Empowering Healthcare through Comprehensive Informatics Education: The Status and Future of Biomedical and Health Informatics Education / 대한의료정보학회지

Objectives@#Education in biomedical and health informatics is essential for managing complex healthcare systems, bridging the gap between healthcare and information technology, and adapting to the digital requirements of the healthcare industry. This review presents the current status of biomedical and health informatics education domestically and internationally and proposes recommendations for future development. @*Methods@#We analyzed evidence from reports and papers to explore global trends and international and domestic examples of education. The challenges and future strategies in Korea were also discussed based on the experts’ opinions. @*Results@#This review presents international recommendations for establishing education in biomedical and health informatics, as well as global examples at the undergraduate and graduate levels in medical and nursing education. It provides a thorough examination of the best practices, strategies, and competencies in informatics education. The review also assesses the current state of medical informatics and nursing informatics education in Korea. We highlight the challenges faced by academic institutions and conclude with a call to action for educators to enhance the preparation of professionals to effectively utilize technology in any healthcare setting. @*Conclusions@#To adapt to the digitalization of healthcare, systematic and continuous workforce development is essential. Future education should prioritize curriculum innovations and the establishment of integrated education programs, focusing not only on students but also on educators and all healthcare personnel in the field. Addressing these challenges requires collaboration among educational institutions, academic societies, government agencies, and international bodies dedicated to systematic and continuous workforce development.

Mediating Effects of Health literacy on the Relationship between Patient Safety Environment and Patient Safety Participation in Inpatients / 간호행정학회지

Purpose@#This study aimed to verify the effect of patient safety environment (PSE) and health literacy (HL) on patient safety participation (PSP) and the mediating effect of HL. @*Methods@#We recruited patients who were hospitalized at a tertiary general hospital in “D” city. A total of 230 people responded to a questionnaire survey we conducted from March 15 to July 10, 2020. The collected data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficient analysis, and hierarchical regression using SPSS/WIN 26.0. @*Results@#PSP was found to be significantly associated with PSE (r=.29, p<.001) and HL (r=.44, p<.001). PSE and HL were found to have a significant effect on PSP (power: 23%). HL was found to have a partial mediating effect (indirect effect: 0.09, 95% CI: 0.04~0.14) between PSE and PSP. @*Conclusion@#The findings from this study can contribute to developing interventions for patient participation in the PSE and providing directions for offering safe and high-quality medical care to patients.

Effect of Infection Control Education Based on Isolation Room-Simulation for Nursing Students / 간호행정학회지

Purpose@#This study aimed to analyze the effects of infection control education (ICE) prospectively, based on isolation room simulation for nursing college students. @*Methods@#From September 21 to 30 2020, a total of 97 students in the 4th grade of nursing college located in D city, were enrolled (48 in the experimental group and 49 in the control group).The experimental group received an isolation room simulation for ICE. The control group conducted an objective structured clinical evaluation for the same education. The effects after education were evaluated using the items of awareness of standard precaution, knowledge of wearing personal protective equipment (PPE), and confidence in wearing it. @*Results@#There was no statistically significant difference in the awareness of standard precautions between the two groups, and the knowledge of wearing PPE was significantly higher in the experimental group (t=-3.41, p<.001) after education. The confidence score for wearing PPE was also significantly higher in the experimental group (t=-2.23, p=.028). @*Conclusion@#The ICE using the isolation room simulation can be effective for knowledge and confidence regarding the aspect of wearing PPE for nursing students, during and after the pandemic.

Effects of a Mobile-App-Based Self-Management Support Program For Elderly Hemodialysis Patients / 대한의료정보학회지

