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7 "Sensitivity"
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Original Articles
External Validation of Carbapenem-Resistant Enterobacteriaceae Acquisition Risk Prediction Model in a Medium Sized Hospital
Seo, Su Min , Jeong, Ihn Sook
J Korean Acad Nurs 2020;50(4):621-630.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.20137
AbstractAbstract PDF
Purpose
This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital.
Methods
This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness.
Results
The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors’ cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively.
Conclusion
The CREP-model’s discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.
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Evaluation of Validity of the Korean Triage and Acuity Scale
Heejung Choi, Jong Sun Ok, Soo Young An
J Korean Acad Nurs 2019;49(1):26-35.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.26
AbstractAbstract PDF
Purpose

The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).

Methods

This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.

Conclusion

The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

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Nurse Managers' Moral Self Concept and Ethical Sensitivity
Yong Soon Kim, Jee Won Park, Youn Jung Son, Sung Suk Han
Journal of Korean Academy of Nursing 2002;32(7):1072-1078.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.7.1072
AbstractAbstract PDF

PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers.
METHODS
Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers.
RESULTS
1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00).
CONCLUSION
It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.

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Review Article
Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis
Seong-Hi Park, Yu-Sun Park
J Korean Acad Nurs 2014;44(6):595-607.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.595
AbstractAbstract PDF
Purpose

The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development.

Methods

Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4.

Results

Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies.

Conclusion

The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

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Original Articles
Systematic Review and Meta-Analyses of Diagnostic Accuracy of Infrared Thermometer when Identifying Fever in Children
Young Joo Park, Seong-Hi Park, Chang-Bum Kang
J Korean Acad Nurs 2013;43(6):746-759.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.746
AbstractAbstract PDF
Purpose

Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children.

Methods

Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4.

Results

Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low.

Conclusion

The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.

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Effects of a Breast Feeding Promotion Program for Working Women
Ji-Won Yoon, Young-Joo Park
J Korean Acad Nurs 2008;38(6):843-852.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.843
AbstractAbstract PDF
Purpose

The purpose of this study was to measure the effects of a breast feeding promotion program for working women on breast feeding continuation, mother-infant attachment, and maternal sensitivity.

Methods

The design of this study is nonequivalent control group design with repeated measures.

Results

There were significant differences in breast feeding continuation between two groups at each time point except 2 days and 1 week after delivery. The scores of mother-infant attachment and maternal sensitivity of experimental group were higher than those of the control group, but there were no significant differences between two groups.

Conclusion

Although some modifications in contents and administration will be required to increase the effectiveness of the program, breast feeding promotion program for working women can be an effective nursing intervention which can facilitate breast feeding continuation and mother-infant relationships.

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Development and Psychometric Evaluation of a Quality of Life Scale for Korean Patients with Cancer (C-QOL)
Eun Hyun Lee
Journal of Korean Academy of Nursing 2007;37(3):324-333.   Published online April 30, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.3.324
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and evaluate a quality of life scale for Korean patients with cancer (C-QOL).

Methods

The C-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. A total of 337 patients diagnosed with stomach, liver, lung, colon, breast, or cervix cancer were recruited. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, the SF-36, and the ECOG performance status. The obtained data was analyzed using descriptive statistics, factor analysis, multidimensional scaling (MDS), multitrait/multi-item matrix, ANOVA, t-test, and Cronbach's alpha.

Results

Preliminarily twenty-six items were generated through content validity and a pilot study. Factor analysis and MDS extracted a total of 21 items with a 5-point Likert-type scale (C-QOL). The C-QOL included five subscales: physical status (6 items), emotional status (6 items), social function (3 items), concern status (2 items), and coping function (4 items). The C-QOL established content validity, construct validity, item convergent and discriminant validity, known-groups validity, reliability, and sensitivity.

Conclusion

The Newly developed C-QOL is an easily applicable instrument which established psychometric properties and reflected Korean culture. It is recommended for further study to examine the responsiveness of the C-QOL using a longitudinal research design.

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