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Original Articles
A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design
So Young Yun, Ja Yun Choi
J Korean Acad Nurs 2019;49(1):92-103.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.92
AbstractAbstract PDF
Purpose

This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students.

Methods

In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test.

Results

The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=−6.49, p<.001) and clinical judgment (t=−4.71, p<.001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202).

Conclusion

The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.

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A Comparison of Interventions Recorded in Nursing Notes between Actue and Subacute Stage after a Cerebrovascular Accident
Ja Yun Choi, Soon Joo Park
Journal of Korean Academy of Nursing 2006;36(2):227-235.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.227
AbstractAbstract PDF
Purpose

This study aimed to: 1) determine the core nursing interventions, and 2) compare acute interventions with subacute interventions recorded in the nursing notes of patients with cerebrovascular accidents (CVA).

Methods

The nursing records covering the first 10 days of 30 patients with a CVA who were admitted from January to December 2004 at C University Hospital in Korea were examined. Data was collected using the nursing interventions classification (NIC) from January to April 2005. Finally, data analysis was carried out using mean, SD, and paired t-test according to domains, classes, and interventions.

Results

The most frequent nursing intervention at both stage was “Neurologic monitoring”. There were differences in interventions belonging to the “Physiological: complex,” “Behavioral,” “Safety,” and “Health system” domains between the acute and subacute stages. The frequency of interventions belonging to the “Immobility management,” “Neurological management,” “Tissue perfusion management,” “Patient education,” “Risk management,” “Health system mediation,” and “Information management” classes at the acute stage was higher compared to the subacute stage.

Conclusions

This study found out that nurses relatively recorded more nursing interventions during the acute stage hence the unsuccessful documentation of the subacute stage particularly in describing the specific nursing interventions at this stage.

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Development of Clinical Performance Indicators for Establishing a Connecting System between Hospital Performance Management and Quality Improvement
Keum Seong Jang, Sam Yong Lee, Yun Min Kim, Sun Young Hwang, Nam Young Kim, Se Ang Ryu, Soon Joo Park, Ja Yun Choi
Journal of Korean Academy of Nursing 2005;35(7):1238-1247.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1238
AbstractAbstract PDF
Purpose

This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures.

Methods

The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs.

Results

One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level.

Conclusions

CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.

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Effects of a Constipation Intervention Program on Inpatients' Defecation
Ja Yun Choi
Journal of Korean Academy of Nursing 2004;34(1):72-80.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.1.72
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effect of a constipation reduction program for inpatients.

Method

Subjects were selected in one medical ward of C University Hospital from May, 2001 to November, 2001. Twenty-nine subjects were assigned to an experimental group and 32 subjects to a control group. Data related to the frequency of defecation and to the length and amount of laxative drugs used was collected by a medical record review and data on the degree of constipation was obtained by a self-report using a constipation assessment scale.

Result

More than 90% of the subjects admitted in the department of neurology and one third of total subjects presented with activity limitation and about one fourth of the subjects were fed with a nasogastric tube. There was a significant difference in the degree of constipation, frequency of defecation, and the length and amount of laxative drug use between the two groups.

Conclusion

This program is effective in inpatient's constipation reduction. Further studies need to apply this program in various clinical environments and properly use this program in different clinical settings.

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A Comparison on the Degree of Pain according to Methods of Blood Sugar Test between DM Patients and Healthy Group
Ja Yun Choi
Journal of Korean Academy of Nursing 2003;33(7):928-935.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.928
AbstractAbstract PDF
Purpose

This study attempts to compare the degree of pain when different methods of blood sugar test are used between a DM patient group and a healthy group.

Method

A sample is composed of 56 DM patients and 57 their family who are admitted in a ward of C university hospital in Gwangju. Data were collected from July, 2001 to December, 2001. The blood sugar tests are administered four different ways. The degree of pain is measured twice with a visual analog scale in a week interval.

Result

The differences in the degree of pain according to methods of blood sugar test were not found between the DM patient group and the healthy group in both measures. The only use of a 27G needle method was shown to cause highest level of pain in comparison with the rest of methods in the first measure of the DM patient group and in both the measures of the healthy group.

