[Lived Experience of Kidney Transplant Recipients with Kidney Graft Failure].

PURPOSE: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. METHODS: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. RESULTS: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. CONCLUSION: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

Association Between Nurse-Led Multidisciplinary Education and Cardiac Events in Patients With Heart Failure: A Retrospective Chart Review.

PURPOSE: This study examined the modifiable factors, including nurse-led multidisciplinary education and in/out-of-hospital rehabilitation, to predict cardiac events in patients with heart failure (HF) in South Korea. METHODS: A retrospective review of the medical records was conducted using data of patients admitted for HF between June 2021 and April 2022. A total of 342 patients were included in this study. Information related to HF education, cardiac rehabilitation, and demographic and clinical characteristics were collected. Cardiac events, including emergency department visits, readmissions, and deaths, were defined as a composite of events. After adjusting for covariates, a multivariate Cox proportional hazard regression model was used to explore the association between modifiable factors and cardiac events in patients with HF. RESULTS: During the follow-up period (median, 823 days), 123 patients (36.0%) experienced at least one cardiac event. In the Cox regression model, patients who received nurse-led multidisciplinary HF education during hospitalization were less likely to experience cardiac events (hazard ratio: 0.487; 95% confidence interval [CI]:0.239-0.993). Additionally, high NT-pro BNP levels were associated with an increased risk of cardiac events. CONCLUSIONS: The education led by nurses on HF was a factor that reduced adverse prognoses in patients with HF. Our results highlight the importance of a nurse-led multidisciplinary approach during hospitalization.

The Lived Experiences of COVID-19 Patients in South Korea: A Qualitative Study.

The purpose of this qualitative study is to provide an in-depth understanding and description of the disease experiences of COVID-19 patients. The participants were 16 patients discharged from hospitals after receiving treatment for COVID-19 in isolation. Data collection was conducted through individual in-depth interviews until data saturation, and the interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's phenomenological method. The participants were quarantined after their COVID-19 diagnosis was confirmed, and they experienced desperate and uncertain times during treatment. The participants expressed shock and dissatisfaction due to an excessive invasion of privacy during the quarantine process and in the quarantine system. As confirmed COVID-19 cases, the participants experienced social stigma and feelings of guilt, negative attitudes from others and society, and negative influences from social networking services and the media. The participants also experienced mental and physical difficulties due to COVID-19 symptoms. However, they rediscovered meaningful relationships through the support of their family and friends in the midst of adversity. It is necessary to provide an integrated psychosocial rehabilitation program to reduce social stigma and improve the resilience of COVID-19 patients.

A multi-center, randomized controlled clinical trial, cost-effectiveness and qualitative research of electroacupuncture with usual care for patients with non-acute pain after back surgery: study protocol for a randomized controlled trial.

BACKGROUND: Although pain after back surgery is known to be difficult to control, various treatment options are available to patients and physicians. A protocol for a confirmatory randomized controlled trial (RCT) on pain and function after back surgery was designed based on the results of a pilot trial. The aim of this study is to compare the effectiveness and safety of electroacupuncture (EA) with usual care (UC) versus UC alone on pain control and functional improvement after back surgery. METHODS/DESIGN: This study is a multi-center, randomized, assessor-blinded trial with an active control conducted in conjunction with a cost-effectiveness analysis and qualitative research. Participants with non-acute low back pain with or without leg pain after back surgery who have a Visual Analogue Scale (VAS) pain intensity score ≥ 50 mm will be randomly assigned to either the EA with UC group (n = 54) or the UC group (n = 54). Following randomization, participants in both groups will receive the same UC treatment twice a week for a four-week treatment period. Participants assigned to the EA with UC group will additionally receive EA twice a week for the same four-week period. The primary outcome measure will be assessed using a VAS pain intensity score for low back pain. The secondary outcomes will include the Oswestry Disability Index, EuroQol 5-Dimension score, and drug intake. The primary and secondary outcomes will be measured at one, four, and eight weeks post randomization. DISCUSSION: The results of this study will provide evidence of the effectiveness and cost-effectiveness of EA in managing postoperative pain following back surgery. In addition, the qualitative research results will help improve the quality of integrative medical interventions. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea, KCT0001939 . Registered on 8 June 2016.

Experiences of Depression in Low Income Elderly Women.

