The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC.

Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities.

Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership.

There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

The purpose of this article is twofold: 1) introducing logistic regression (LR), a multivariable method for modeling the relationship between multiple independent variables and a categorical dependent variable, and 2) examining use and reporting of LR in the nursing literature.

Text books on LR and research articles employing LR as main statistical analysis were reviewed. Twenty-three articles published between 2010 and 2011 in the Journal of Korean Academy of Nursing were analyzed for proper use and reporting of LR models.

Logistic regression from basic concepts such as odds, odds ratio, logit transformation and logistic curve, assumption, fitting, reporting and interpreting to cautions were presented. Substantial shortcomings were found in both use of LR and reporting of results. For many studies, sample size was not sufficiently large to call into question the accuracy of the regression model. Additionally, only one study reported validation analysis.

Nursing researchers need to pay greater attention to guidelines concerning the use and reporting of LR models.

This study was done to examine not only the relationships between body mass index (BMI), self-esteem, body image dissatisfaction (BID) and mental health, according to gender, but the mediating role of BID on mental health in relation to BMI and self-esteem among early adolescents.

Data from 576 (296 boys and 280 girls) elementary school students in grades 5 to 6 were collected. A multiple-group path analysis was utilized to examine the relationships between BMI, self-esteem, BID and mental health by gender.

In the path analysis for all students, poor mental health was related directly to BID, while it was indirectly related to BMI and self-esteem. In the multiple-group path analysis of both genders, BID was found to have a significant direct and indirect effect on mental health for girls alone.

The findings suggested that BID should be examined early to prevent poor mental health in early adolescent girls. This study helps to elucidate the role of early adolescent BID on mental health and provides insight for further prevention and intervention programs in school and community mental health settings.

The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging.

Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program.

Perceived health status (β=0.16, p=.009) and self-esteem (β=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status.

These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.

Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation.

Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program.

There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p= .014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p< .001).

Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.

This study was done to develop and test a scale to measure the partnership between pediatric nurses and hospitalized children's parents.

Instrument development process included construct identification based on concept analysis using the hybrid model of Shuwartz-Barcott and Kim (2000), a process which generated 42 initial items. This number was reduced to 35 items through content validity tests by 5 experts and face validity tests by 5 pediatric nurses and 5 parents of hospitalized children. The preliminary Pediatric Nurse Parent Partnership Scale (PNPPS) was administered to 186 pediatric nurses and 163 parents at eleven children's wards in four hospitals. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha.

Thirty-four items were selected for the final scale. Seven factors evolved from the factor analysis, which explained 68.4% of the total variance. The internal consistency, Cronbach's alpha was .96 and reliability of the subscales ranged from .66 to .93.

The PNPPS demonstrated acceptable validity and reliability. It can be used to assess the partnership of pediatric nurses and parents in practice and research.

The purpose of this project was to develop an international web-based expert system using principals of artificial intelligence and user-centered design for management of mental health by Korean emigrants. Using this system, anyone can access the system via computer access to the web.

Our design process utilized principles of user-centered design with 4 phases: needs assessment, analysis, design/development/testing, and application release. A survey was done with 3,235 Korean emigrants. Focus group interviews were also conducted. Survey and analysis results guided the design of the web-based expert system.

With this system, anyone can check their mental health status by themselves using a personal computer. The system analyzes facts based on answers to automated questions, and suggests solutions accordingly. A history tracking mechanism enables monitoring and future analysis. In addition, this system will include intervention programs to promote mental health status.

This system is interactive and accessible to anyone in the world. It is expected that this management system will contribute to Korean emigrants' mental health promotion and allow researchers and professionals to share information on mental health.

This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV).

An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy.

The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery.

Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.

This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression.

Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression.

Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (κ=.55-.95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum.

The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.

This study was done to develop a measurement tool for evaluation of continuing nursing education programs and to verify its validity for effective management and quality of education programs.

The draft of the evaluation measurement was developed from consultation with professionals, focus group interviews targeting groups of nurses, and individual interviews with education program planners. After 6 professionals examined content validity, 46 items were retained. A pilot-survey was conducted to confirm the time required to complete the questionnaire and the level of understanding of general content and each item in the questionnaire. Construct validity was verified through exploratory factor analysis of data from a survey with 44 items completed by 452 nurses and 59 education program planners.

