Experience of the Collaborative Practice among Health Professionals in Korea / 중환자간호학회지

Purpose@#: This study aimed to understand and describe the experiences of collaborative practice among health professionals in Korea. @*Methods@#: Data were collected through individual in-depth interviews conducted from January to March 2021 with 10 health professionals in Korea. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. @*Results@#: Through content analysis, 10 categories and 3 themes were formed. Three themes, “working based on knowledge,” “having difficulty in building collaborative relationships,” and “playing complementary roles” emerged. @*Conclusion@#: The limitation is that the study participants are 10 health professionals in Korea working at healthcare institutions. However, this study is of great significance in that it provided basic data for preparing measures for collaborative practice among health professionals in Korea.

Influence of Postconceptional Age on the Renal Biomarkers in Very-Low-Birth-Weight Infants

Purpose@#We investigated whether consecutive levels of new emerging renal biomarkers, including serum cystatin C (CysC) and urinary neutrophil gelatinase-associated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in very-low-birth-weight (VLBW) infants. @*Methods@#Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association between renal biomarkers and postconceptional age was assessed using Pearson’s correlation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeated-measures analysis of variance. @*Results@#For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P28 days postnatally seems to be more affected by postconceptional age than serum CysC in VLBW infants.

Influence of Postconceptional Age on the Renal Biomarkers in Very-Low-Birth-Weight Infants

Purpose@#We investigated whether consecutive levels of new emerging renal biomarkers, including serum cystatin C (CysC) and urinary neutrophil gelatinase-associated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in very-low-birth-weight (VLBW) infants. @*Methods@#Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association between renal biomarkers and postconceptional age was assessed using Pearson’s correlation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeated-measures analysis of variance. @*Results@#For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P28 days postnatally seems to be more affected by postconceptional age than serum CysC in VLBW infants.

Influence of Caring Burden and the Way of Coping on Burnout in Caregivers of Cancer Patients / 한국직업건강간호학회지

PURPOSE@#The aims of this study were to identify the effects of caring burden and the way of coping on burnout in caregivers of cancer patients.@*METHODS@#One-hundred and forty family caregivers of cancer patients who visited the cancer center at one tertiary hospital in metropolitan city B were included. The data collection was conducted from August 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression.@*RESULTS@#In the multiple regression analysis, the subject's gender (β=.12, p=.028) and caring burden (β=.74, p<.001) had a significant effect on burnout. The explanatory power of the subject's gender, education level, religion, caring time, number of family caregivers, monthly income, economic burden, expectation for treatment, caring burden, the way of aggressive coping, and the way of passive coping with burnout was 63.8% (F=23.28, p<.001).@*CONCLUSION@#Reducing the caring burden in family caregivers of cancer patients will ultimately contribute to reducing burnout, thereby contributing to an improvement in the psychological well-being and quality of life of family members, as well as positively contributing to the recovery of patients.

Influence of Job Stress, Compassion Satisfaction and Resilience on Depression of Nurses / 한국직업건강간호학회지

PURPOSE@#This study aimed to identify the influence of job stress, compassion satisfaction, and resilience on depression of nurses.@*METHODS@#One hundred seventy six nurses working at one tertiary hospital in one metropolitan city were included. The data collection was conducted from September 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression.@*RESULTS@#The M±SD age of 170 subjects was 29.62±5.59. Depression had significant negative correlations with compassion satisfaction (r=−.50, p < .001) and resilience (r=−.56, p < .001), and a positive correlation with job stress (r=.42, p < .001). In the multiple regression analysis, marital status (β=−.15, p=.015), job stress (β=−.00, p < .001) and resilience (β=−5.47, p < .001) had a significant effect on depression. The explanatory power of the subject's marital status, leisure life, job stress, compassion satisfaction, and resilience on depression was 44.1% (F=27.62, p < .001).@*CONCLUSION@#The study results showed that single status, low job stress, high resilience may decrease depression of nurses. Reducing job stress and improving resilience of nurses will virtually contribute to reduce their depression that can influence on not only nurses' health status but also their performance and qualitative caring for patients.

