Trend Analysis of Research Articles Published in Child Health Nursing Research 2014

PURPOSE: This descriptive study was performed to explore trends in child health nursing research by analyzing the themes, contents and structure of articles published in 2014 in Child Health Nursing Research, the official journal of the Korean Academy of Child Health Nursing. METHODS: Thirty-eight articles were reviewed using keywords, author (s), subjects, ethical considerations, designs, statistics involved, funding resources, and others. RESULTS: Ten domains from 160 keywords were identified as follows, child related, psycho-social variable related, parents and family related, nursing and health related, and others. A mean of 2.9 authors per article was identified and 71% of the authors were academic- affiliated. Twenty-eight articles were human-participant related while 21 articles addressed both Institutional Review Board and written consent. Non-experimental design was the most commonly used method followed by experimental design, and qualitative design. The duration for acceptance was a mean of 89.1 days from submission with most articles requiring a second round of article review. Half of the articles were supported by grant organizations such as Korean National Research Foundation. CONCLUSION: The findings of the analysis show an improvement in the scientific quality with a diversity of articles in Child Health Nursing Research.

Endometrial cancer occurence five years after breast cancer in BRCA2 mutation patient

We recently experienced a case of endometrial cancer 5 years after the diagnosis of breast cancer in a patient with a mutation in the BRCA2 gene. A 55-year-old Korean woman who had a past history of breast cancer in her 50s underwent an operation for endometrial cancer. Final pathology confirmed stage Ia, and no adjuvant treatment was performed. After surgery, considering her history of sequential cancer occurrence, genetic counseling was offered. The result showed the BRCA2 variation of unknown significance mutation. This is the first case report of sequential cancers (endometrial and breast) in a patient with a BRCA2 mutation among a Korean population.

A case of huge retroperitoneal liposarcoma in pregnancy

A 39-year-old woman was referred to our hospital at 28+2 week gestation. Routine obstetric examination revealed a palpable pelvic mass. Initial investigation by magnetic resonance imaging demonstrated a huge solid mass with heterogeneous enhancement that completely filled the right side of the abdomen. She underwent two surgeries: a programmed cesarean section by Department of Obstetrics and Gynecology team and a laparotomy performed by the General Surgery team. Final diagnosis was de-differentiated liposarcoma (French Federation Nationale des Centres de Lutte Contre le Cancer grade 2/3). She has been treated with radiation therapy focusing on high risk area of retroperitoneum followed by adjuvant chemotherapy (doxorubicin and ifosfamide). Below is the full case with literature review.

Clinical impact of symptom-to-door time on 1-year mortality in patients with non-ST segment elevation acute myocardial infarction / 대한내과학회지

BACKGROUND/AIMS: Symptom-to-door time is associated with the prognosis for ST-segment elevation myocardial infarction. However, this value has not been a concern in patients with non-ST segment elevation myocardial infarction (NSTEMI). The aim of this study was to assess the relationship between symptom-to-door time and clinical outcomes in patients with NSTEMI. METHODS: In total, 1,971 patients with NSTEMI (64.8+/-12.1 years, 23.6% women) were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into two groups according to the time difference between the presentation of symptoms and first medical contact: group I (12 hours, n=538). One-year mortality rates were compared between the groups. Thrombolysis In Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores were calculated in all study patients. RESULTS: The mean age was 64.4+/-12.2 years in group I and 65.6+/-12.0 years in group II (p=0.046). No significant differences existed between the two groups, except for the prevalence of hypertension, diabetes mellitus, initial systolic blood pressure, and initial serum creatinine levels. One-year mortality rates decreased significantly in group I patients [hazard ratio (HR)=1.35, 95% CI (confidential interval): 1.03~1.75, p=0.028] based on a multivariate Cox proportional analysis, which was adjusted by GRACE score, baseline characteristic variables, and predictors of a 1-year mortality in a univariate analysis. In intermediate-to high-risk patients (n=1,184, defined as having a TIMI risk score above 3 points), significant differences were observed in mortality rates between the two groups (HR=1.35, 95% CI: 1.02~1.80, p=0.037); the low-risk patients (n=787, HR=1.57, 95% CI: 0.80~3.05, p=0.188), however, showed no such differences. CONCLUSIONS: Symptom-to-door time was an independent long-term clinical predictor in patients with NSTEMI, especially in intermediate-to high-risk groups.

Hospital Nurses' Experience of Do-Not-Resuscitate in Korea / 간호학회지

PURPOSE: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. METHODS: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. RESULTS: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. CONCLUSION: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

The Life of Elderly Women Living Alone

PURPOSE: This study aimed to uncover the fundamental nature of living alone in female elderly. METHODS: The phenomenological research approach developed by van Manen was adopted. RESULTS: The theme was 'taking a firm stand alone on the edges of life'. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children's filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died. CONCLUSION: A nurse should understand the multifarious aspects of elderly women's life, and then intervene to consolidate their strengths for self-supporting the final years of life.

