (experimental: 3.40 vs control: 1.33, F=1998.083, p<.001). There was no significant difference in some categories for organizational culture and intention to report.

Conclusion

The study findings indicate that strategies that promote reporting of errors play an important role in producing positive attitudes to reporting errors and improving behavior of reporting. Further advanced strategies for reporting errors that can lead to improved patient safety should be developed and applied in a broad range of hospitals.

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Factors Influencing Learning Achievement of Nursing Students in E-learning
Jin-Hee Park, Eunha Lee, Sun Hyoung Bae
J Korean Acad Nurs 2010;40(2):182-190.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.182
AbstractAbstract PDF
Purpose

This study was done to identify self-directed learning readiness, achievement goal orientations, learning satisfaction and learning achievement, and to evaluate the factors affecting learning achievement for nursing students using a web-based Health Assessment e-Book.

Methods

The research design was a cross-sectional study with a structured questionnaire and data were collected before using the web-based Health Assessment e-Book and 1 week after finishing. The participants were 80 nursing students who were taking the Health Assessment class from March to June 2009.

Results

Mean score for subjective learning achievement was 31.26 and for objective learning achievement, 69.25. Subjective and objective learning achievement were positively correlated with self-directed learning readiness, mastery goal, attitude toward distance education, and learning satisfaction. In subjective learning achievement, learning satisfaction and mastery goal were significant predictive factors and explained 64% of the variance. Objective learning achievement was significantly predicted by learning satisfaction and self-directed learning readiness, which explained 24% of the variance.

Conclusion

Learning satisfaction, mastery goal and self-directed learning readiness were found to be very important factors associated with learning achievement for nursing students using a web-based Health Assessment e-Book. To provide high quality and effective web-based courses and to improve nursing students' learning achievement and learning satisfaction, educators should consider the learner's characteristics from the initial stages of lecture planning.

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Predictors of Physical Activity in Korean Older Adults: Distinction between Urban and Rural Areas
Seungmi Park, Yeon-Hwan Park
J Korean Acad Nurs 2010;40(2):191-201.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.191
AbstractAbstract PDF
Purpose

The aim of this study was to compare the predictors of physical activity between urban and rural dwelling Korean older adults.

Methods

This study was a cross-sectional descriptive survey. A self-report questionnaire or face to face interviews were used to collect data from 336 older adults (urban: 129, rural: 207) who visited public health centers or welfare centers in 2008.

Results

About half of the participants (urban: 50.4%, rural: 47.3%) were classified as the minimally active group. Cognitive function (odds ratio [OR]=1.106, p=.004) and loneliness (OR=0.965, p=.044) were predicting factors for physical activity in rural elderly. Age (OR=0.326, p=.037), gender (OR=2.841, p=.021) and depression (OR=0.799, p<.001) were significant factors predicting physical activity in urban elders.

Conclusion

These findings provide information that is relevant in designing interventions to enhance physical activity in older adults. There is a need to develop effective mutifaceted physical activity interventions that include reducing psychological barriers such as depression, loneliness.

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Evaluation of an Education Program for Patients with Asthma who use Inhalers
Jong Kyung Lee, Young Hee Yang
J Korean Acad Nurs 2010;40(2):202-212.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.202
AbstractAbstract PDF
Purpose

This study was done to evaluate the effectiveness of an education program for patients with asthma who use inhalers.

Methods

The research design for this study was a non-equivalent control group quasi-experimental study. Participants in this study were 36 patients for the control group, and 43 patients for the experimental group. The experimental group participated in the education program. The control group received the usual care. Data were collected before and 1 month and 2 months after the program finished and were analyzed using the SPSS 12.0 program.

Results

The experimental group had significantly higher scores of knowledge of inhalers, and inhalation technique compared to the control group. However, no significant differences were found between two groups for PEFR, asthma instability, and satisfaction with inhalers.

Conclusion

According to the results, the education program was effective in improving knowledge of inhalers, and inhalation technique. Therefore, it is recommended that this education program be used in clinical practice as an effective nursing intervention for patients with asthma on inhalers.

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Development and Effect of a Web-based Child Health Care Program for the Staff at Child Daycare Centers
Ji Soo Kim
J Korean Acad Nurs 2010;40(2):213-224.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.213
AbstractAbstract PDF
Purpose

The purpose of the study is to develop a web-based program on child health care, and to identify the effect of the program on knowledge of, attitudes towards child health care, and health care practice in staff of daycare centers.

Methods

The program was developed through the processes of needs analysis, contents construction, design, development, and evaluation. After the program was developed, it was revised through feedback from 30 experts. To identify the effect of developed program, onegroup pretest-posttest design study was conducted with 64 staff members from 12 daycare centers in Korea.

