Nursing Students’ Clinical Judgment and Performance in Simulation of Recognizing and Responding of the Deterioriating Patient ; a retrospective mixed-methods / 중환자간호학회지

Purpose@#: This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients. @*Methods@#: Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants. @*Results@#: Quantitative analysis showed that most participants demonstrated a “being skillful” level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time. @*Conclusion@#: To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.

Comparison of Sleep, Perceived Health, and Job Stress According to Symptoms of Shift Work Disorder in Shift Nurses

This study aimed to investigate the prevalence of symptoms of shift work disorder (SSWD) and its related factors in rapidly rotating three-shift nurses. Methods: We enrolled 344 nurses (mean age, 28.7 years) without prior history of sleep disturbance before starting shift work in a university-affiliated hospital. SSWD were defined using self-reported sleep questionnaires (insomnia severity index >14 and/or Epworth Sleepiness Scale ≥10) and without any sleep problem before shift work. Sleep pattern in each of the three shifts was measured using the Munich Chronotype Questionnaire for Shift-Workers. Mood (anxiety, depression) and job stress were also measured using self-reported questionnaires. Results: Our results showed that 62.2% of the participants presented SSWD. Compared to the non-SWD group, the SSWD group showed worse sleep hygiene, lower total sleep time (TST) during workdays, higher anxiety and depressive mood, and higher job stress. In the SSWD group, the evening chronotype individuals presented the shortest TST during day shifts, while the morning chronotype individuals presented the shortest TST during evening shifts. Conclusions: SSWD is highly prevalent in fast rotating three-shift nurses. This study suggests that intensive education on sleep hygiene and appropriate scheduling of shift work while considering individual chronotypes may improve sleep patterns and sleep quality of shift workers and minimize SSWD.

Nurses’ Attitude toward Hospitalized Patients after Attempted Suicide; Integrative Review / 중환자간호학회지

Purpose@#: This study aims to identify nurses’ attitudes toward patients hospitalized after attempting suicide and inform directions for research and interventions to establish a therapeutic environment. @*Methods@#: For integrative review, the five stages suggested by Whittemore and Knafl were followed. Articles and theses published before February 2021 were searched using eight databases and a manual search. The search terms were suicide, self-harm, emergency department (ED), intensive care unit (ICU), nurses, and attitudes. @*Results@#: Five studies met the inclusion criteria; three of them were descriptive studies, one was a qualitative study, and one a mixed-method study. In most studies (80%), the participants were ED nurses. ED/ICU nurses showed positive or neutral attitudes toward patients. All studies suggested that suicide-related education programs are needed to increase nurses’ positive attitudes such patients. @*Conclusion@#: More research is required on ICU nurses’ attitudes toward patients who have attempted suicide, and efforts to identify various aspects of such attitudes are necessary. In addition, suicide education programs and support from trained psychiatric personnel should be provided to establish a therapeutic environment.

Gambling Subgroups among Korean Out-of-school Adolescents

Purpose@#The number of Korean adolescents engaging in gambling is increasing, especially among out-of-school adolescents. This study aimed to identify patterns of gambling activities and factors related to specific subgroups of out-of-school adolescent gambling activities. @*Methods@#This descriptive study analyzed secondary data from the 2015 Korea Youth Gambling Problem Survey, including 1,200 out-of-school adolescents. Latent class analysis was conducted to identify patterns of gambling activities. The factors related to gambling subgroups were verified with multinomial logistic regression. @*Results@#Three latent classes of gambling activities were identified: rarely gambling (RG), immediate gain gambling (IGG), and broad gambling (BG). These subgroups differed significantly in terms of gender, age at and type of first gambling experience, number and type of gambling activities, gambling frequency, time and money spent on gambling, problem gambling severity, and motivation for gambling. Compared to the RG subgroup, both the IGG and BG subgroups were strongly associated with an older age at the first gambling experience. @*Conclusion@#Out-of-school adolescents who first gambled at an older age and who gambled mainly in order to gain money immediately were at risk of problem gambling. Developing strategies for early screening and referral to professionals is necessary to prevent gambling problems from worsening.

Transition of Simulation-Based Learning in Nursing Schools: A Concept Analysis / 중환자간호학회지

PURPOSE: The purpose of this study was to identify the attributes, antecedents, and consequences of the transition of simulation-based learning (SBL) in nursing schools.METHODS: The study was conducted in accordance with Walker and Avant's conceptual analysis process. We searched MEDLINE, CINAHL, EMBASE, Google Scholar, and RISS (Korean Education and Research Information Service) databases, resulting in nine studies for an in-depth review.RESULTS: The attributes of transition of SBL include (1) preparing for a professional role, (2) practicing in a real clinical setting, and (3) progressing toward expected competency. Antecedents of the concept include novice status, changing roles, clinical experience in controlled settings, and expected competency in the clinical setting.CONCLUSION: The transition of SBL includes the important feature of progression toward expected competency. Further research is needed to identify graduate nurses' experiences during this transition to establish a strategy for improving it and developing a measurement tool that reflects attributes of the concept.

Path Analysis of Performance of Multidrug-Resistant Organisms Management Guidelines among Intensive Care Unit Nurses : With Focus on the Theory of Planned Behavior and Patient Safety Culture / 중환자간호학회지

PURPOSE: The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO).METHOD: Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized.RESULTS: The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %.CONCLUSION: The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

Critical Care Nursing Courses in Bachelor of Science in Nursing Programs: Present and Future Directions / 중환자간호학회지

PURPOSE: This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions.METHODS: The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi.RESULTS: Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing.CONCLUSION: The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients' health. It is necessary to develop a practical and integrative curriculum for critical care nursing education.

The Effects of Socio-demographic Factors, Acculturation Stress and Resilience on Depression among Mothers-in-law in Multicultural Families

PURPOSE: The purpose of this study was to investigate factors influencing depression among mothers-in-law in multicultural families. METHODS: For this study, 159 participants from multicultural familieswere recruited through administrative units of the B. & U. Metropolitan City and G. Province. Data related to acculturation stress, resilience, and depression were collected fromApril to August 2014 and analyzed through t-test, one-way ANOVA, Pearson correlation coefficients, and regression analysis with the SPSS/WIN 22.0 for Windows program. RESULTS: The participants had a moderate level of acculturation stress (2.43+/-0.75: range 1~5) and resilience (4.74+/-1.14: range 1~7). About 58% of the participants had depression. The results of stepwise multiple regression analysis indicated that mothersin-law's depression was affected by resilience (beta=-1.17, p<.001), acculturation stress (beta=0.85, p=.026), perceived economic level (beta=-0.83, p=.016), difficulty in physical activity (beta=-0.62, p=.027), relationship satisfaction (beta=-0.51, p=.035), and education level (beta=-0.48, p=.033). The explanatory power of these factors was 35%. CONCLUSION: The findings indicated the need to lower the level of depression by enhancing resilience and reducing acculturation stress among mothers-in-law in multicultural families. Future research to reduce depression among mothers-in-law inmulticultural families should consider how to enhance resilience and reduce acculturation stress.