Effect of White Noise on Pain Response, Heart Rate, and Oxygen Saturation During Heel Puncture in Premature Infants: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to investigate the effect of white noise on pain response, heart rate, and oxygen saturation during heel puncture in premature infants. METHODS: A randomized, controlled, pretest-posttest design was used. The participants were premature infants admitted to the neonatal intensive care unit of a university hospital in Gyeonggi Province. Sixty premature infants were assigned to either an experimental (n = 30) or control (n = 30) group. The experimental group was exposed to white noise during heel puncture, and the measured variables were pain response, heart rate, and oxygen saturation. The data were analyzed using the independent t test, chi-squared test, and analysis of covariance. RESULTS: Premature infants in the experimental group had a lower pain response and heart rate than the control group (F = 81.26, P < .01; F = 7.05, P = .01), and higher oxygen saturation than the control group (F = 4.76, P = .03). CONCLUSION: These results demonstrated that the white noise intervention is an effective nursing intervention to reduce the pain response and stabilize heart rate and oxygen saturation in premature infants during heel puncture.

Associations of dual use of tobacco cigarettes and e-cigarettes, sleep duration, physical activity and depressive symptoms among middle-aged and older Korean adults.

AIM: There is limited evidence of the association between dual tobacco-e-cigarette use and health-related variables in Korea. Thus, this study aimed to investigate the associations between types of cigarette smoking, sleep duration, physical activity and depressive symptoms among Korean adults. DESIGN: A cross-sectional study design using the 2019 Korean Community Health Survey. METHODS: The study subjects consisted of 179,004 adults older than 40 years from a total of 229,099 individuals. Self-reported general characteristics, smoking history, sleep duration, physical activity and depressive symptoms were analysed. RESULTS: In multinomial logistic regression, dual users of tobacco cigarettes and e-cigarettes were more likely to have sleep duration of less than 7 h per day and to report both mild and moderate-to-severe depressive symptoms than non-smokers. Single use of either cigarettes or e-cigarettes increased the risk of short sleep duration and moderate-to-severe depressive symptoms.

The Effects of a Smartphone-Based Education Program Designed to Help Mothers Safely Administer Medication to Their Children.

This study aimed to determine the effect of a smartphone-based medication education program to help mothers safely administer medication to their children at home. A quasi-experimental, non-equivalent control group, pretest-posttest design was utilized. There were 33 participants in the experimental group and 30 in the control group. The experimental group participated in the KidsMedi program for 6 weeks. The experimental group, receiving the KidsMedi program, had a statistically significant higher perception of antipyretic analgesics and higher eHealth literacy than the control group. The medication education program developed in this study is a mobile Web-based program. It is an effective program for mothers to improve their knowledge about administering drugs to children at home. This program is not affected by time and place, allowing repetitive self-directed learning. Nurses can utilize this program in daycare centers, schools, hospitals, communities, and public institutions to educate parents about safe medication for children.

[The Effects of the Infant Health Promotion Program for Mothers with Their Firstborn Infants].

PURPOSE: This study was intended to evaluate the effects of an Infant Health Promotion Program (IHPP) for mothers with their firstborn infants. METHODS: This study employed a non-equivalent control group pretest-posttest design. The participants consisted of 17 mothers with their firstborn infants in the experimental group and 17 in the control group from two women's hospitals. The experimental group received eight sessions of the program for four weeks. The collected data were analyzed using the chi-square test and repeated-measures ANOVA using an SPSS/WIN ver. 22.0. RESULTS: The experimental group receiving the program had statistically significant higher levels of infant health promotion knowledge (F = 22.91, p < .001), social support (F = 27.64, p < .001), maternal role confidence (F = 8.25, p = .005) and health promotion behavior for infants (F = 16.85, p < .001) than the control group. The experimental group had a statistically significant lower level of parenting stress than the control group (F = 29.93, p < .001). CONCLUSION: The study's findings indicate that the IHPP is effective in improving health promotion knowledge, social support, and maternal role confidence and decreasing parenting stress among mothers with their firstborn infants. A method of delivering intervention, focused on readily accessible online platforms, coupled with intervention strategies grounded in the theory of self-efficacy, proves to be an advantageous approach for this particular target group.