Results

The program was developed based on users' needs and consisted of five parts: health promotion, disease and symptoms management, oral health, injury and safety, sheets and forms. This study showed that the total score of staff who used the program was significantly higher in terms of knowledge, attitudes, and their health care practice compared with pretest score (p<.05).

Conclusion

These results suggest that this Web-based program can contribute to the child health promotion as well as can provide the staff with the insightful child health information. Therefore, it is expected that this program will be applied to staff of other child care settings for children's health.

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Factors Affecting Mother's Adaptation to Breastfeeding
Sun Hee Kim
J Korean Acad Nurs 2010;40(2):225-235.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.225
AbstractAbstract PDF
Purpose

The aim of this study was to identify factors which influence breastfeeding adaptation from among the following: parity and feeding behavior, social support, psychological, and demographic factors.

Methods

The respondents were 179 breastfeeding mothers. Data were collected from June 2 to 19, 2009 at two community health centers and one pediatric outpatient department. Data were analyzed using the SPSS program and included descriptive statistics, t-test, ANOVA, correlation, and multiple regression.

Results

The major findings of this study were: 1) Significant differences in the level of breastfeeding adaptation were related to number of children, current problems related to breastfeeding, and lay supporters. 2) Level of breastfeeding adaptation was significantly related to marriage satisfaction, proportion of breastfeeding, length of previous breastfeeding, planned length of breastfeeding, parenting stress, and encouragement to breastfeed given by medical personnel. 3) Regression analysis showed that parenting stress, marriage satisfaction, current problems related to breastfeeding, and proportion of breastfeeding explained 44.3% of variance for breastfeeding adaptation. Length of previous breastfeeding also explained 9.7% of breastfeeding adaptation among mothers who had breastfed an elder child.

Conclusion

Mothers with lower marriage satisfaction, breastfeeding problems, and higher parenting stress require more help from their family and nurses for breastfeeding adaptation. Future research should include variables, such as mother's and baby's behavior related to breastfeeding, knowledge about breastfeeding, and attitude toward breastfeeding.

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Development of a Questionnaire to Measure Resilience in Children with Chronic Diseases
Dong Hee Kim, Il Young Yoo
J Korean Acad Nurs 2010;40(2):236-246.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.236
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a Korean questionnaire to measure resilience in children with chronic illness.

Methods

Item construction was drawn from an extensive review of the literature, existing questionnaires and interviews with parents. Content validity was tested by experts. To further refine the questionnaire and test its reliability and validity, data were collected from the 202 children with asthma, diabetes mellitus or nephrotic syndrome. Corrected items were used to total correlation coefficient and test-retest reliability. Questionnaire testing was conducted using factor analysis, Cronbach's α, and correlation coefficients. Validity of the questionnaire was tested using internal consistency, construct validity, and criterion-related validity.

Results

Components of the questionnaire were in three domains; interpersonal characteristics, characteristics of coping, and intrapersonal characteristics. Factor analysis is showed five factors; positive self-understanding, self-reliance, resourcefulness, perception of positive family relationships, and intimacy. The questionnaire showed a high internal consistency. A significant positive correlation with the Numerical Rating Score and negative correlation with the Child Depression Inventory support the validity of the questionnaire.

Conclusion

This instrument demonstrated high reliability and validity. Therefore, this instrument can contribute to the evaluation of resilience of chronically ill children and to any subsequent intervention as well as to develop a theory for resilience.

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Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults
Gaeul Joo, Kyeong-Yae Sohng
J Korean Acad Nurs 2010;40(2):247-254.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.247
AbstractAbstract PDF
Purpose

To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements.

Methods

The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT.

Results

The average thickness of gluteal SCF was 15.92±4.08 mm in males and 24.90±5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients.

Conclusion

The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

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Effects of an Empowerment Education Program in the Prevention of Internet Games Addiction in Middle School Students
Aeran Joo, Inhyae Park
J Korean Acad Nurs 2010;40(2):255-263.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.255
AbstractAbstract PDF
Purpose

The purpose of this study was to determine effects of an empowerment education program (EEP) on internet games addiction, empowerment, and stress in middle school students.

Methods

The EEP used in this study was based on the Freire's Empowerment Education Model. The research design of this study was a non-equivalent control group pretest-posttest design for 48 middle school students, who were conveniently assigned to an experimental group or a control group. The data were collected from May 29 to June 19, 2005. Data were analyzed using SPSS/PC program with frequencies, χ2-test, Fisher exact test, t-test, mean, standard deviation and ANCOVA.