Influence of Caring Burden and the Way of Coping on Burnout in Caregivers of Cancer Patients / 산업간호학회지

PURPOSE: The aims of this study were to identify the effects of caring burden and the way of coping on burnout in caregivers of cancer patients. METHODS: One-hundred and forty family caregivers of cancer patients who visited the cancer center at one tertiary hospital in metropolitan city B were included. The data collection was conducted from August 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression. RESULTS: In the multiple regression analysis, the subject's gender (β=.12, p=.028) and caring burden (β=.74, p<.001) had a significant effect on burnout. The explanatory power of the subject's gender, education level, religion, caring time, number of family caregivers, monthly income, economic burden, expectation for treatment, caring burden, the way of aggressive coping, and the way of passive coping with burnout was 63.8% (F=23.28, p<.001). CONCLUSION: Reducing the caring burden in family caregivers of cancer patients will ultimately contribute to reducing burnout, thereby contributing to an improvement in the psychological well-being and quality of life of family members, as well as positively contributing to the recovery of patients.

Influence of Job Stress, Compassion Satisfaction and Resilience on Depression of Nurses / 산업간호학회지

PURPOSE: This study aimed to identify the influence of job stress, compassion satisfaction, and resilience on depression of nurses.METHODS: One hundred seventy six nurses working at one tertiary hospital in one metropolitan city were included. The data collection was conducted from September 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression.RESULTS: The M±SD age of 170 subjects was 29.62±5.59. Depression had significant negative correlations with compassion satisfaction (r=−.50, p < .001) and resilience (r=−.56, p < .001), and a positive correlation with job stress (r=.42, p < .001). In the multiple regression analysis, marital status (β=−.15, p=.015), job stress (β=−.00, p < .001) and resilience (β=−5.47, p < .001) had a significant effect on depression. The explanatory power of the subject's marital status, leisure life, job stress, compassion satisfaction, and resilience on depression was 44.1% (F=27.62, p < .001).CONCLUSION: The study results showed that single status, low job stress, high resilience may decrease depression of nurses. Reducing job stress and improving resilience of nurses will virtually contribute to reduce their depression that can influence on not only nurses' health status but also their performance and qualitative caring for patients.

Innovative Behavior in Nursing Context: A Concept Analysis

PURPOSE: The aim of this study was to understand the concept of innovative behavior and its theoretical and practical implications for nursing. METHODS: Eight-step modification of Wilson's classic concept analysis procedure (1963) by Walker and Avant's (2005) was used to explore the antecedents, attributes, and consequences of innovative behavior in the literature. Electronic searches were conducted in PubMed, Google Scholar, OVID Medline, Science Direct, and ERIC databases using “innovative behavior” or “innovative work behavior”, “innovativeness”, “innovation”, “leadership”, “healthcare”, and “nursing” as keywords, with no limitation on publication date. RESULTS: Organizing the framework based on the method of concept analysis by Walker and Avant, defining attributes to innovative behavior were opportunity exploration, idea generation, idea search, idea communication, promotion of idea, idea championing, application, and overcoming obstacles. Antecedents to innovative behavior are categorized into three groups: organizational characteristics, work environmental characteristics, and individual characteristics. Consequences of innovative behavior included job productivity, lower levels of job burnout, job satisfaction, solving the organizational problems, organizational commitment, organizational efficiency, and effectiveness. CONCLUSION: Eight dimensions including opportunity exploration, idea generation, idea search, idea communication, idea promotion, championing, application, and overcoming obstacles were analyzed. We suggest promoting innovative behavior through leadership and management in nursing. Future research should focus on developing instruments and conducting empirical studies on innovative behavior in nursing research and practice.

Multiple daily injection of insulin regimen for a 10-month-old infant with type 1 diabetes mellitus and diabetic ketoacidosis

The incidence of type 1 diabetes is increasing worldwide, and the greatest increase has been observed in very young children under 4 years of age. A case of infantile diabetic ketoacidosis in a 10-month-old male infant was encountered by these authors. The infant's fasting glucose level was 490 mg/dL, his PH was 7.13, his pCO₂ was 15 mmHg, and his bicarbonate level was 5.0 mmol/L. The glycosylated hemoglobin level had increased to 9.4%. Ketonuria and glucosuria were detected in the urinalysis. The fasting C-peptide and insulin levels had decreased. The infant was positive for anti-insulin and antiglutamic acid decarboxylase antibodies. Immediately after the infant's admission, fluid therapy and intravenous insulin infusion therapy were started. On the second day of the infant's hospitalization and after fluid therapy, he recovered from his lethargic condition, and his general condition improved. Feeding was started on the third day, and he was fed a formula 5 to 7 times a day and ate rice, vegetables, and lean meat. Due to the frequent feeding, the frequency of rapid-acting insulin injection was increased from 3 times before feeding to 5 times, adjusted according to the feeding frequency. The total dose of insulin that was injected was 0.8-1.1 IU/kg/day, and the infant was discharged on the 12th day of his hospitalization. The case is presented herein with a brief review of the relevant literature.

