Mediating Effects of Role Perception of Life-sustaining Treatment in the Relationship between Knowledge of Lifesustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among Nursing College Students / 한국호스피스완화의료학회지

Purpose@#This study examined the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among nursing college students, and attempted to identify the mediating effect of Role Perception on Life-sustaining Treatment in that relationship. It is hoped that the findings will ultimately contribute to the development of active nursing strategies. @*Methods@#The participants were 142 nursing college students in the third and fourth years of study who had experienced clinical practice at two universities in cities Y and C. Data were collected from November 1 to 30, 2019. For data analysis, SPSS for Windows version 22.0 was used to calculate descriptive statistics, the t-test, Pearson’s correlation coefficients, and multiple regression. To analyze the mediating effect, the Baron and Kenny bootstrapping method was used. @*Results@#Attitudes toward Withdrawal of Life-sustaining Treatment of nursing college students had a significant positive correlation with Knowledge of Life-sustaining Treat-ment Plans (r=0.34, P＜0.001) and Role Perception on Life-sustaining Treatment (r=0.44, P ＜0.001). Role Perception on Life-sustaining Treatment partially mediated the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment (95% CI, 0.446~1.055). @*Conclusion@#Based on the results of this study, improving nursing college students’ Role Perception on Life-sustaining Treatment could be used as a coping strategy to establish positive Attitudes toward Withdrawal of Life-sustaining Treatment.

Blood Pressure Reference Values for Normal Weight Korean Children and Adolescents: Data from The Korea National Health and Nutrition Examination Survey 1998–2016: The Korean Working Group of Pediatric Hypertension

BACKGROUND AND OBJECTIVES: Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents. METHODS: BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles. RESULTS: The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP. CONCLUSIONS: We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.

Blood Pressure Reference Values for Normal Weight Korean Children and Adolescents: Data from The Korea National Health and Nutrition Examination Survey 1998–2016: The Korean Working Group of Pediatric Hypertension

BACKGROUND AND OBJECTIVES@#Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents.@*METHODS@#BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles.@*RESULTS@#The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP.@*CONCLUSIONS@#We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.

Nutritional Intervention for a Patient with Acute Lymphoblastic Leukemia on Allogeneic Peripheral Blood Stem Cell Transplantation

Hematopoietic stem cell transplantation (HSCT) causes many complications such as anorexia, nausea, vomiting, diarrhea, and mucositis. Most patients undergoing HSCT have risk for malnutrition in the process of transplantation so artificial nutrition support is required. The purpose of this case report is to share our experience of applying nutrition intervention during the transplantation period. According to HSCT process, the change of the patient's gastrointestinal symptoms, oral intake and nutritional status was recorded. By encouraging oral intake and providing parenteral nutrition, the patient had only 0.3%, losing weight during the transplantation period. In conclusion, it emphasized that the nutritional status changes during the HSCT period should be closely monitored and nutritional management through appropriate nutritional support and interventions in hospital and after discharge.

Association of Dietary Quality Indices with Glycemic Status in Korean Patients with Type 2 Diabetes

The present study was performed to evaluate the relationship between dietary quality indices including the Diet Quality Index-International (DQI-I), Alternate Healthy Eating Index (AHEI), and Healthy Diet Indicator (HDI) and glycemic status in Korean patients with type 2 diabetes. A total of 110 consecutive outpatients with type 2 diabetes who visited 2 university hospitals in Seoul and Seongnam from April 2004 to November 2006 were enrolled as subjects. At the time of enrollment, anthropometric parameters, dietary habits, experience of exercise, and metabolic parameters were obtained. Experienced registered dietitians collected one-day dietary intake using the 24-hour recall method. The mean scores for DQI-I, AHEI, and HDI were 68.9 +/- 8.2, 39.4 +/- 8.9, and 5.0 +/- 1.3, respectively. After adjustment for age, body mass index, and energy intake, DQI-I and HDI were found to have a significant correlation with hemoglobin A1c (HbA1c) (r = -0.21, p < 0.05; r = -0.28, p < 0.05), fasting plasma glucose (r = -0.21, p < 0.05; r = -0.23, p < 0.05), and postprandial 2-h glucose (r = -0.30, p < 0.05; r = -0.26, p < 0.05, respectively). However, AHEI did not have a significant correlation with HbA1c. In conclusion, the DQI-I and HDI may be useful tools in assessing diet quality and adherence to dietary recommendations in Korean patients with type 2 diabetes. Future research is required to determine whether the dietary quality indices have predictive validity for dietary and glycemic changes following diet education in a clinical setting.