Conclusion

The study results indicate that the method using lanceter is more recommendable than method of using a 27G needle. Furthermore, the ice therapy and EMLA cream is likely to be more effective on the pain relief in the healthy group than the DM patient group.

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A Correlation Study of Perceived Importance of Nursing Interventions with Performance Frequency in Psychiatric Nursing Units Using the 3th NIC
Ja Yun Choi, Hye Suk Kim, Mi Sun Park
Journal of Korean Academy of Nursing 2003;33(1):95-103.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.1.95
AbstractAbstract
Purpose

The purpose of this study was to identify the perceived importance of nursing intserventions of psychiatric nurses according to domains, classes and interventions using the 3th NIC.

Method

In this study, a 435 of 486 nursing interventions were selected from 75% consent reached by experts. Data were collected from 9 hospitals and 141 nurses(return rates : 94.0%) in Seoul, Kyonggi, Chungnam, Gwang-ju and Chonnam region from January, 2002 to February, 2002 using 4 point Likert scale.

Result

Total perceived importance score was 2.905+/−0.463 and total correlation score with performance frequency was r=0.295. The most important perceived domain and class was found to be ‘ safety’ (3.217+/−0.465) and ‘ community health promotion’ (3.285+/−0.866). The most correlated domain and class with performance frequency appeared to be ‘ behavioral’ (r=0.431, p=0.000) and ‘ communication enhancement’ (r=0.439, p=0.000). The most important perceived nursing intervention was found to be ‘ active listening’ (3.652+/−0.549).

Conclusion

In conclusion, nurses in clinical settings were found to perform less than perceive its importance. Therefore, further researches are needed to identify factors related to impede and develop strategies to improve the performance of nursing interventions.

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Effect of Debriefing Based on the Clinical Judgment Model on Simulation Based Learning Outcomes of End-of-Life Care for Nursing Students: A Non-Randomized Controlled Trial
Kyung In Jeong, Ja Yun Choi
J Korean Acad Nurs 2017;47(6):842-853.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.842
AbstractAbstract PDF
Abstract Purpose

This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education.

Methods

Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students’ skill training, and evaluators’ training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing.

Results

ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups.

Conclusion

This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

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Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial
Ja Yun Choi, Young-Ran Kweon
J Korean Acad Nurs 2017;47(5):613-623.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.613
AbstractAbstract PDF
Abstract Purpose

This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma.

Methods

Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables.

Results

There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL.

Conclusion

This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

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Effects of Dietary Program based on Self-efficacy Theory on Dietary Adherence, Physical Indices and Quality of Life for Hemodialysis Patients
Kyung Soon Yun, Ja Yun Choi
J Korean Acad Nurs 2016;46(4):598-609.   Published online August 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.4.598
AbstractAbstract PDF
Purpose

The purpose of this study was to examine effects of a dietary program based on self-efficacy theory on dietary adherence, physical status and quality of life (QoL) in hemodialysis patients.

Methods

A non-equivalent control group pre-post test design was used. The intervention group received the dietary program for 8 weeks from August 4 to September 26, 2014. The control group received only usual care.

Results

ANCOVA showed that dietary adherence (F=64.75, p<.001) was significantly different between the two groups. Serum albumin (F=12.13, p =.001), interdialytic weight gain (F=56.97, p<.001), calories (F=15.80, p<.001) as physical status indices were significantly different, but serum potassium (F=2.69, p=.106) and serum phosphorus (F=1.08, p=.303) showed no significant difference between the two groups. In terms of health-related QoL, the physical component scale (F=10.05, p=.002) and the mental component scale (F=16.66, p<.001) were significantly different between the two groups. In addition, in terms of diet related QoL, diet level (F=35.33, p<.001) and satisfaction level (F=15.57, p<.001) were significantly different between the two groups, but dietary impact level (F=1.23, p =.271) was not significantly different.