[Mothers' Experiences of Caring for Children with Precocious Puberty: A Q-Methodological Approach].

PURPOSE: This study explored experiences of mothers caring for children with precocious puberty. METHODS: Q-methodology was used for analyzing individual subjectivity. Seventy Q-statements were selected and scored by 50 participants on an 11-point scale. The collected data were analyzed using the PC QUANL program. RESULTS: The following eight types of care experiences of mothers of children with precocious puberty were identified: Type I-1: hypersensitive and best-result oriented, Type I-2: treatment burden, Type II-1: treatment-oriented, Type II-2: self-blame, Type III-1: accepting and compliant, Type III-2: treatment confused, Type IV-1: serious and engaged, and Type IV-2: naturalism-oriented. CONCLUSION: These results can help develop specific education programs based on types of care experiences for the promotion of care among mothers of children with precocious puberty.

[Development of an Aging Anxiety Scale for Middle-Aged Women].

PURPOSE: This was a methodological study that aimed to develop a measurement scale for aging anxiety among middle-aged women. METHODS: In this study, construct factors were extracted, and a conceptual framework was established through an extensive literature review and in-depth interviews with middle-aged women. Under the conceptual framework, 44 preliminary items were constructed, and a preliminary scale of 25 items was completed after two rounds of expert validation and item review. For this study, data were collected from 201 women aged 40~59 years, and the construct validity and reliability of the preliminary scale were verified. RESULTS: To verify the construct validity, exploratory factor analysis was conducted. Four factors containing 19 items were extracted. Concurrent validity of the developed scale was verified with Pearson's correlation analysis. The final scale comprised 4 factors ("Social valueless", "Physical weakness", "Concern about changes in appearance", and "Expectations of old age") and 19 items. The Cronbach's α value was .91. CONCLUSION: The scale for measuring aging anxiety in middle-aged women developed in this study validly reflected the peculiarities of aging anxiety in middle-aged women, who experience many physical, emotional, and social changes. The scale can be said to reflect the cultural background, as it reflected real experiences gained through in-depth interviews with middle-aged women.

Association of perceived stress and self-control with health-promoting behaviors in adolescents: A cross-sectional study.

Health-related habits acquired during adolescence are strongly related to health problems and behaviors in adulthood. Understanding the health-promoting behaviors of adolescents might help in efforts to encourage them to form lifelong healthy habits, which in turn would have wide-ranging benefits for their quality of life. This study was conducted to examine the associations of perceived stress and self-control with health-promoting behaviors in adolescents. The participants were 292 adolescents (136 boys, 156 girls) ages 15 to 18 years who were asked to complete a self-administered questionnaire. Hierarchical multiple linear regression analysis revealed that middle school students, higher economic status, subjective health status, and self-control were significant influencing factors of health promoting-behaviors. The total explanatory power of these associations was 23.9%. This finding suggests that schools and communities should take an interest in adolescents' health-promoting behaviors and develop proactive programs that promote the practice of these behaviors.

Impact of health literacy on medication adherence in older people with chronic diseases.

Medication adherence is a key factor of the therapy of chronic diseases in older people with chronic diseases. Inadequate health literacy results in poor health outcomes. Therefore, the aim of this study is to investigate the effect of health literacy on medication adherence to provide information for improving health outcomes in older people with chronic disease. This was a cross-sectional study of older people (people aged over 65 years) with chronic diseases in Korea taking one or more medications for 6 months and over from an academic referral medical center. Each patient completed a structured questionnaire by interview or self-report. Of the 291 older participants, 30.6% had high medication adherence. In hierarchical multiple regression analysis, health literacy was the strongest predictor of medication adherence (ß = 0.190, P = 0.001). In addition, perceived health status, use of magnifying glass, and assistance with medication administration were also significant factors related to medication adherence. In conclusion, enhancing health literacy may improve medication adherence of older people with chronic disease. The development, implementation and evaluation of health literacy interventions for older people with chronic conditions are important to increase medication adherence and potentially improve patient outcomes. Such programs would also raise awareness of the impact of health literacy on patient outcomes. Furthermore, this could contribute to reducing health inequalities worldwide.

