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BACKGROUND: The increased survival rate among individuals with CHD has sparked interest in their transition to adult healthcare. Although there is a general agreement on the importance of transition interventions, the empirical evidence supporting them is insufficient. Therefore, this study aimed to conduct a systematic review and meta-analysis of transition interventions for adult healthcare in adolescents and young adults. METHODS AND RESULTS: A literature search was conducted for studies comparing the quantitative effects of transition interventions with control groups, published up to March 15, 2023, in major databases (CENTRAL, Embase, PubMed, Web of Science, CINAHL, KISS, and KMbase), major clinical trial registries, academic journal sites related to the topic, and grey literature databases. Ten studies involving a total of 1,297 participants were identified. Transition interventions proved effective in enhancing disease-related knowledge (Hedge's g = 0.89, 95% CI = 0.29-1.48) and self-management (Hedge's g = 0.67, 95% CI = 0.38-0.95), as well as reducing loss to follow-up (OR = 0.41, 95% CI = 0.22-0.77). The certainty of evidence for the estimated values of each major outcome was low or very low. CONCLUSIONS: This study supports the implementation of transition interventions by demonstrating that they can improve patients' disease knowledge and self-management, while also promoting treatment continuity. However, since the available data on transition interventions for adolescents and young adults with CHD remain limited, the widespread adoption of structured transition interventions in the future may alter the conclusions of this study. REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO. Unique identifier: CRD42023399026.
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BACKGROUND: The debriefing process after health care simulations should provide a psychologically safe learning environment for nursing students. Case video-based debriefing on a simulation of high-risk neonatal care can help nursing students feel psychologically safe and make learning more effective. In this study, we developed case video-based debriefing materials for a simulation of high-risk neonatal care for nursing students in South Korea and evaluated their effects. METHODS: This mixed-methods study, consisting of a survey and an in-depth interview, was conducted between August and December 2022. The participants were 27 nursing students for the development of the case video-based debriefing and 51 nursing students for the evaluation of its effects (25 in the experimental group and 26 in the control group) at a university in South Korea. A case video-based debriefing on a simulation of high-risk neonatal care was developed, and the experimental group took part in case video-based debriefing. The participants' self-efficacy, critical thinking, state anxiety, and satisfaction with practice were examined. The experimental group's learning experiences were explored. Quantitative data were analyzed using the chi-square test, the unpaired t-test, and repeated-measures analysis of variance. Qualitative content analysis was conducted. RESULTS: In the experimental group, critical thinking and satisfaction with practice increased to a greater extent than in the control group. However, the changes in self-efficacy and state anxiety were not significantly different between the experimental and control groups. Four categories were extracted from nursing students who participated in the case video-based debriefing: "learning facilitated by the simulation," "expanded learning," "safe learning environment," and "efficient utilization of case videos." CONCLUSIONS: Case video-based debriefing on a simulation of high-risk neonatal care effectively enhanced nursing students' critical thinking and satisfaction with practice, and it will be utilized to improve nursing students' competency in high-risk neonatal care.
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PURPOSE: We developed a virtual reality (VR) program for use in pediatric nursing practicums to help nursing students learn to measure vital signs in children. METHODS: The analysis, design, development, implementation, and evaluation model was employed between July 2021 and December 2021 at a university in South Korea. In the analysis phase, in-depth interviews were conducted with four nursing students, two nursing school graduates, and four experts. The topic and contents of the VR program were settled in the design phase. The VR program was developed and subsequently used and evaluated by 20 nursing students and four experts. RESULTS: The contents of the VR program for pediatric nursing practicums included the measurement of vital signs in a newborn baby and a young child, as well as an evaluation system. The mean score for the nursing students' satisfaction with practice was 4.02 out of 5 points. The mean scores for overall satisfaction with the VR program were 4.15 and 4.79 out of 5 points for nursing students and experts, respectively. CONCLUSION: The VR program developed in this study allows nursing students to practice measuring vital signs in children, thus improving the students' clinical performance in pediatric nursing.