ObjectivesTo identify the effects of a mobile-app-based self-management program for elderly hemodialysis patients on their sick-role behavior, basic psychological needs, and self-efficacy.MethodsA nonequivalent control group with a non-synchronized design was utilized, and 60 participants (30 in each of the experimental and control groups) were recruited from Chungnam National University Hospital from March to August 2018. The program consisted of continuous training on how to use the mobile-app, self-checking via the app, message transfer through Electronic Medical Records, and feedback. The control group received the usual care. Data were analyzed using the χ2-test, the t-test, the repeated-measures ANOVA, and the McNemar test. A formalized messaging program was developed, and the app was developed with consideration of the specific physical and cognitive limitations of the elderly.ResultsComparisons were conducted between the experimental (n = 28) and control (n = 28) groups. Statistically significant increases in sick-role behavior, basic psychological needs, and self-efficacy were found in the experimental group (p < 0.001). Physiological parameters were maintained within the normal ranges in the experimental group, and the number of non-adherent patients decreased, although the change was not statistically significant.ConclusionsThe mobile-app-based self-management program developed in this study increased the sick-role behavior, basic psychological needs, and self-efficacy of elderly hemodialysis patients, while physiological parameters were maintained within the normal range. Future studies are needed to develop management systems for high-risk hemodialysis patients and family-sharing apps to manage non-adherent patients.

ICT-Based Comprehensive Health and Social-Needs Assessment System for Supporting Person-Centered Community Care / 대한의료정보학회지

OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.

A Predictive Model on Patient-Centered Care of Hospital Nurses in Korea

PURPOSE@#Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required.@*METHODS@#The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables.@*RESULTS@#The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care.@*CONCLUSION@#These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.

A Predictive Model on Patient-Centered Care of Hospital Nurses in Korea

PURPOSE: Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required. METHODS: The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables. RESULTS: The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care. CONCLUSION: These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.

Psychometric Validation of the Korean Version of the Camberwell Assessment of Need for the Elderly in Individuals with Dementia

PURPOSE: The prevalence of dementia has increased rapidly with an aging Korean population. Compared to those without dementia, individuals with dementia have more and complex needs. In this study, the Korean version of the Camberwell Assessment of Need for the Elderly (CANE-K) was evaluated to determine its suitability for individuals with dementia in Korea. METHODS: The CANE-K was developed following linguistic validation. The reliability of the measurement was examined with Cronbach α coefficient. The factor structure and construct validity were evaluated by performing exploratory factor analysis and confirmatory factor analyses. Pearson's correlation coefficients with related measures were used to ensure concurrent validity. RESULTS: Four factors extracted with exploratory factor analysis and confirmatory factor analyses validated the model structure (χ² = 367.25, p < .001, goodness-of-fit index = .84, adjusted goodness-of-fit index = .80, root mean square error of approximation = .07, and comparative fit index = .83). Items on the CANE-K loaded on the four factors in a range between .40 and .80. The output of Pearson's correlation coefficient with cognitive impairment, behavioral problems, activities of daily living, and caregiver burden showed acceptable concurrent validity. CONCLUSION: The CANE-K showed a reasonable degree of reliability and validity. Therefore, it has good potential to appropriately measure the needs and unmet needs of those with dementia.

Factors Influencing Nurses' Implementation of Evidence-based Fall Management in Geriatric Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to identify factors that influence nurses' implementation of evidence-based fall management in geriatric hospitals. METHODS: Data from the Evidence Based Practice Survey of Fall Management in Geriatric Hospitals were examined for this study. The participants were 248 nurses from geriatric hospitals. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation analysis, and stepwise regression. RESULTS: Factors related to implementation of evidence-based fall management were belief in evidence-based practice with organizational culture, work experience, use of fall guideline, and experience of patient falls. These factors explained 56.7% of variance in implementation of evidence-based fall management. Among these factors, the significant predictors for implementation of evidence-based fall management were belief in evidence-based practice, organizational culture of evidence-based practice, work experience, use of fall guideline and experience of patient falls. CONCLUSION: Results of this study suggest that it is necessary to develop a systematic program to enhance nurses' belief in evidence-based practice at the individual level. In addition, fostering organizational culture toward evidence-based practice and disseminating fall management guidelines at the organizational level can be important strategies to enhance evidence-based fall management in geriatric hospitals.

A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers

PURPOSE: The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers. METHODS: The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program. RESULTS: Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction. CONCLUSION: Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.

Effects of Family Support Programs for Caregivers of People with Dementia - Caregiving Burden, Depression, and Stress: Systematic Review and Meta-analysis

PURPOSE: The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia. METHODS: A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes. RESULTS: Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chisquare test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25). CONCLUSION: The review results indicate that a support programs can assist family caregivers in reducing their psycho-emotional distress.