[Factors Influencing Burnout among Mothers of Children with Cerebral Palsy].

PURPOSE: The purpose of this study was to examine the effects of parental stress, social support, and coping behavior on burnout among mothers caring for children with cerebral palsy. METHODS: Participants in this cross-sectional, descriptive study were 185 mothers who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, t-test, one-way ANOVA, correlation and multiple linear regression analyses with IBM SPSS Win 22 program. RESULTS: Parental stress and coping behavior were strong predictors of burnout among mothers of children with cerebral palsy. These variables explained 50.0% of the variance in burnout. Social support was not a predictor of burnout. A higher level of burnout was associated with higher levels of parental stress and lower levels of social support and coping behavior. CONCLUSION: Mothers of children with cerebral palsy are vulnerable to burnout. These results show that effective strategies for reducing parental stress and improving positive coping behavior are needed to reduce burnout in these mothers.

Development and application of course-embedded assessment system for program outcome evaluation in the Korean nursing education: A pilot study.

BACKGROUND: Program outcome evaluation is important because it is an indicator for good quality of education. Course-embedded assessment is one of the program outcome evaluation methods. However, it is rarely used in Korean nursing education. OBJECTIVES: The study purpose was to develop and apply preliminarily a course-embedded assessment system to evaluate one program outcome and to share our experiences. DESIGN AND SETTINGS: This was a methodological study to develop and apply the course-embedded assessment system based on the theoretical framework in one nursing program in South Korea. DATA: Scores for 77 students generated from the three practicum courses were used. METHODS: The course-embedded assessment system was developed following the six steps suggested by Han's model as follows. 1) One program outcome in the undergraduate program, "nursing process application ability", was selected and 2) the three clinical practicum courses related to the selected program outcome were identified. 3) Evaluation tools including rubric and items were selected for outcome measurement and 4) performance criterion, the educational goal level for the program, was established. 5) Program outcome was actually evaluated using the rubric and evaluation items in the three practicum courses and 6) the obtained scores were analyzed to identify the achievement rate, which was compared with the performance criterion. RESULTS: Achievement rates for the selected program outcome in adult, maternity, and pediatric nursing practicum were 98.7%, 100%, and 66.2% in the case report and 100% for all three in the clinical practice, and 100%, 100%, and 87% respectively for the conference. These are considered as satisfactory levels when compared with the performance criterion of "at least 60% or more". CONCLUSION: Course-embedded assessment can be used as an effective and economic method to evaluate the program outcome without running an integrative course additionally. Further studies to develop course-embedded assessment systems for other program outcomes in nursing education are needed.

Perceptions regarding medication administration errors among hospital staff nurses of South Korea.

OBJECTIVE: To identify reasons for medication administration errors (MAEs) and why they are unreported, and estimate the percentage of MAEs actually reported among hospital nurses. DESIGN: A cross-sectional survey design. SETTING: Three university hospitals in three South Korean provinces. PARTICIPANTS: A total of 312 hospital staff nurses were included in this study. MAIN OUTCOME: Medication administration errors. RESULTS: Actual MAEs were experienced by 217 nurses (69.6%) during their clinical career, whereas 149 nurses (47.8%) perceived that MAEs only occur less than 20% rate. MAEs occurred mostly during intravenous (IV) administrations. Nurses perceived that the most common reasons for MAEs were inadequate number of nurses in each working shift (4.88 ± 1.05) and administering drugs with similar names or labels (4.49 ± 0.94). The most prevalent reasons for unreported MAEs included fears of being blamed (4.36 ± 1.10) and having too much emphasis on MAEs as a measure of nursing care quality (4.32 ± 1.02). The three most frequent errors perceived by nurses for non-IV related MAEs included administering medications to the incorrect patients and incorrect medication doses and drug choices. The three most frequent IV related MAEs included incorrect infusion rates, patients and medication doses. CONCLUSIONS: Nurse-staffing adequacy could be helpful to prevent MAEs among nurses as well ongoing education, and training regarding safe medication administration using the problem-based simulation education. In addition, encouraging nurses to identify and report work related errors in a non-punitive milieu will increase error reporting.

Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events.

BACKGROUND: Medication administration errors are the most common type of error in pediatric medicine. Preventing medication errors is an important part of ensuring safe and quality patient care for pediatric patients. Few studies have described this issue from the perspective of the parents of pediatric patients. PURPOSE: This study describes parents' administration of medication to their children at home and the understanding of these parents of adverse drug events (ADEs). METHODS: A cross-sectional survey design was used to gather data from 179 parents of pediatric patients at two pediatric units at a hospital and three children's daycare centers in Korea. Data were collected from July to August 2012 using a self-reported questionnaire. RESULTS: Participants reported administering antipyretics (94.4%), decongestants (89.4%), and antibiotics (77.7%) to their children at home. The major source of medication information was instruction sheets. Parents more commonly used dosing cups (43.6%) and droppers (32.9%) when administering liquid medication to children. Furthermore, 12.3% of the children experienced ADEs. Only 48% of the participants were provided information on ADEs, 15.1% were unsure about the recommended dosage, and 11.2% were unsure of the recommended method for administering the medication. Analysis of variance and post hoc tests showed that level of parental education and monthly income each had a significant impact on participant understanding of ADEs. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study suggests that parents should be educated about ways to avoid common medication errors in children. In addition, in the case of low-income families, home visits should be carried out to understand how to reduce home medication errors and provide drug-related information to parents. Strategies are needed to reduce pediatric home medication errors and minimize ADEs and to provide medication information to parents.

Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing.

PURPOSE: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. METHODS: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. RESULTS: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. CONCLUSION: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

Effect of trunk-to-head bathing on physiological responses in newborns.

OBJECTIVE: To determine the effect of trunk-to-head bathing versus the traditional head-to-trunk bathing on newborns' body temperature, heart rate, and oxygen saturation. DESIGN: A prospective, two-group, quasi-experimental repeated measures design. SETTING: A newborn nursery in an urban university hospital. PARTICIPANTS: Sixty-two healthy full-term newborns. METHODS: Newborns were randomly assigned to two groups. The newborns in the experimental group were bathed from trunk to head; those in the control group were bathed from head to trunk. Measurements of body temperature, heart rate, and oxygen saturation were obtained at four time points: before the bath, immediately after the bath, 30 minutes after the bath, and 60 minutes after the bath. RESULTS: No significant differences in body temperature, heart rate, or oxygen saturation were observed between groups. However, body temperature was significantly different across measurement times, and there was a significant interaction between group and measurement time. The mean body temperature dropped 0.2°C after bathing in both groups, but the experimental group returned to their initial body temperature more rapidly than the control group. CONCLUSION: These findings suggest that newborns who were bathed from trunk to head and whose heads were wet for shorter periods of time benefited with a more rapid recovery of body temperature and decreased heat loss due to evaporation.

Influence of Type D personality on health-related quality of life among Korean patients with end-stage renal disease.

The purposes of this study were to explore the prevalence of Type D personality and the impact of Type D personality (the combination of negative affectivity and social inhibition) on health-related quality of life (HRQOL) in end-stage renal disease (ESRD) patients and to determine whether this link of Type D personality to HRQOL is mediated by depressive symptoms. Patients (n = 144) from an outpatient nephrology clinic of a university hospital participated in this cross-sectional study. The prevalence of Type D personality using Type D Personality Scale-14 was 26%. After adjustment for patients' characteristics and depressive symptoms in multivariate analysis, Type D personality was an independent predictor of HRQOL. This relation of Type D personality to HRQOL was mediated by depressive symptoms. Our findings underline that intervention should be directed towards reducing depressive symptoms in patients with Type D personality in order to improve HRQOL of ESRD patients.