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PURPOSE: This study aimed to explore nursing students' experiences of neonatal nursing simulations using peer tutoring. METHODS: In this qualitative content analysis study, data were collected using a narrative survey and focus group interviews with 27 third-year nursing students and six fourth-year nursing students from April to May 2022. Content analysis of the collected data was conducted. RESULTS: Four categories-"stabilizing emotionally through each other", "advancing together", "difficulties in relationships", and "hoping to continue"-and nine sub-categories were extracted. The sub-categories "reduced burden" and "gaining confidence" were grouped into the first category, "stabilizing emotionally through each other". The sub-categories "being motivated to learn," "increased learning ability", and "preparation as a process" were grouped under "advancing together", and "attitudes affecting study environment" and "depending on help" were grouped into the third category of "difficulties in relationships". The fourth category of "hoping to continue" had "wanting to supplement for development" and "wanting to participate in different roles" as sub-categories. CONCLUSION: Based on the results of this study, we expect pediatric nursing practicum education to improve through the active use of neonatal nursing simulation education incorporating peer tutoring.
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PURPOSE: The present study aimed to develop and examine the effectiveness of a pediatric nursing competency-building program for nursing students. METHODS: This was a quasi-experimental study with a nonequivalent control group pretest-posttest design conducted between October and December 2021. The participants included 40 nursing students (20 each in the experimental and control groups) at a university in a South Korean city. The pediatric nursing competency-building program integrated problem-based learning and simulation into clinical field practice. The experimental group participated in the program, while the control group did not. Data were analyzed using the x2 test, the independent t-test, and repeated-measures analysis of variance. RESULTS: Pediatric nursing competency and clinical performance showed a greater increase in the experimental group than in the control group. However, the change in problem-solving ability in the experimental group was not significantly different from that in the control group. CONCLUSION: The pediatric nursing competency-building program effectively improved students' pediatric nursing competency and clinical performance.
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Project-based learning (PjBL) allows nursing students to participate in real problem-solving, construct knowledge, and improve their nursing skills in the process of accomplishing meaningful projects. This study was conducted to develop a PjBL program on high-risk newborn care for nursing students and evaluate its effects. A quasi-experimental study using a nonequivalent control group pretest-posttest design was employed between June and December 2021. The participants were 45 nursing students (24 in the experimental group and 21 in the control group). A PjBL program involving the creation of an educational video clip about high-risk newborn care for nursing students was developed, and the experimental group took part in PjBL. The participants' nursing competency for high-risk newborns, self-leadership, and practicum-related stress were assessed. In the experimental group, nursing competency for high-risk newborns increased and practicum-related stress decreased to a greater extent than in the control group. However, the change in self-leadership was not significantly different between the experimental and control groups. PjBL effectively improved students' nursing competency for high-risk newborns and decreased their practicum-related stress. PjBL will be utilized to enhance nursing students' expertise in high-risk newborn care.
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Education, Nursing, Baccalaureate , Students, Nursing , Clinical Competence , Humans , Infant, Newborn , Problem SolvingABSTRACT
PURPOSE: Practical training in pediatric nursing gives students the opportunity to apply nursing knowledge to children in a realistic clinical context. Clinical practice faculty (CPF) and clinical nursing instructor (CNI) have played important roles in the pediatric nursing practicum. This study was conducted to develop a protocol to guide clinical practicum in pediatric nursing. METHODS: A service design methodology was employed between August 2020 and May 2021 at four universities and four hospitals in South Korea. The participants were five CPFs, five CNIs, five nursing college graduates, and 60 nursing students. The service design process had four phases: discovery, definition, development, and delivery. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics. RESULTS: The participants reported needs for providing concrete guidance and explanation, nursing practice experience, and a link between school and the clinical field. A protocol was developed to fulfill the participants' needs. The protocol comprised detailed information, teaching methodology, and partnership to guide students in the pediatric nursing practicum. CONCLUSION: The protocol developed in this study can be used to provide guidance for students' clinical practice in the field of pediatric nursing.