The final evaluation measurement for continuing nursing education programs consisted of 6 evaluation factors and 36 evaluation items. The 6 evaluation factors included identifying program goals and target groups, program planning, performance, operation and management, program outcomes, and program effectiveness.

The evaluation measurement for continuing nursing education programs developed in this study is considered suitable to utilize as an evaluation measurement of the quality of continuing education programs for nurses.

This study was done to evaluate the effects of 3 times/week and 5 times/week abdominal meridian massage with aroma oils (AMMAO) on the relief of constipation among hospitalized children with disabilities involving the brain lesions (cerebral palsy, epilepsy, and others).

The participants were 33 hospitalized children with a disability involving the brain (15 were in the 5 times/week of AMMAO group and 18 were in the 3 times/week of AMMAO group). Data were collected from March 21 to May 1, 2011. Chi-square test, t-test, and repeated measures ANOVA with SPSS 18.0 were used to evaluate the effects of AMMAO.

While there was no significant difference between the two groups, there was a significant difference within groups between baseline and the end of the intervention period for the following, frequency of suppository use or enemas, amount of stool, and number of bowel movements.

The results of this study indicate that AMMAO is an effective nursing intervention in relief of constipation for hospitalized children with a disability involving the brain. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for relief of constipation to these children.

The purpose of this study was to develop a measurement tool of nurse's turnover intention.

Data were collected from questionnaires completed by 678 nurses who worked in 3 university hospitals in South Korea and analyzed using the SPSS 18.0 and AMOS 18 programs. Thirty-seven preliminary items were selected from 161 basic items extracted via a literature review and in depth interviews with 6 hospital nurses. Three steps with factor analysis were undertaken to verify the reliability and validity of the preliminary instruments. Finally, confirmative factor analysis was carried out.

As a result of the analysis, 3 factors including 10 items were selected. Cronbach's Alpha for the 10 items was .83, for job satisfaction (4 items), .78, for interpersonal relationships (3 items), .80, and for work performance (3 items), .74, which was stable.

This study is meaningful because through it a scale reflecting Korean culture was developed to measure turnover intention in nurses. Further studies that test the psychometrics of this scale in more diverse samples are warranted.

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension.

The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program.

There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure.

The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

This study was done to examine actor and partner effect of dementia knowledge, self-efficacy and depression on dementia preventive behavior in elderly couples.

Participants were 115 couples aged 60 years or over who met eligibility criteria. All measures were self-administered. Data were analyzed using SPSS 18.0 and AMOS 18.0 program.

Dementia knowledge in elderly couples showed actor and partner effect on dementia preventive behavior. Self-efficacy in the wife did not have direct effects on dementia preventive behavior, but showed indirect effects through dementia knowledge. Self-efficacy in the husband showed direct effects on dementia preventive behavior and indirect effects through dementia knowledge. Wife's depression had direct actor effect on dementia preventive behavior and indirect effect through self-efficacy and dementia knowledge. Husband's depression did not have direct actor effect on dementia preventive behavior, but indirect effect through self-efficacy and dementia knowledge. Effect size of wives' dementia knowledge, self-efficacy and depression on dementia preventive behavior was larger than that of husbands'. Dementia preventive behavior, dementia knowledge and depression had a mutual effect.

Results indicate that to promote dementia preventive activity in elderly couples, programs should be conducted for both of the couple, but focused differently for wife and husband.

The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization.

Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method.

During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality.

Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

The purpose of this study was to investigate the prevalence of depression and suicidal ideation in elders with dementia and to identify factors influencing their suicidal ideation.

A descriptive and cross-sectional study was conducted from February to March, 2011. The participants were 298 older adults whose MMSE-KC score was 15 to 23. Collected Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression.

According to the Geriatric Depression Scale (GDS) classification criteria, 86.2% of the elders in this study exhibited depression (GDS=5), and 31.5% manifested severe depression. The mean score of suicidal ideation was 5.70 (range 0-20). The risk factors for suicidal ideation were depression, suicidal attempt experience, present location for care, and activities of daily living.

The results of this study can be utilized in the development of suicide prevention programs for older adults with dementia. In particular, depression should be screened and managed to reduce suicidal ideation of older adults with dementia.