Multiple daily injection of insulin regimen for a 10-month-old infant with type 1 diabetes mellitus and diabetic ketoacidosis

The incidence of type 1 diabetes is increasing worldwide, and the greatest increase has been observed in very young children under 4 years of age. A case of infantile diabetic ketoacidosis in a 10-month-old male infant was encountered by these authors. The infant's fasting glucose level was 490 mg/dL, his PH was 7.13, his pCO₂ was 15 mmHg, and his bicarbonate level was 5.0 mmol/L. The glycosylated hemoglobin level had increased to 9.4%. Ketonuria and glucosuria were detected in the urinalysis. The fasting C-peptide and insulin levels had decreased. The infant was positive for anti-insulin and antiglutamic acid decarboxylase antibodies. Immediately after the infant's admission, fluid therapy and intravenous insulin infusion therapy were started. On the second day of the infant's hospitalization and after fluid therapy, he recovered from his lethargic condition, and his general condition improved. Feeding was started on the third day, and he was fed a formula 5 to 7 times a day and ate rice, vegetables, and lean meat. Due to the frequent feeding, the frequency of rapid-acting insulin injection was increased from 3 times before feeding to 5 times, adjusted according to the feeding frequency. The total dose of insulin that was injected was 0.8-1.1 IU/kg/day, and the infant was discharged on the 12th day of his hospitalization. The case is presented herein with a brief review of the relevant literature.

Temporary Transcutaneous Pacing in a Low Birth Weight Preterm Neonate with Congenital Complete Atrioventricular Block: A Case Report

Congenital complete atrioventricular (AV) block is a rare neonatal disease. It is a passively acquired immune-mediated injury of the conduction system, triggered by transplacental passage of maternal anti-SSA/Ro and anti-SSB/La antibodies. Management of premature infants with symptomatic complete AV block is challenging. If medical treatment with a β-adrenergic agonist and inotropic drugs is not effective, early cardiac pacing should be considered. Here we report a case of congenital complete AV block in a low birth weight, preterm neonate, who was successfully treated with temporary transcutaneous pacing immediately after birth. Temporary transcutaneous pacing may be an option for the emergent management of a low birth weight preterm neonate with congenital complete AV block prior to permanent pacemaker implantation.

Single-port laparoscopic debulking surgery of variant benign metastatic leiomyomatosis with simultaneous lymphatic spreading and intraperitoneal seeding

Benign metastatic leiomyomatosis (BML) is a rare disease characterized by smooth muscle cell proliferation in extrauterine sites including the lung, abdomen, pelvis, and retroperitoneum. Depending on location, BML is classified as intravenous leiomyomatosis and diffuse peritoneal leiomyomatosis. Pathogenesis of BML can be iatrogenic after previous myomectomy or hysterectomy, hormonal, or coelomic metaplasia. Treatment options are observation, hormonal suppression, and/or surgical debulking via laparotomy or laparoscopy. Laparoscopic surgery is gaining in popularity in the gynecologic field compared to laparotomic surgery and single-port laparoscopy has the benefits of cosmesis and early tissue extraction by transumbilical morcellation. We report a 39-year-old woman with BML who underwent single-port laparoscopy debulking surgery.

A Case of Piriform Sinus Fistula Complicated with Suppurative Thyroiditis Treated with Chemocauterization Using Trichloroacetic Acid / 계명의대학술지

A 23 months-old girl visited the hospital because of fever and left neck mass. She was diagnosed as acute suppurative thyroiditis with piriform sinus fistula. Thyroid sonography showed perithyroidal abscess formation and thyroid scan showed decreased uptake of Tc-99m pertechnate of both thyroid glands. Magnetic resonance imaging of neck showed abscess cavity extending to the swollen left thyroid gland. And there was tiny fistula between thyroid and piriform sinus in the barium esophagogram. Streptococcus gordonii was isolated on needle aspiration culture. We report a case of piriform sinus fistula of the neck complicated with suppurative thyroiditis. The fistula was treated with chemocauterization using trichloroacetic acid.