PURPOSE: The purpose of this qualitative research was to understand the meaning of the depression in low income elderly women. METHODS: Participants were 15 elderly women, aged between 60 and 80 who were registered in two senior welfare centers in Seoul. Data were collected from June to December, 2012 after having obtained consent from participants. In-depth interviews were done with open-ended questions about their depression experiences, which were audio-taped and transcribed with verbatim. Data were analyzed using qualitative content analysis to discover the categories considering their relationships and abstractness. RESULTS: Depressions of aged women were a part of the their life throughout their long lived hardship and was implied unhealed wounds within the relationship. Participants did not know how to manage with depression symptoms that they tried to overcome individually but due to decreased activities and interpersonal relationships, their depressions were tended to continue. They have tried to get out from depressive symptoms, but it still remains unseen shadow of mind. CONCLUSION: This results suppose that social support and aged welfare policy included reliving the economical difficulty and improving relationships will be provided to manage the depression for low income elderly women.

Qualitative content analysis of psychologic discomfort and coping process after needlestick injuries among health care workers.

BACKGROUND: This study was designed to survey psychologic discomfort and coping processes of health care workers that suffered needlestick injuries (NSIs). METHODS: This qualitative analysis was performed with 15 health care workers who experienced NSIs. Data were collected using face-to-face interviews. The study subjects were asked the following: please describe the psychologic discomfort that you experienced after the NSI incidence. Data were evaluated by qualitative content analysis. RESULTS: Types of psychologic discomfort after NSI among health care workers included anxiety, anger, and feelings of guilt. Some personnel adopted active coping strategies, such as seeking first aid or reporting the incident to a monitoring system, whereas others used passive coping methods, such as avoidance of reporting the incident, vague expectancy to have no problems, and reliance on religious beliefs. Recommended support strategies to improve the prevention of NSIs were augmenting employee education and increasing recognition of techniques for avoiding NSIs. CONCLUSION: Medical institutions need to provide employees with repeated education so that they are familiar with guidelines for preventing NSIs and to stimulate their alertness to the risk of injuries at any time, in any place, and to anybody.

Experiences with, perceptions of and attitudes towards traditional Korean medicine (TKM) in patients with chronic fatigue: a qualitative, one-on-one, in-depth interview study.

OBJECTIVES: To explore perceptions and experiences of patients with chronic fatigue with traditional Korean medicine (TKM) and their motivation for choosing TKM. DESIGN: Qualitative, one-on-one, in-depth interview study. SETTING: Primary TKM hospitals in Seoul, Incheon and Daejeon, South Korea. RESULTS: 15 patients with chronic fatigue were interviewed in this study. Patients with chronic fatigue experienced physical and psychological symptoms that resulted in severe difficulties associated with routine daily activities. The motivations for choosing TKM were primarily dissatisfaction with conventional medicine and previous positive experiences with TKM. While undergoing TKM treatment, patients found that TKM practitioners considered fatigue to be a treatable illness; also, patients felt comfortable with the doctor-patient relationship in TKM. CONCLUSIONS: Healthcare providers need to be concerned about the symptoms of chronic fatigue to a degree that is in line with the patient's own perceptions. Korean patients with chronic fatigue choose TKM as an alternative to fulfil their long-term needs that were unmet by conventional medicine, and they are greatly positively influenced by TKM. TKM may present a possible therapy to alleviate symptoms of diseases that conventional medicine does not address and is an approach that has a considerable effect on Korean patients.

Phenomenological Study on Burnout Experience of Clinical Nurses Who have Turnover Intention.

PURPOSE: This study was aimed to understand the meaning and essentials of the experience of burnout for hospital nurses with turnover intention. METHODS: The design was a qualitative research of phenomenological study. Participants: Seven hospital nurses who had worked over three years and had experiences of turnover intention in a hospital with over 400 beds were included. RESULTS: Nine meaningful themes related to burnout experiences and four theme clusters of 1) battery warning sounds almost out; 2) the player who hit the drum and double-headed drum; 3) the target flying arrow without a break; and 4) the pendulum swaying to turn over. Registered nurses (RNs) felt burnout with an overload of work and by the thought that it was illegal action for registered nurses to receive insufficient rewards for their work. RNs also experienced there were no problem solving strategies to verbal violence by patient and medical team. CONCLUSION: The findings show that burnout experiences for those who had turnover intention was developed from the insight that insufficient training to do work independently with over-load for nurses was not ethical. It suggests that it is necessary to rethink training systems for nursing and hospitals to relieve turnover intention.

A qualitative study of the experiences of patients with knee osteoarthritis undergoing moxibustion.