Prevalence of metabolic syndrome and associated risk factors among Korean adolescents: analysis from the Korean national survey.

The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and to identify the associated risk factors of MS among Korean adolescents. A total of 606 adolescents aged 12 to 18 years from the third Korea National Health and Nutrition Examination Survey (KNHNES) in 2005 participated in a community-based and cross-sectional survey through face-to-face interviews. The authors defined pediatric MS using the modified National Cholesterol Educational Program-Adult Treatment Panel III. The overall weighted prevalence of MS in Korean adolescents was 13.0% (15.4% boys, 10.0% girls). In multivariate logistic regression analysis, boys, adolescents with body mass index (BMI) greater than the 85th percentile, and adolescents who watched TV for more than 2 hours per day were significantly more likely to have MS. These findings suggest that lifestyle modification focusing on weight control by increasing physical activity is important for the prevention of MS in adolescents.

Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases.

Although prior research in Western societies has revealed an association between self-efficacy and both self-management behaviours and better health status, little is known about the applicability of this association in Korean populations. We examined the differences in self-management behaviours and health status among three groups according to the level of self-efficacy (high, moderate and low). We used a descriptive and correlational design, and administrated a questionnaire to 322 Korean patients with diabetes mellitus, hypertension or arthritis at three ambulatory clinics in a university medical centre. We performed the Pearson chi-square test to test for differences in proportions, and the Kruskall-Wallis and Mann-Whitney U-tests for non-parametric measures. The level of self-efficacy was associated with self-management behaviours (P < 0.05) and with better health status indices (P < 0.001) except fatigue (P < 0.277). The mean age (Mean ± standard deviation, 53.71 ± 12.60), the percentage of high level of education (62.4%) and the level of employment (51.4%) were significantly higher in high self-efficacy group than in low self-efficacy group or moderate self-efficacy group. Further study of the potential factors affecting any relationship between self-efficacy and fatigue is recommended. Self-efficacy-enhancing interventions can be beneficial for Korean chronic patients to improve their self-management behaviours and health status.

Quality of life of women with urinary incontinence: a systematic literature review.

PURPOSE: The purpose of this study was to review studies that have examined the quality of life of women with urinary incontinence. MATERIALS AND METHODS: A review was conducted that used the databases PubMED, Proquest, CINAHL, and Sciencedirect. Articles were included that were published in English between 2005 and 2010 the key words use were urinary incontinence, women, and quality of life. RESULTS: A total of 18 studies were identified, and the prevalence of urinary incontinence varied depending on the definition of incontinence used and the age of the population studied. The Incontinence Quality of Life (I-QoL), Incontinence Impact Questionnaire-short form (IIQ-7), and King's Health Questionnaire (KHQ) were the most commonly used instruments. Demographic, medical, physical, psychological, health, and intervention factors were reported as influencing factors on the quality of life of women with incontinence. Age, severity of urinary incontinence, type of urinary incontinence, number of urinary incontinence episodes, body weight, stress, and help-seeking behavior were statistically significant variables influencing quality of life. CONCLUSION: Future studies are needed to identify factors related to quality of life among women with incontinence and to use validated instruments according to specific subjects.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum.

Sensitivity to ethical issues confronted by Korean hospital staff nurses.

This descriptive study was undertaken to identify the degree of ethical sensitivity of staff nurses and to analyze the differences in ethical sensitivity in terms of both general and ethics-related characteristics. Participants were 236 staff nurses working in general hospitals in Korea. Ethical sensitivity was measured by means of an instrument developed by the researchers. The results showed that the mean score for the degree of ethical sensitivity was 0.71 out of a possible maximum score of 1 (range 0.30 to 0.97). For general characteristics, there was a significant difference in ethical sensitivity according to age (F (df 2233) = 3.99, P = 0.02). For characteristics related to ethics, there was a significant difference in ethical sensitivity according to attitude towards the nursing profession (F (df 4231) = 2.94, P = 0.03). It is therefore recommended that a training program reflecting these variables be developed to enhance staff nurses' ethical sensitivity.