This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model.

This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24.

In the final model, admission via emergency department (B=.06, p=.019), age over 65 years (B=.11, p=.001), unconsciousness (B=.18, p=.001), dependent activities (B=.12, p=.001), abnormal vital signs (B=.12, p=.001), pressure ulcer risk (B=.12, p=.001), enteral nutrition (B=.12, p=.001), and use of restraint (B=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (B=.06, p=.038), hospital length of stay (B=5.06, p=.010), and discharge to another facility (not home) (B=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium.

The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

The purpose of this study was to monitor the use of health-related quality of life (HRQOL) instruments in Korean studies of patients with diabetes.

Of 86 Korean studies initially identified, 17 studies met the inclusion criteria. For each study, a description of the instrument and its psychometric properties were monitored by the Instrument Review Criteria of the Scientific Advisory Committee. These criteria include conceptual definition, attributes, taxonomy, reliability, validity, responsiveness, administrative mode, and language adaptations.

Five generic and one diabetes specific type questionnaires were identified from the 17 studies. Of those studies, conceptual definitions with the attributes of multi-dimension and subjectiveness were provided for 11 studies (71%). In the analysis of conceptual taxonomy, only 6 studies were classified as HRQOL, while other studies were done as QOL or health status. In monitoring of psychometric properties, reliability, validity, and responsiveness were reported for 88.2%, 64.7%, and 29.4%, respectively. One generic instrument was developed with a Korean population, while the other instruments were developed for Western countries. However, language adaptations were performed for only a few of the instruments.

The psychometric properties including responsiveness of most instruments warrants further research, and the development of diabetes-specific HRQOL measurements should be sought to facilitate intervention outcomes across Korean studies of patients with diabetes.

In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea.

After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated.

The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life.

The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.