OBJECTIVE: To explore and understand how patients with knee osteoarthritis (OA) experience moxibustion. METHOD: This qualitative research was conducted as part of a larger clinical trial of the effectiveness of moxibustion for the treatment of knee OA by qualitative content analysis. Sixteen patients with mild knee OA who participated in a 12-week moxibustion treatment as part of the trial were interviewed using open-ended questions. RESULTS: The participants recognised knee OA as a normal ageing process that caused physical and emotional discomfort in daily life. Regardless of any adverse effects of moxibustion, most of the participants were interested in continuous moxibustion treatment as a long-term management strategy and for general health. CONCLUSIONS: This study suggests that moxibustion can be helpful in managing symptoms related to knee OA. Patients' attitudes towards moxibustion can affect the treatment result and those who prefer it want to continue the treatment for a long time because they understand that knee OA is a chronic condition which needs continuous care. However, practitioners need to pay more attention to those who are very enthusiastic because they tend to endure treatment-related adverse events in their desire for better effects.

Job analysis of clinical research coordinators using the DACUM process.

PURPOSE: This study was done to analyze the job of clinical research coordinators (CRCs). METHODS: Through the "developing a curriculum (DACUM)" workshop, the definition of CRCs' role was described and CRCs' duties and tasks were identified. Finally, the developed duties and tasks were validated for importance, difficulty, and frequency. RESULTS: A CRC is defined as the one who coordinates and performs tasks related to clinical research/trials among investigators, participants, and sponsors according to the Good Clinical Practice at institutions conducting clinical trials. Twelve duties and 78 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks represented as A, B, and C respectively. Based on determinant coefficient (DC) of the task, the highest ranked task was confirming the eligibility of participants for research (DC=8.03) and the lowest was inventory management for clinical study materials (3.95). CONCLUSION: In this study, the job of a CRC was analyzed through the DACUM process and it was found that CRCs were doing various duties and tasks. Based on these results, it is suggested that it is necessary to develop CRC education programs considering the career ladder of CRCs.

Professional values in Korean undergraduate nursing students.

Developing professional values among undergraduate nursing students is important since such values are a significant predictor of quality care, clients' recognition, and therefore nurses' job satisfaction. This study explored South Korean nursing students' perception of nursing professional values (NPV) and compared the NPV scores between groups according to participants' demographic characteristics. The study participants comprised of 529 students, mostly female (96.4%), with a mean age of 22.29years, sampled from six universities throughout the country. The NPV scores, measured with the 29-item Likert scale developed by Yeun et al. (2005), were significantly higher in students who entered nursing schools following their aptitude or desire for professional job than in those who entered the schools just because their entrance exam scores were sufficient. The NPV scores were also higher in students who were planning to pursue graduate study than in those who had not yet decided. The NPV scores were significantly different between the six regions, suggesting needs of in-depth studies to understand the underlying reasons. The NPV scores were not correlated, at the .05 level of significance, with academic year, gender, or academic performance.

[Evaluation of nurses' competency in nurse-patient communication about medications: conversational analysis approach].

PURPOSE: The purpose of this study was to develop evaluation criteria for conversations about medication and to demonstrate conversational analysis with actual dialogues on medication as examples. METHODS: This study was a secondary analysis of qualitative research using conversational analysis which showed functional phases and patterns of dialogue about medication (greeting, identifying the patient, medicating, finishing). Nurse-patient conversations were videotaped and transcribed and 75 conversations were used for analysis. RESULTS: Not all functional phases were showed in the conversations about medication. Therefore, conversations about medication can be considered as incomplete dialogues. The evaluation-criteria were represented in terms of the structure and content of the dialogues. Structural evaluation-criteria were the same as the functional phases, as functional stage is the standard for evaluation. The criteria of evaluation for content suggested 3 domains, content, expression, and interaction with 20 items scored on a Likert-type scale of 5-points. Finally, analysis of actual conversations about medication according to the evaluative criteria were provided. CONCLUSION: The results provide the basic data to develop educational programs and strategies to improve nurses' competency in conversation about medication.

[Evaluation of the Korean formal educational program for training care workers for frail elderly].

PURPOSE: This study was done to evaluate the formal education program provided by the Korean government for care workers for frail elderly people. METHODS: This study was a cross-sectional survey in which 438 certified care workers who had completed the education program participated. Data were collected from June to October 2009, using a self-report questionnaire consisting of satisfaction with, and understanding of the education program. RESULTS: The participants had a mean age of 46.7 yr, 87.9% were female and 58.2% were high school graduates. For the theory part of the education, the highest score for understanding was for'supporting household & activities of daily living' while the lowest score for understanding was for'care for death and dying'. For the practical education, the highest score for understanding was for'talking with the client' and the lowest score was for'first aid & basic life support'. There was a significant difference in satisfaction and understanding of the theoretical and practical parts according to educational level. CONCLUSION: Continuing education programs are needed for care workers for elders, both in the theoretical and practical areas. Also the content of programs should address the weak points of this formal education program.

[Quality of life and illness intrusiveness by type-D personality in the patients with coronary artery disease].