Results

1) The first hypothesis that, "the experimental group would have higher empowerment scores than the control group." was supported. 2) The second hypothesis that, "the experimental group would have lower internet games addiction scores than the control group." was supported. 3) The third hypothesis that, "the experimental group would have lower stress scores than the control group." was supported.

Conclusion

We suggest, therefore, that the EEP should be used with adolescent to help them control their stress, internet games addiction and to increase their empowerment.

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A Predictive Model of Health Promotion Behavior in Obese School-Age Children
Mi Suk Jeon, Hyeon-Ok Kim
J Korean Acad Nurs 2010;40(2):264-276.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.264
AbstractAbstract PDF
Purpose

The purpose of this study was to propose and to test a predictive model that could explain and predict the health promotion behavior of obese school-age children in Korea.

Methods

Participants for this study were 365 students from 13 elementary schools located in Jeonbuk Province, Korea. The data were analyzed using SPSS 15.0 program and Amos 7.0 program.

Results

The results verified the factors that influence health promotion behavior of the participants. Important direct factors were prior health-related behavior, perceived self-efficacy, and commitment to a plan of action and indirect factors were perceived barrier and activity-related effect. These factors explained 75.3% of variance in the participants' health promotion behavior. The proposed model was concise and extensive in predicting health promotion behavior of the participants.

Conclusion

Findings may provide useful assistance in developing effective nursing interventions for maintaining and promoting health promotion behavior in obese school-age children.

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Effects of Breast-feeding Education and Support Services on Breast-feeding Rates and Infant's Growth
Gun-Ja Jang, Sun-Hee Kim
J Korean Acad Nurs 2010;40(2):277-286.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.277
AbstractAbstract PDF
Purpose

This study was done to investigate the effects of breast-feeding education and support services on rate of breast-feeding three and six months after birth, and the effect on infant's growth (weight, height, body mass index [BMI]). The experimental group which had both education and support services was compared with the control group which had only breast-feeding education.

Methods

This study was a quasi-experimental study with a time-series design. The participants were 39 mothers who were hospitalized for childbirth. Twenty mother were assigned to the experimental group and 19 mothers, to the control group. The breast feeding education was done during hospitalization, and support services were provided once a week after discharge for a month (a total 4 times) by a maternity ward nurse. Data regarding breastfeeding rate at one month after childbirth was collected by phone call; the breast-feeding rates at three and six months after childbirth were collected in a visit to the families. The child's weight and height were also measured during the visit.

Results

The experimental group had a statistically significant higher rate for frequency of breast-feeding at one, three and six months after childbirth than the control group. However, there was no meaningful difference between the two groups for infant growth.

Conclusion

The results of this study suggest that breast-feeding education is helpful for a start, but support services are also necessary to sustain breast-feeding.

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Factors Influencing Health-related Quality of Life in Patients with Benign Prostatic Hyperplasia
Jeong Sun Kim, Vit Na Moon
J Korean Acad Nurs 2010;40(2):287-297.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.287
AbstractAbstract PDF
Purpose

This study was done to examine the relationship of low urinary tract symptoms (LUTS), depression, sexual function, and health-related quality of life (HRQoL), and to identify factors influencing HRQoL in patients with benign prostatic hyperplasia (BPH) living in the community.

Methods

A total of 218 patients with BPH were recruited into the study. The data were collected by personal interviews using questionnaires and were analyzed with SPSS (version 17.0) computer program, and included descriptive statistics, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis.

Results

The relationship between HRQoL and LUTS with depression had a significant negative correlation, whereas the relationship between HRQoL and sexual function had a significant positive correlation. Depression, age, LUTS, number of chronic disease, and excercise were found to be significant predictors (35.6%) of the Physical Component Summary of HRQoL. Depression, stress, smoking, LUTS, and sexual function were found to be significant predictors (48.2%) of the Mental Component Summary of HRQoL.

Conclusion

To improve HRQoL of patients with BPH, nurses should focus on the factors identified in this study when doing nursing assessments, and should develop nursing intervention programs for BPH prevention and symptoms management in primary care settings.

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Risk Factors for Surgical Site Infections in Patients Undergoing Craniotomy
Kyeong-Sook Cha, Ok-Hee Cho, So-Yeon Yoo
J Korean Acad Nurs 2010;40(2):298-305.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.298
AbstractAbstract PDF
Purpose

The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy.

Methods

This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, χ2-test and logistic regression analyses were used for data analysis.

Results

The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (≤7 days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (≤7 scores) (OR=4.71, 95% CI=1.64-13.50).

Conclusion

The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

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