Conclusion

Findings show that the dietary program based on self-efficacy theory is an effective nursing intervention program to improve adherence to diet, and to maintain physical status and QoL for hemodialysis patients.

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Factors Predicting Patient Discomfort after Coronary Angiography
Ae Ran Park, Ja Yun Choi
J Korean Acad Nurs 2009;39(6):860-867.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.860
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors that predict discomfort after coronary angiography or percutaneous coronary intervention (PCI) among hospitalized patients.

Methods

A total of 203 patients who underwent coronary angiography or PCI were recruited from C hospital located in S city, J province, from June through August 2008. The level of discomfort was measured and standardized by two instruments, discomfort questionnaire and the Visual Analogue Scale (VAS).

Results

Stepwise multiple regression showed that the factors predicting the level of discomfort were type of angiography, gender, previous angiography, dysuria, pre-information, and sleep satisfaction, which together explained 30.6% of the total variance of the level of discomfort.

Conclusion

Patients who had previous experience with these procedures, received a pre-information about the upcoming procedure, had no dysuria, and had slept well after the procedure were less likely to complain discomfort. Pre-informed education should be given by nurses to patients who will have an angiography or PCI to reduce their physical and emotional discomforts.

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Validity and Reliability of a Clinical Performance Examination using Standardized Patients
Ja Yun Choi, Keum Seong Jang, Soon Hee Choi, Mi Soon Hong
Journal of Korean Academy of Nursing 2008;38(1):83-91.   Published online February 28, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.1.83
AbstractAbstract PDF
Purpose

The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing.

Methods

70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station

Results

There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048).

Conclusion

Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.

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A Comparison of Perceived Nursing Needs among Oncology Nurses, Patients with Non-terminal Cancer and Patients with Terminal Cancer
Ja Yun Choi
Journal of Korean Academy of Nursing 2005;35(6):1135-1143.   Published online October 31, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.6.1135
AbstractAbstract PDF
Purpose

The purpose of this study was to compare the perceived importance and the perceived caring of nursing needs among oncology nurses, patients with non-terminal cancer and patients with terminal cancer.

Method

A total of 83 oncology nurses, 56 patients with non-terminal cancer and 39 patients with terminal cancer served as subjects. Data was collected based on the 4-point Likert scale using a self-administered questionnaire from Mar. to Sept. 2004. Finally, data was analyzed using mean, SD, paired-test, and ANOVA.

Results

The score of the perceived importance of nursing needs was higher than that of the perceived performance of nursing needs in all three groups. There was also a difference in the degree of perceived performance of nursing needs among the three groups. In contrast, there was no difference in the total score of the perceived importance of nursing needs among the three groups, unlike the importance of informational and physical needs as a subgroup of perceived importance, where a difference was noted.

Conclusions

Strategies should be developed to narrow down these gaps between nurses and patients. In particular, informational and educational programs should be designed for patients with terminal cancer.

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Comparison of Cancer Nursing Interventions Recorded in Nursing Notes with Nursing Interventions Perceived by Nurses of an Oncology Unit: Patients with Terminal Cancer
Ja Yun Choi, Keum Seong Jang
Journal of Korean Academy of Nursing 2005;35(3):441-450.   Published online June 30, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.3.441
AbstractAbstract PDF
Purpose

The purposes of this study were to determine the core nursing interventions in nursing notes and the practice which was perceived by nurses of an oncology unit with patients with terminal cancer. Also, comparing interventions in nursing notes with interventions in perceived practice was done.

Method

Subjects were 44 nursing records of patients with terminal cancer who had died from Jan. to Dec. 2002 at C University Hospital and 83 nurses who were working on an oncology unit for more than one year. Data was collected using a Nursing Interventions Classification and analyzed by means of mean and t-test.

Results

The most frequent nursing intervention was ‘nausea management’ in the nursing note and was ‘medication administration : oral’ in perceived practice. The frequency of nursing interventions in the nursing record was lower than in perceived practice.

Conclusion

This study finds that nurses actually practice nursing care, but they may omit records. To correct for omitted nursing records, development of a systematic nursing record system, continuous education and feedback is recommended.

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