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PURPOSE: This study was conducted to explore the child-rearing experiences of mothers with early adolescents in Korean multicultural families. METHODS: The participants were six mothers with early adolescents in Korean multicultural families. Data were collected through in-depth interviews. The main question was, "Could you tell me about your child-rearing experiences with your adolescent child?" The data were analyzed using qualitative content analysis. RESULTS: Four categories resulted from the analysis of child-rearing experiences of mothers with early adolescents in Korean multicultural families, as follows: "separation between myself and others", "distance between myself and my adolescent child", "making efforts to bridge the gap between myself and others", and "trying to connect with my adolescent child closely". CONCLUSION: These findings indicate that mothers in Korean multicultural families made many efforts to bridge the gap between themselves and other people, and tried to connect with their children closely. The findings of this study emphasize specific aspects of how mothers with early adolescents experienced child-rearing in Korean multicultural families.
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PURPOSE: This study was conducted to investigate the educational needs for practicing neonatal intensive care among Korean nursing students. METHODS: An explorative, sequential, mixed-methods design was used. Qualitative content analysis was conducted of in-depth interviews of six nursing students, five clinical practice faculty members, and five nurses in the neonatal intensive care unit. The results of a survey of 174 nursing students were analyzed quantitatively. RESULTS: Nursing students, clinical practice faculty members, and nurses wanted opportunities for direct nursing practice and education in school during neonatal intensive care practice. In terms of specific educational content, nursing students expressed the highest observation-related educational needs for communication with medical team members, and they expressed the highest practice-related educational needs for operating medical equipment used for neonatal intensive care. The nursing students' needs with regard to the method of practice education were highest for orientation from the head nurses. CONCLUSION: Communication and operating medical equipment were found to be areas with high educational needs for practicing neonatal intensive care among Korean nursing students. Further research is needed to develop an educational framework and setting for practicing neonatal intensive care that would meet their needs.
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BACKGROUND: Nursing students who have achieved ego identity are able to develop their careers to become professional nurses. To care for patients in a clinical context, nursing students need to be psychologically and socially mature. Attainment of ego identity and maturity is a key developmental task during students' time at university as they prepare to become professional nurses. OBJECTIVES: This study was conducted to examine changes of ego identity and psychosocial maturity in nursing students. DESIGN AND SETTING: A longitudinal study design was employed between June 2016 and June 2019 at a university in a metropolis in South Korea. PARTICIPANTS: The participants were 102 nursing students who responded to surveys on at least two occasions. Seventy-six nursing students completed questionnaires on four occasions (in 2016, 2017, 2018, and 2019). METHODS: Data were collected through self-report questionnaires composed of items assessing ego identity, psychosocial maturity, and demographic characteristics. Participants returned questionnaires every June from 2016 to 2019. The data were analyzed using descriptive statistics, the kappa statistic, repeated-measures analysis of variance, and one-way analysis of variance. RESULTS: In terms of ego identity status, 17.1% of nursing students progressed to a more advanced status, 5.3% of them regressed to a less developed status, 57.9% of students had a fluctuating status, and 19.7% of them had a status that remained stable. Overall, psychosocial maturity in nursing students increased over time. Psychosocial maturity was higher among students in the achievement and moratorium statuses than among those in other statuses. CONCLUSIONS: These findings indicate that ego identity status fluctuated during students' time at nursing school, while psychosocial maturity simultaneously improved. Nursing students who explored their options also became psychologically and socially mature.
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Students, Nursing , Ego , Humans , Longitudinal Studies , Personality , Republic of Korea , Surveys and QuestionnairesABSTRACT
PURPOSE: This study was conducted to investigate the educational needs of parents of infants and toddlers with congenital heart disease (CHD) after hospital discharge. METHODS: Qualitative content analysis was conducted of in-depth interviews of eight parents, and the results of an online survey of 171 parents were analyzed quantitatively. RESULTS: Only 16.4% of parents reported that they had received education after hospital discharge on how to provide care for a child with CHD at home. The main reason why parents did not receive education on this topic was that they did not have sufficient opportunities or information (75.5%). In addition, 97.1% of parents stated that they needed educational programs that would be available at home after discharge. In terms of specific educational content, parents expressed the highest needs for education on the symptoms of CHD and ways to cope with them, the prognosis of CHD, and the growth and development of infants and toddlers with CHD. CONCLUSION: The study showed that parents' educational needs were high in many ways. However, the information and educational opportunities offered after discharge were insufficient compared to those needs. Further research is needed to develop post-hospital educational programs that meet their needs.