Disability Intervention Model for Older Adults with Arthritis: An Integration of Theory of Symptom Management and Disablement Process Model

To evolve a management plan for rheumatoid arthritis, it is necessary to understand the patient's symptom experience and disablement process. This paper aims to introduce and critique two models as a conceptual foundation from which to construct a new model for arthritis care. A Disability Intervention Model for Older Adults with Arthritis includes three interrelated concepts of symptom experience, symptom management strategies, and symptom outcomes that correspond to the Theory of Symptom Management. These main concepts influence or are influenced by contextual factors that are situated within the domains of person, environment, and health/illness. It accepts the bidirectional, complex, dynamic interactions among all components within the model representing the comprehensive aspects of the disablement process and its interventions in older adults with rheumatoid arthritis. In spite of some limitations such as confusion or complexity within the model, the Disability Intervention Model for Older Adults with Arthritis has strengths in that it encompasses the majority of the concepts of the two models, attempts to compensate for the limitations of the two models, and aims to understand the impact of rheumatoid arthritis on a patient's physical, cognitive, and emotional health status, socioeconomic status, and well-being. Therefore, it can be utilized as a guiding theoretical framework for arthritis care and research to improve the functional status of older adults with rheumatoid arthritis.

The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes

PURPOSE: This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population. METHODS: This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients. RESULTS: In the regression model, diabetes knowledge (beta=.322, p<.001), exercise (beta=.337, p<.001), and experiences of diabetes education (beta=.241, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled. CONCLUSION: To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

Evaluation of the Seeplex(R) Meningitis ACE Detection Kit for the Detection of 12 Common Bacterial and Viral Pathogens of Acute Meningitis

BACKGROUND: Bacterial meningitis is an infectious disease with high rates of mortality and high frequency of severe sequelae. Early identification of causative bacterial and viral pathogens is important for prompt and proper treatment of meningitis and for prevention of life-threatening clinical outcomes. In the present study, we evaluated the value of the Seeplex Meningitis ACE Detection kit (Seegene Inc., Korea), a newly developed multiplex PCR kit employing dual priming oligonucleotide methods, for diagnosing acute meningitis. METHODS: Analytical sensitivity of the kit was studied using reference strains for each pathogen targeted by the kit, while it's analytical specificity was studied using the human genome DNA and 58 clinically well-identified reference strains. For clinical validation experiment, we used 27 control cerebrospinal fluid (CSF) samples and 78 clinical CSF samples collected from patients at the time of diagnosis of acute meningitis. RESULTS: The lower detection limits ranged from 101 copies/microL to 5x101 copies/microL for the 12 viral and bacterial pathogens targeted. No cross-reaction was observed. In the validation study, high detection rate of 56.4% was obtained. None of the control samples tested positive, i.e., false-positive results were absent. CONCLUSIONS: The Seeplex Meningitis ACE Detection kit showed high sensitivity, specificity, and detection rate for the identification of pathogens in clinical CSF samples. This kit may be useful for rapid identification of important acute meningitis-causing pathogens.

Seroprevalence of Toxoplasmosis in Pregnant Women in Daejeon, Korea

BACKGROUND: Toxoplasma gondii can cause devastating disease in the fetus and newborn infant. Serologic testing of pregnant women for Toxoplasma-specific antibodies can be used to identify those women at risk of transmitting Toxoplasma gondii infection. In Korea, despite a few reports on the seroprevalence of Toxoplasma (Toxo) antibody, the incidence of acute or chronic toxoplasma infection during pregnancy has not been well established. We performed a prospective screening for Toxoplasma antibodies to obtain a basic epidemiological data on the seroprevalence of acute and chronic toxoplasma infection. METHODS: During a 6-month period, 787 pregnant women at various weeks of gestation were enrolled in the prospective study. Toxo IgG and IgM antibodies were determined by the Abbott AxSYM Toxo IgG and IgM assays. Serum specimens showing positive results of both IgG and IgM antibodies were further tested using the Abbott ARCHITECT Toxo IgG Avidity test. RESULTS: The seropositivities of Toxo-specific IgG and IgM antibodies in this cohort were 2.3% (18/787) and 0.1% (1/787), respectively. No woman showed positive results for both Toxoplasma IgG and IgM antibodies. One specimen showing IgG positive and IgM grayzone results was tested by Toxo IgG avidity test and a low avidity test result (9%) was obtained, suggesting a possible acute primary infection. CONCLUSIONS: This study was the first trial on the investigation of the seroprevalence of both IgG and IgM antibodies in Korea, and we found that the seroprevalence of the antibodies was lower than that previously reported.