Implementing Evidence into Practice for Best Dementia Care

PURPOSE: The purpose of this paper was to discuss the need for translation studies in dementia care and current translational endeavors, and to provide recommendations for evolving evidence-based dementia care. METHODS: A literature review yielded current evidence and translational efforts. RESULTS: Dementia care interventions need to be implemented at various service levels. Barriers to translation include evidence gaps, lack of the use of a conceptual framework to explain the implementation process, and unsupportive funding mechanisms for applying innovations. CONCLUSION: There is clear evidence of the need for and benefits of evidence-based dementia care for patients with dementia, family caregivers, and care professionals. The urgent need now is finding ways to advance translational activities and facilitate future research into translation science.

Knowledge Discovery in a Community Data Set: Malnutrition among the Elderly / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to design a prediction model that explains the characteristics of elderly adults at risk of malnutrition. METHODS: Data were obtained from a large data set, 2008 Korean Elderly Survey, in which the data of 15,146 subjects were entered. With nutritional status a target variable, the input variables included the demographic and socioeconomic status of participants. The data were analyzed by using the SPSS Clementine 12.0 program's feature selection node to select meaningful variables. RESULTS: Among the C5.0, C&R Tree, QUEST, and CHAID models, the highest predictability was reported by C&R Tree with the accuracy rate of 77.1%. The presence of more than two comorbidities, living alone status, having severe difficulty in daily activities, and lower perceived economic status were identified as risk factors of malnutrition in elderly. CONCLUSIONS: A reliable decision support model was designed to provide accurate information regarding the characteristics of elderly individuals with malnutrition. The findings demonstrated the good feasibility of data mining when used for a large community data set and its value in assisting health professionals and local decision makers to come up with effective strategies for achieving public health goals.

Knowledge, Attitude, and Confidence on Patient Safety of Undergraduate Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to determine undergraduate students' level of knowledge, attitude, and confidence toward patient safety. METHODS: A descriptive survey design was used. The subjects consisted of 932 senior nursing students who have had clinical practice in nursing schools in a metropolitan city in Korea. The data were collected from March 4th to 28th in 2011. Knowledge, attitude, and confidence on patient safety were measured using self administered questionnaires. Data were analyzed with SPSS 18.0 using descriptive statistics, t-test, One-Way ANOVA, and Pearson correlation coefficient. RESULTS: Knowledge of patient safety was relatively low and attitude and confidence were at moderate level. There were statistically significant differences in knowledge, attitude, and confidence toward patient safety according to gender, educational system, grades, satisfaction with nursing major or clinical practice, and experience of patient safety education or patient safety campaign. There was a significant positive correlation among knowledge, attitude and confidence on patient safety. CONCLUSION: The study findings suggests that concept and skills on patient safety need to be educated systematically during undergraduate curriculum linked with clinical practicum.

Comparison of Demographic Characteristics, Comorbidity, and Health Habits of Older Adults with Mild Cognitive Impairment and Older Adults with Normal Cognitive Function

PURPOSE: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). METHODS: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. RESULTS: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. CONCLUSION: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.

Development and Evaluation of a Computerized Multimedia Approach to Educate Older Adults about Safe Medication

PURPOSE: Interactive multimedia education using computer technology is increasing in the area of health education. The purpose of this study was to examine the effects of interactive multimedia education on community dwelling older adults' self-efficacy and knowledge for medication and level of satisfaction with the education program. METHODS: A nonequivalent control group pretest and post-test design was used in this study. The multimedia education was designed to enhance safe medication of older adults. Education consisted of seven modules which contained the medication name, usage, side effects, interactions, and storage requirements. Computerized interactive learning activities consisted of multimedia animations and games. A total of 60 older adults from two local senior centers were recruited and assigned to the experimental and control group. Twenty-six participants in experimental group used the interactive multimedia education on laptop computers. RESULTS: Participants receiving interactive multimedia education had significantly higher self-efficacy (F = 20.03, p < .001) and knowledge (F = 36.26, p < .001) scores than the control group did at post intervention. The experimental group indicated a high degree of satisfaction with the interactive multimedia education. CONCLUSION: The study results suggest that the interactive multimedia education is an effective teaching method that empowers older adults to facilitate individual learning using computer technology.