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PURPOSE: This study was conducted to identify correlations between how much fever management information mothers obtained from the internet and their actual knowledge and practices of fever management. METHODS: This was a descriptive survey of 172 mothers with children aged between 0 and 3 attending five daycare centers located in the city of Daegu. Descriptive statistics, the independent t-test or one-way analysis of variance, and Pearson correlation coefficients were used for data analysis. RESULTS: In total, 75% of the mothers had searched the internet for information on fever management. The overwhelming majority (92.2%) used information from the internet to help manage fever in their children. Positive correlations were found between acquiring fever management information from the internet and fever management practices (r=.18, p=.038), and between mother's knowledge and practices of fever management (r=.27, p<.001). CONCLUSION: Based on the results of this study, to improve fever management practices, it is necessary to increase mothers' knowledge. Therefore, resources should be developed to augment mothers' knowledge of fever management through the internet.
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PURPOSE: This study was conducted to examine factors associated with obesity among Korean adolescents. METHODS: The participants were 436 Korean adolescents aged 12~18 years who took part in the seventh Korea National Health and Nutrition Examination Survey (2016). The data were analyzed by descriptive statistics, the x 2 test, one-way analysis of variance, and multinomial logistic regression using complex sample analysis. RESULTS: Among the participants, 9.7% were classified as being obese, and 11.9% as being overweight. Several health parameters, including systolic blood pressure, diastolic blood pressure, waist circumference, and triglyceride, fasting blood sugar, and alanine aminotransferase levels, varied according to obesity. Distorted perceptions of body shape showed a significant negative association with overweight, and carbohydrate intake was negatively associated with obesity. CONCLUSION: These findings indicate that obesity in Korean adolescents was associated with lifestyle and health parameters. Therefore, intervention programs for obese or overweight adolescents should focus on preventing them from developing health problems.
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PURPOSE: This study was conducted to explore Korean mothers' experiences of the development of parent-adolescent relationships. METHODS: The participants were 18 Korean parents of adolescents. Data were collected through in-depth interviews. The main question was, "Could you tell me about your experiences of developing a relationship with your adolescent child?" The data were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: The central phenomena of the experiences of parent-adolescent relationships among Korean mothers were "trying to reduce my expectations, but not being able to" and "having no idea where to go". The major action/interaction strategies were "putting aside my desires and adapting to my child's needs" and "waiting and seeing at a distance". The consequences included "appreciating myself and my child at the same time". CONCLUSION: These findings indicate that mothers tried to adapt to their children's needs and to keep their children at a distance. Their efforts were influenced by advice from friends and family members. The findings of this study emphasize specific aspects of how Korean mothers experienced the process of developing respectful relationships with their children.
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PURPOSE: This study was conducted to design services for improving the quality of care of hospitalized children with acute diseases. METHODS: The service design process had four phases: discovery, definition, development, and delivery. The participants were 23 mothers of hospitalized children with an acute disease, and seven nurses and three doctors working at a pediatric hospital. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics. RESULTS: The participants reported needs for explanations about the treatment, skillful nursing, and environmental improvements. The concept of the services was familiarity and enjoyment, aimed at solving the problems of unfamiliarity and boredom. A six-guideline was presented for improving the quality of care of hospitalized children with acute diseases: improvement of awareness, development of educational materials, improvement of skills, environmental improvements, play activities, and evaluations of user satisfaction. CONCLUSION: These findings indicate that nursing services should deliver familiarity and enjoyment to hospitalized children and their families. The findings of this study emphasize that the service design methodology can be used to improve the quality of care of hospitalized children with acute diseases.
