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9 "Hwa Soon Kim"
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Original Articles
Development of Concrete Sensory Information for Patients Undergoing Catheterization
Cho Ja Kim, Hwa Soon Kim
Journal of Nurses Academic Society 1997;27(2):433-443.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.433
AbstractAbstract PDF

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objectives information for patients undergoing cardiac catheterization ; 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms-coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor of nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%, and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

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The Influencing Factors on Health Behavior of Patients with Coronary Artery Disease
Young Whee Lee, Hwa Soon Kim, Eui Young Cho
Journal of Korean Academy of Nursing 2002;32(1):40-49.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.1.40
AbstractAbstract PDF

PURPOSE: The purpose of this study was to investigate the influencing factors on health behavior among patients with coronary artery disease.
METHOD
The subjects were 95 patients who visited the out-patient department of a university hospital for follow-up. The four health belief concepts (motivation, benefit, barrier, seriousness), general self-efficacy, health behaviors on medication, diet, exercise, stress management, smoking, and drinking were measured.
RESULT
There were significant differences in the health behavior scores of subjects according to family support and the experience of surgical procedure. Subjects were found to have a high degree of compliance in taking medication. However subjects reported the lowest degree of compliance in regular exercise. In the multiple regression analysis, surgical procedure and motivation were significant predictors to explain diet. Motivation and barrier were significant predictors to explain exercise. Self-efficacy, motivation and family support were significant predictors to explain stress management. Family support and seriousness explained 16% of variance in drinking. Also, family support explained 30% of variance in smoking.
CONCLUSION
Since predicting factors on each health behavior indicator were different, then nurses should consider these differences to construct strategy enhancing patient's recovery.

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The Administration Patterns of Analgesics and Sedatives for Patients in SICU
Hwa Soon Kim
Journal of Korean Academy of Nursing 2001;31(2):304-314.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.2.304
AbstractAbstract PDF

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The
results
of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

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A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients
Hwa Soon Kim, Wha Sook Suh
Journal of Korean Academy of Nursing 2000;30(3):741-749.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.741
AbstractAbstract PDF

This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( 2) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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The Effect of Job Stress and Lifestyle on Blood Lipid Levels in Male Aircrew Personnel
Eui Young Cho, Young Whee Lee, Hwa Soon Kim
Journal of Korean Academy of Nursing 2005;35(4):672-679.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.4.672
AbstractAbstract
Introducion

Cardiovascular disease has the potential to lead to sudden in-flight incapacitation and permanent grounding. The aims of this study are to examine the relationships between lifestyle, job stress and blood lipid levels of male aircrew personnel of a Korean airline and to identify which factors influence their hyperlipidemia.

Methods

Two hundred sixteen male aircrew personnel completed a questionnaire by self-report and consented to participate in the study. The questionnaire collected data related to job stress, life style, serum cholesterol levels and general characteristics of the aircrew. The cholesterol levels of the subjects were collected from their most recent health check-up records. Subjects were divided into two groups (the desirable group and the risk group) based on their serum cholesterol level, 200 mg/dl.

Results

Mean age and marital status were significantly different between the two groups. More subjects in the risk group had habits of eating high lipid foods, while more subjects in the desirable group exercised more frequently than the risk group. In logistic regression analysis, after controlling age and marital status, types of working situation (domestic duty or international duty, odds ratio=.390, p=.018), diet (odds ratio=.429, p=.037), and exercise (odds ratio=.320, p=.055) were influencing factors on aircrew's serum cholesterol levels.

Conclusions

The cholesterol level of aircrew personnel is closely related to their lifestyle, such as lipid diet and exercise. The type of work situations, e.g. staying in an airplane for long periods of time or staying abroad, may influence these diet patterns and exercise habits.

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Prospective Study on the Relating Factors to the Stages of Change in Smoking Cessation and Barriers in Coronary Artery Disease Patients
Hwa Soon Kim
Journal of Korean Academy of Nursing 2005;35(1):27-36.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.1.27
AbstractAbstract PDF
Purpose

The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model.

Method

Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months.

Result

In the baseline, the distribution of the subjects' stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant.

Conclusion

Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

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Clinical Implications of the Glucose Test Strip Method for Early Detection of Pulmonary Aspiration in Nasogastric Tube- Fed Patients
Hwa Soon Kim
Journal of Korean Academy of Nursing 2004;34(7):1215-1223.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.7.1215
AbstractAbstract PDF
Purpose

This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients.

Method

The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria.

Result

The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=. 038). More subjects in the no aspiration group (73%) than the aspiration group (56%) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups.

Conclusion

The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

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Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
Yun Jeong Choi, Ji Young Lim, Young Whee Lee, Hwa Soon Kim
J Korean Acad Nurs 2008;38(5):656-666.   Published online October 12, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.656
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC).

Methods

This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs.

Results

Two main visions of nursing service for ICUs were established. These were ‘realization of harmonized professional nursing with human respect’ and ‘recovery of health through specialized nursing’ respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC.

Conclusion

The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

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Comprehensive Predictors of Fatigue for Cancer Patients
Young Min Seo, Hyun Soo Oh, Wha Sook Seo, Hwa Soon Kim
Journal of Korean Academy of Nursing 2006;36(7):1224-1231.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1224
AbstractAbstract PDF
Purpose

This study was conducted to identify comprehensive predictors of fatigue in cancer patients.

Methods

One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study.

Results

The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant.

Conclusion

From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.

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