PURPOSE: The purpose of this study was to identify the influence of the type-D personality on quality of life and illness intrusiveness. METHODS: This study was a cross-sectional study. Data were collected using self-reported questionnaire from 200 patients with coronary artery disease (CAD). Variables were measured with the Type-D Scale-14 (DS14), Korean Health Related Quality of Life Scale (KoQoLS), and the Illness Intrusiveness Rating Scale (ILRS). RESULTS: Of the patients, 38% were classified as type-D personality. Among the 10 subcategories of quality of life, the highest mean score was bodily pain (5.84+/-.85) and the lowest was role limitation (1.52+/-.20). Among 13 item of illness intrusiveness, the highest mean score was health (3.78+/-.73) and the lowest was family relationships (2.14+/-.58). There were significant differences in all the subcategories of quality of life between type-D and non type-D except for subcategories of bodily pain and role limitation. However, there were no significant differences in illness intrusiveness between type-D and non type-D. CONCLUSION: Type-D is an important factor in quality of life in patients with CAD, but no correlations between type-D and illness intrusiveness were found. These results can be used as basic data for developing cardiac rehabilitation programs to improve quality of life in type-D patients.

[The life of elderly women living alone].

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

[Family caregivers' experiences utilizing a nursing home for their elderly family members].

PURPOSE: The purpose of this study was to explore and describe the experiences of the family caregivers using a nursing home for their elderly family members. METHOD: Participants for this study were 1 man and 9 women caregivers. Data was collected through in-depth interviews from October, 2005 to April, 2006 and analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: "Finding a way to live together" emerged as a core category and it reflected expanding consciousness allowing them to see each other in a more positive view. The basic social process of "finding a way to live together" includes 3 phases: 1) recognizing the problems, 2) finding solutions to the problems, and 3) accepting the changes in their surrounding. Lack of privacy, family troubles, extreme distress, and unavailable caregivers are reflected in the process of recognizing the problems. The process of finding solutions was making a decision, obtaining family agreement, choosing the best nursing home, and enduring the financial burden. Possible outcomes of the last phase include recovering peace of mind and continuing conflict. CONCLUSION: Findings from this study offer suggestions for developing a strategy to help not only the elderly but also the family caregivers.

[Functional phases and patterns of dialogue sequence in nurse-patient conversation about medication].

PURPOSE: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. METHOD: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. RESULTS: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored: greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. CONCLUSION: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.

[The experiences of transplantation coordinators' practice].

PURPOSE: The purpose of this phenomenological study was to understand the experiences in the transplantation coordinators' practice. METHOD: Data was collected through a tape-recorded in-depth interview from nine participants who were transplantation coordinators of their hospitals. It was analyzed using the phenomenological method proposed by Colaizzi(1978). RESULTS: From significant statements, six categories of themes were integrated into the essential structure of the experiences of transplantation coordinators. Six categories of themes were 'continue to be professional during dash this way and rush that', 'burden due to persistent heavy work', 'the uniqueness in family care of the brain-dead patients', 'support of family and a professional group', 'worthiness and achievement of the patients' recovery', and 'establishment of self-confidence as a coordinator'. CONCLUSION: Although the transplantation coordinators played various roles, they had a conflict in role identity due to poor working environments. The results of this study suggested that development of an educational program, an increase in understanding for the coordinators' role, and institutional support for better working conditions are needed to get professional acknowledgement for transplantation coordinators.

[Role-identity of home care nurse practitioners].

INTRODUCTION: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. METHOD: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was "what is the role of HCNP?" The debriefing notes and field notes were analyzed using consistent comparative data analysis method. RESULT: First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. CONCLUSION: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.

[The experiences of recovery from disease in patients doing meditation].

PURPOSE: The purpose of this study was to explore the experiences of recovery from disease in the patients doing a kind of Buddhist meditation, and to develop a grounded theory about meditation. METHOD: Data was collected by an in-depth interview using tape-recordings from sixteen participants doing meditation. The data was analyzed using the grounded theory method proposed by Strauss and Corbin(1998). RESULT: The core category was discovering the true self. The participants began to do meditation because of their disease. They experienced obstacles due to incomplete religious acceptance. However, their faith grew gradually based on religious experiences that were indescribable. Finally, they entirely trusted the inner healer, which is emphasized in meditation. The strategies that they used were self reflection and seeking help for accepting deep meditation. They were stabilized in physical, psychological and social daily living. The processes of discovering the true self were identified as entering religious discipline, embodying religious discipline, self-accomplishing religious faith, and recovering mind-body health. CONCLUSION: This study provided the understanding of mind-body integration. Empirical research may be needed to prove scientifically the effects of meditation.