Academic Achievement, Self-directed Learning, and Critical Thinking Disposition According to Learning Styles of Nursing Students / 기본간호학회지

PURPOSE: This descriptive study was done to identify the academic achievement, self-directed learning (SDL), and critical thinking disposition (CTD) of nursing students according to their learning styles. METHOD: The participants were 240 nursing students. Data were collected using structured questionnaires which included Kolb's Learning Style Inventory, Academic Achievement in Fundamental Nursing and Health Assessment, Self Directed Learning Readiness Scale, and California Critical Thinking Disposition Inventory. Data were analyzed using chi2 test, ANOVA, Pearson' correlation coefficients, and Spearman rank correlation coefficient. RESULTS: One third of respondents were shown to be Convergers in their learning style (33.3%). The Academic Achievement of students who were Convergers was significantly higher than those who were Divergers or Accommodators (F=5.95, p=.001). The SDL and CTD of students who were Convergers were significantly higher than Divergers and Assimilators (F=9.67, p<.001 and F=8.42, p<.001). No significant correlations were found between Academic Achievement and SDL or CTD, but a statistically significant positive correlation was found between SDL and CTD (r=.68, p<.001). CONCLUSION: The findings of this study indicate that learning style influences academic achievement, SDL and CTD.

Knowledge, Attitude, and Practice of Obstetric Nurses in Relation to Breast Cancer and Breast Self-examination / 여성건강간호학회지

PURPOSE: This study aims to determine obstetrics nurses knowledge, attitude, and practice about breast cancer and breast self-examination (BSE), and to contribute to the early detection of breast cancer during breastfeeding periods. METHODS: For the survey, 163 individuals (obstetric nurses) were chosen by convenience sampling and agreed to participate in the study. Their knowledge, attitude, and practice about breast cancer and BSE. RESULTS: Knowledge and attitude averaged 70.45+/-10.90 (of 100) and 3.64+/-0.27 (of 5), respectively. While most nurses (99%) recognized the importance of BSE, only 58.9% experienced BSE. BSE practice level averaged 8.35+/-1.96 (of 12). Only 20.2% had recommended BSE to their clients. Practice level varied significantly for different marital status, breastfeeding experience, and education, while knowledge and attitude remained independent. Nurses who had experienced mammogram or breast ultrasonogram themselves scored higher in knowledge. Attitude was higher for nurses who received recommendation for BSE, performed BSE, received BSE education, or recommended BSE to clients. Practice level was higher for nurses who received BSE education or willing to perform BSE in future. Practice level had a positive correlation with attitude but no correlation to knowledge. CONCLUSION: Obstetric nurses need continuing education for practicing BSE. Practical BSE education can not only promote preventive behavior of nurses, but it can also improve the breast health management of obstetrical clients.

The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE)(n = 35), and the other receiving intensive nutritional education (IE)(n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p < 0.05) and systolic blood pressure (p < 0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p < 0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p < 0.05). Mean time taken for a dietitian to educate the subject was 67.9 +/- 9.3 min/person for BE group, while 96.4 +/- 12.2 min/person for IE group. Mean number of educational materials was 1.9 +/- 0.7/person for BE group and 2.5 +/- 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA1c, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.