Proportions of Cells Expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ in the Regenerating Bone Marrows During Complete Remission of Acute Leukemia or After Bone Marrow Transplantation / 대한진단검사의학회지

BACKGROUND: The hemopoietic stem cells increase in number during the regeneration after chemotherapy or bone marrow transplantation (BMT). Although the proportion of hemopoietic stem cells and their differentiation have been studied by immunophenotyping using the flow cytometry, no substantial research efforts have been directed toward the regenerating marrow. We attempted to discover the proportions of undifferentiated stem cells, committed stem cells, B cell precursors, and myeloid precursors in the regenerating bone marrows during complete remission (CR) and after engraftment of BMT. METHODS: Bone marrow samples from 82 patients with acute leukemia in CR and from 25 patients after BMT engraftment, along with 22 control samples, were used to find the numbers of CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells in the large lymphocyte gate by flow cytometry. We cross-analyzed our results in terms of groups: CR, BMT, and initial diagnosis groups. We performed significance tests on age, relapse, chromosomal abnormalities, clinical outcomes, and initial immunophenotypes of the leukemic cells. RESULTS: The proportions of CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells are more highly distributed in acute B-lymphoblastic leukemia than the normal group and also in the CR than the BMT group. CD19+/CD34+ cells were increased in the relapse group and CD38+/ CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells were increased in the group with chromosomal abnormality. The results were irrelevant to the initial immunophenotype of the leukemic blasts. CONCLUSIONS: The increases of the markers spanned too widely to apply one specific cutoff value to analyze them. They seemed to be the results of normal regeneration, irrelevant to relapse or initial immunophenotype of leukemic blasts.

Usefulness of Automated PCR Test for the Detection of Mycobacterium Tuberculosis in Fresh Biopsy Tissues / 결핵및호흡기질환

BACKGROUND: Although there have been several studies regarding the clinical value of an automated TB-PCR study using sputum, bronchial washing, and other body fluid samples for the detection of pulmonary tuberculosis, there are only a few reports on the use of fresh tissue samples. MATERIALS AND METHODS: The acid-fast bacilli stain(AFB), tuberculosis culture, automated TB-PCR study, and histopathology examination were performed in 42 fresh tissue samples. RESULTS: Among the 42 cases, 18 cases were diagnosed with tuberculosis based on the clinical findings. Sixteen of the 18 cases were TB-PCR positive and of these 16 cases, only 2 cases were positive in the AFB stain or culture study. However, all 18 cases showed the histopathology findings of chronic granulomatous inflammation that was compatible with tuberculosis. Based on the clinical findings, the sensitivity, specificity, positive predictability, and negative predictability of the automated TB-PCR study were 88.9%, 100%, 100%, and 92.3% respectively. CONCLUSION: An automated TB-PCR assay is an important diagnostic tool for diagnosing tuberculosis in fresh tissue samples.

Morphometric Analysis for Cytological Diagnosis of Thyroid Papillary Carcinoma / 대한세포병리학회지

The diagnosis of papillary thyroid cancer is generally based on the findings of intranuclear cytoplasmic inclusions and nuclear grooves. Although anisokaryosis and poikilokaryosis, in papillary thyroid cancer, are not distinct when compared to other cancers, cytological examination can provide useful preoperative information. Our study evaluated the diagnostic role of computer-assisted image analysis for the pre-surgical assessment of papillary thyroid carcinoma. Thyroid aspirates from twenty female patients who were histologically confirmed to have both papillary carcinoma and benign nodules were studied. Different populations of 50 benign cells and 50 malignant cells were analyzed. Five morphometric parameters were selected for analysis: nuclear area, perimeter, maximum length, maximum width and intensity standard variation. The values obtained for papillary carcinomas were higher than the surrounding benign nodules as follows: nuclear area 63.5 vs. 36.1 (p=0.000), nuclear perimeter were 29.4 vs. 22.0 (p=0.000), maximum length 9.6 vs. 7.1 (p=0.000), maximum width 8.2 vs. 6.3 (p=0.000), the ratio between maximal length and maximal width 1.16 vs. 1.13 (p=0.000), the standard variation of intensity 14.9 vs. 15.9 (p=0.101) respectively. Therefore, morphometric information can be helpful for the differential cytological diagnosis of papillary thyroid carcinoma.