Characteristics of Nursing Performance based on the Expertise among ICU Nurses / 성인간호학회지

PURPOSE: The purpose of this research was to describe how nurses in intensive care units (ICU) work. METHOD: A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. RESULTS: Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. CONCLUSION: The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.

The Lived Experience of Mothers of Children with Muscular Dystrophy / 아동간호학회지

The purpose of this phenomenological study was to understand the lived experience of mothers of children with muscular dystrophy. The participants were 11 mothers recruited by snowball sampling, who agreed with the objectives of the research and could verbally communicate with the researcher and who lived with their sons who had muscular dystrophy. Data collection was done through in-depth interviews with participants in their own homes. Each interview took 50 to 120 minutes. All of the interviews were audiotaped and then transcribed. Data were analyzed using Colaizzi's (1978) method of phenomenology. From the transcripts 109 significant sentences and phrases were selected and 13 clusters of themes were categorized from 67 significant statements. These results were integrated into the essential structure of the lived experience of mothers of children with muscular dystrophy. 1.Anxious and relying on chance due to indefinite diagnosis. 2. Only able to cry with shock because of son's fatal disease. 3.Seeing the future as dismal and feeling resentment that this disease in transmitted through the mother. 4.Feeling caught between a husband who is distancing himself from his family and the family which is disintegrating. The author would like to thank Dr. Kasil Oh at Yonsei University, College of Nursing for her guidance, 5.Feeling like a sinner for transmission of genetic disease(Feeling guilt for conceiving a son with a genetically transmitted fatal disease). 6. Empathizing with other suffers of muscular dystropy and their parents in their grief and helping to dissipate their heavy feelings. 7. Deciding to sacrifice self as a way of taking responsibility for giving birth to a handicapped son. 8.Losing hope (feeling despair) as son's condition deteriorates in spite of all attempts to help him. 9.Wishing to die with son who becomes progressively immobile. 10. Accumulating Han, because of rising Hwa(anger), and becoming sick both mentally and physically. 11.Seeing events as destiny and finding self-control through faith. 12.Finally, giving up sacrificing self for son and becoming concerned(involved) with other children in the family. 13.Feeling fear at son's impending death. This is the first research on the experience of Korean mothers of children with muscular dystrophy. In applying the phenomenology research method, this study not only helps health professionals understand the experience of these mothers in the Korean patriarchal social system, but the researcher, as a nurse, can share their agony and grief through identification of their inner world through in-depth personal interviews. The results obtained in this study will not only help in the development of family nursing practice for families with genetically transmitted diseases but also prepare basic data for family nursing practice in the Korean sociocultural context.

Expertise in ICU Nursing: A Qualitative Approach / 간호학회지

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.

The Lives of Daughters-in-Law Who Care for Parents with Dementia / 간호학회지

This study was done to investigate the lives of the daughters- in- law caring for parents with dementia and participate in their lives through having quality time with them. Data were collected by depth interviews and interpreted through the hermeneutic circle as follows. These daughters-in-law have conflict between social custom and subjective self. They had ambivalence toward their demented partents-in- law and were fighting a battle between rationality and emotions in their mind. These daughters-in law and mothers-in- law did not get along and the parents' dementia aggravated the relationships. They were alienated from their family by the parents with dementia. The indifference of their family especially their husbands, made these subjects live in misery. They cared for the demented mother-in-law with hatred. Even though they had this yoke, there daughters- in-law were not able to throw off the shackles of convention.

Study on the Effects of the Supportive Nursing Intervention Program for Body Image and Self Esteem of the Child with Cancer / 간호학회지

The increased potential for the lifespan of a child with cancer is largely due to advance in drug treatment, radiation treatment, and surgical techniques. In this generation cancer has become associated with chronic illness. Therefore supportive nursing intervention for children with cancer is needed to promote normal growth and development. This study was designed to develop and test the supportive nursing intervention program for promoting body image and self-esteem of children with cancer. The supportive nursing intervention program involved emotional, physical, informational, and social support. The subjects were 41 children with cancer(20 in intervention group, 21 in control group) in K city. Measurements were taken concerning body image and self-esteem from both groups during pre and post test. The data were analyzed using Cronvach's alpha, x2-test, paired t-test and t-test. The results were as follows: The intervention group had a more positive body image as measured by the Body Cathexis Scale(t=2.436, p=.020) and a more self esteem as measured by the Cpopersmith self-inventory (t=2.768, p=.009) than the control group at post test. According to this study, the supportive nursing intervention program was effective for promoting the body image and self-esteem of children with cancer. Repeated research is needed to develop a refined supportive nursing intervention program for children with chronic illness.