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Fibroblast growth factor (FGF) signaling has been implicated in the pathogenesis of pulmonary fibrosis. Mice lacking FGF2 have increased mortality and impaired epithelial recovery after bleomycin exposure, supporting a protective or reparative function following lung injury. To determine whether FGF2 overexpression reduces bleomycin-induced injury, we developed an inducible genetic system to express FGF2 in type II pneumocytes. Double-transgenic (DTG) mice with doxycycline-inducible overexpression of human FGF2 (SPC-rtTA;TRE-hFGF2) or single-transgenic controls were administered intratracheal bleomycin and fed doxycycline chow, starting at either day 0 or day 7. In addition, wild-type mice received intratracheal or intravenous recombinant FGF2, starting at the time of bleomycin treatment. Compared to controls, doxycycline-induced DTG mice had decreased pulmonary fibrosis 21 days after bleomycin, as assessed by gene expression and histology. This beneficial effect was seen when FGF2 overexpression was induced at day 0 or day 7 after bleomycin. FGF2 overexpression did not alter epithelial gene expression, bronchoalveolar lavage cellularity or total protein. In vitro studies using primary mouse and human lung fibroblasts showed that FGF2 strongly inhibited baseline and TGFß1-induced expression of alpha smooth muscle actin (αSMA), collagen, and connective tissue growth factor. While FGF2 did not suppress phosphorylation of Smad2 or Smad-dependent gene expression, FGF2 inhibited TGFß1-induced stress fiber formation and serum response factor-dependent gene expression. FGF2 inhibition of stress fiber formation and αSMA requires FGF receptor 1 (FGFR1) and downstream MEK/ERK, but not AKT signaling. In summary, overexpression of FGF2 protects against bleomycin-induced pulmonary fibrosis in vivo and reverses TGFß1-induced collagen and αSMA expression and stress fiber formation in lung fibroblasts in vitro, without affecting either inflammation or epithelial gene expression. Our results suggest that in the lung, FGF2 is antifibrotic in part through decreased collagen expression and fibroblast to myofibroblast differentiation. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Alveolar Epithelial Cells/metabolism , Bleomycin , Cell Differentiation , Collagen/metabolism , Fibroblast Growth Factor 2/metabolism , Lung/metabolism , Myofibroblasts/metabolism , Pulmonary Fibrosis/prevention & control , Actins/metabolism , Alveolar Epithelial Cells/pathology , Animals , Cells, Cultured , Disease Models, Animal , Extracellular Signal-Regulated MAP Kinases/metabolism , Fibroblast Growth Factor 2/genetics , Humans , Lung/pathology , Mice, Transgenic , Myofibroblasts/pathology , Phenotype , Pulmonary Fibrosis/chemically induced , Pulmonary Fibrosis/metabolism , Pulmonary Fibrosis/pathology , Receptor, Fibroblast Growth Factor, Type 1/metabolism , Signal Transduction , Stress Fibers/metabolism , Stress Fibers/pathology , Time FactorsABSTRACT
Idiopathic pulmonary fibrosis (IPF) is characterized by progressive pulmonary scarring, decline in lung function, and often results in death within 3-5 five years after diagnosis. Fibroblast growth factor (FGF) signaling has been implicated in the pathogenesis of IPF; however, the mechanism through which FGF signaling contributes to pulmonary fibrosis remains unclear. We hypothesized that FGF receptor (FGFR) signaling in fibroblasts is required for the fibrotic response to bleomycin. To test this, mice with mesenchyme-specific tamoxifen-inducible inactivation of FGF receptors 1, 2, and 3 (Col1α2-CreER; TCKO mice) were lineage labeled and administered intratracheal bleomycin. Lungs were collected for histologic analysis, whole lung RNA and protein, and dissociated for flow cytometry and FACS. Bleomycin-treated Col1α2-CreER; TCKO mice have decreased pulmonary fibrosis, collagen production, and fewer α-smooth muscle actin-positive (αSMA+) myofibroblasts compared with controls. Freshly isolated Col1α2-CreER; TCKO mesenchymal cells from bleomycin-treated mice have decreased collagen expression compared with wild type mesenchymal cells. Furthermore, lineage labeled FGFR-deficient fibroblasts have decreased enrichment in fibrotic areas and decreased proliferation. These data identify a cell autonomous requirement for mesenchymal FGFR signaling in the development of pulmonary fibrosis, and for the enrichment of the Col1α2-CreER-positive (Col1α2+) mesenchymal lineage in fibrotic tissue following bleomycin exposure. We conclude that mesenchymal FGF signaling is required for the development of pulmonary fibrosis, and that therapeutic strategies aimed directly at mesenchymal FGF signaling could be beneficial in the treatment of IPF.