Implementation of Evidence Based Nursing Education into Nursing Management Clinical Practicum: Outcome Evaluation and Diffusion Strategies / 간호행정학회지

PURPOSE: This practice study was done to describe the process and outcomes of application of Evidence Based Nursing (EBN) Education to nursing management clinical practicum and suggest strategies to diffuse EBN into nursing management education. METHODS: Education on the evidence based nursing management process was provided to 65 senior nursing students from a university. Nursing management clinical practicum integrated with EBN. The setting was a five full day-clinical practicum. Group and individual training on EBN process with lectures, small group discussions, conferences, and educational prescription were provided. Outcomes were analyzed using paired t test for 65 participants. RESULTS: Evidence based nursing competency increased significantly showing improvement in understanding EBN, formulating clinical question, searching & classifying the evidence, recognizing level of evidence, considering patient preference, and evaluating outcomes. Nursing students' access and use of evidence based information resource also improved. CONCLUSION: The results of this study indicate that the application of EBN to nursing management clinical practicum is effective to improve EBN competency in undergraduate students and should be further applied in nursing education using the systematic strategies.

Analysis of the Characteristics of the Older Adults with Depression Using Data Mining Decision Tree Analysis

PURPOSE: The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. METHODS: A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. RESULTS: The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. CONCLUSION: The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Effects of Interactive Pictorial Education on Community Dwelling Older Adult's Self Efficacy and Knowledge for Safe Medication

PURPOSE: The purpose of this study was to examine the effects of interactive pictorial education on community dwelling older Korean adults' self-efficacy and knowledge for safe medication. METHODS: A quasi-experimental, three-group pre- and post-intervention design was used in this study. The interactive pictorial education was designed to suit the learning patterns and psychomotor skills of older adults. The education content, dealing with safe medication, was delivered over three sessions. A total of 136 older adults from local senior centers were assigned to one of the three groups: a) interactive pictorial education plus information booklet (experimental); b) education only with information booklet (conventional); or c) no intervention (control). RESULTS: Participants receiving interactive pictorial education had significantly higher self-efficacy (F=24.32, p<.001) and knowledge (F=24.26, p<.001) scores than the information booklet or control group at post intervention. Post-hoc analyses indicated that both the interactive pictorial and the information booklet groups had significantly higher self-efficacy and knowledge scores than the control group at the post-test point (p<.05). Furthermore, the interactive pictorial group had higher self-efficacy and knowledge scores than the information booklet group at the post-test point (p<.05). CONCLUSION: These results suggest that the interactive pictorial education is an innovative approach that provides a means for older adults to learn appropriate medication use to improve their own health. It empowers older adults with different literacy levels to enhance their self-efficacy and knowledge for the safe use of medication.

Family Membe's Caregiving Stress and Satisfaction of Care for Patients with Dementia in Long Term Care Facilities and Day Care Centers / 성인간호학회지

PURPOSE: This study was to explore family member's caregiving stress and satisfaction of care for patients with dementia in long term care facilities and day care centers. METHODS: The subjects were 129 family members of elders with dementia from ten long term care facilities and eight day care centers in Daegu and Kyungsangbukdo. Data were collected from August to October, 2007. The instruments were self administered questionnaires and included. The Family Perceptions of Caregiving Role (FPCR) and the Family Perceptions of Care Tool (FPCT) which were developed by Maas and Buckwalter (1990) and translated by Park (2002). RESULTS: Family member's care giving stress in day care centers were higher than that of long term care facilities (t=-2.89, p=.005) especially in the categories of captivity (t=-3.27, p=.001), guilty (t=-2.93, p=.004), and loss (t=-2.44, p=.016). Family member's satisfaction of care in day care centers was higher than that of long term care facilities (t=-3.21, p=.002) in the (use - categories or measures since you are referring to the instrument and delete aspects) aspects of effective management (t=-3.69, p=.000) and activity (t=-2.00, p=.045). CONCLUSION: The results of this study showed that family members' perceptions toward their care giving roles and satisfaction of care differ whether the facilities are long term care or day care centers. This study provides baseline data that could be used for improving the quality of long term care services.