Comparing the effects of patient safety education using design thinking and case based learning on nursing students' competece and professional socialization: A quasi-experimental design.

Background: Patient safety issues should be constantly monitored and sensitively recognized. In nursing education, it is necessary to find effective teaching methods to increase students' competencies in patient safety. Objectives: This study aimed to compare the effectiveness of a new method, design thinking (DT), and a traditional method, case-based learning (CBL), in patient safety education. Design: This study used a quasi-experimental, pre-post control group design. Settings: A 30-h training tutorial was developed for intervention groups, DT and CBL, while the control group received no treatment. Participants: In this study were junior nursing students receiving baccalaureate nursing education with experiences of at least 480-h clinical practice. A total of 53 students (21 in the DT group, 19 in the CBL group, and 13 in the control group) were recruited. Methods: Clinical reasoning competency, patient safety competency, and professional socialization were measured immediately after the end of the educational program using DT and CBL, 4 weeks later, and 8 weeks later. Effects of DT and CBL were analyzed using a generalized estimating equation. Results: Both DT and CBL were effective in clinical reasoning competency (χ2 = 15.432, p = 0.017) and knowledge domain of patient safety competency (χ2 = 42.824, p < 0.001), showing no significant difference between the two. CBL was more effective in professional socialization than DT. Conclusions: DT was as effective as CBL in clinical reasoning competency and knowledge domain of patient safety competency. In the healthcare field, where improving the patient experience is becoming increasingly important, DT is worth applying as an educational method to train nursing students who can take a creative and human-centered problem-solving approach. It is expected that educational curricula utilizing DT will be developed not only in the field of patient safety but also in various patient care areas.

The effects of flipped learning and gamification on nursing students' patient safety education: A mixed method study.

Background: The importance of enhancing education to promote nursing students' patient safety competency is increasing. Hence, implementing diverse educational programs and assessing their outcomes is essential. Objectives: To examine the effects of flipped learning and gamification on nursing students' patient safety education. Design: A mixed-method design employing a quasi-experimental design with a pre-post control group design and qualitative thematic analysis. Methods: The study was conducted at a South Korean university in W City from September to December 2022. It included 55 s-year nursing students. The experimental group (n = 28) participated in a 30-h patient safety education course using flipped learning and gamification, whereas the control group (n = 27) received only written patient safety education materials. Learning motivation, collective efficacy, patient safety competency, and game evaluations were measured. Data were analyzed using the χ2 test, Fisher's exact test, t-test, repeated-measures multivariate analysis of covariance, repeated measure analysis of covariance, and generalized estimating equations. Self-reflection journals on game participation experiences were analyzed using qualitative thematic analysis. Results: Learning motivation scores did not differ significantly between groups for time, or interactions between groups and time, but collective efficacy and patient safety competency scores showed significant differences in the interactions between groups and time. The experimental group showed a high satisfaction score in game evaluation. Qualitative analyses were used to extract four themes-three positives: "fun and immersion differentiated from existing classes," "improved the learning outcomes and learning motivation," and "realized the value of collaboration and communication," and one negative: "feeling down due to unfamiliarity." Conclusions: This program creates positive learning experiences and enhances nursing students' collective efficacy and patient-safety competencies. It is expected to be utilized in various future nursing courses.

Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study.

Purpose: This study investigated the levels of health literacy, self-efficacy, self-management, and glycated hemoglobin (HbA1c) levels in older adults with diabetes to identify the relationships between these factors. Patients and Methods: This descriptive study consisted of 162 elderly outpatients with diabetes at the departments of endocrinology of three general hospitals in J Province, South Korea. Data were collected using a structured self-report questionnaire between October 21 and November 16, 2019. The data were analyzed using SPSS/WIN version 23.0. Results: Health literacy was positively correlated with self-efficacy (rs=0.64, p<0.001) and self-management (rs=0.44, p<0.001) and significantly negatively correlated with HbA1c levels (rs=-.42, p<0.001). Self-efficacy showed a significantly positive correlation with self-management (rs=0.65, p<0.001) and a significantly negative correlation with HbA1c levels (rs=-.30, p<0.001). Moreover, a significant negative correlation was found between self-management and HbA1c levels (rs=-.35, p<0.001). Hence, health literacy and patient self-management levels were associated with HbA1c levels in older adults with DM. Conclusion: Health education for community-dwelling older adults with diabetes should consider their health literacy levels. Moreover, measures to improve self-management abilities may be needed when developing educational programs for older adults with diabetes.

Types of Empathy Among Certified Caregivers of Older Adults with Dementia.

Purpose: This study identifies the unique phenomena and subjectivity of empathy as exhibited by certified caregivers. Methods: Q-methodology was used to define types and describe the characteristics of empathy in certified caregivers. After in-depth interviews with 10 certified caregivers and a review of the related literature, the final 38 Q-samples were selected by collecting experts' opinions. These Q-samples were sorted by 30 certified caregivers (P-samples). The PC-QUNAL program was used to analyze the Q-sort data. Results: Seven distinctive Q-factors for the empathy of certified caregivers were identified: I. Information-oriented cognition, II. Sensory communication, III. Compassion, IV. Performance-seeking through self-reflection, V. Intuitive empathy, VI. Role-centered sincerity, and VII. Passive obligation. The empathy of certified caregivers caring for older adults with dementia showed various characteristics according to each of their subjective values and judgments. Conclusion: This study's results help identify the empathy types and characteristics of certified caregivers caring for older adults with dementia and may contribute to improving the quality of care.

Professional socialization of hospital nurses: A scale development and validation study.

BACKGROUND: Tools currently available to measure professional socialization are outdated or could not reflect various properties of professional socialization of nurses. Thus, the objective of this study was to develop and validate a professional socialization measurement instrument for hospital nurses. METHODS: Fifty-two items were initially extracted from literature reviews and in-depth interviews with 32 nurses. After content validity testing, 48 items remained. They were used to survey 881 hospital nurses in Korea in the testing phase for construct validity and reliability. RESULTS: Four factors (21 items) were extracted: ethical practice and reflection, perception of respect and recognition, clinical competency based on leadership, and desires and motivation for professional development. These factors demonstrated good construct validity and reliability. Correlation coefficients of professional socialization with professional value, compassion satisfaction, secondary traumatic stress, and burden were 0.58 (p < 0.001), 0.70 (p < 0.001), - 0.08 (p = 0.014), and - 0.56 (p < 0.001), respectively. Reliability had a Cronbach's alpha of 0.95. Test-retest reliability intraclass correlation coefficient was 0.90. CONCLUSIONS: The four professional socialization scale factors in this study reflected attributes of knowledge, skills, values, and professional roles. Professional socialization of nurses can be continuously developed by emphasizing elements of the professional socialization scale in nursing education programs. Nursing managers should help nurses go through the professional socialization process. The professional socialization scale will serve as a tool for developing careers of hospital nurses.

Registered Nurses' Experiences of End-of-Life Care in Nursing Homes of South Korea: A Qualitative Study.

This study aimed to qualitatively describe how registered nurses (RNs) experienced and perceived end-of-life (EOL) care for older residents in South Korean nursing homes. The participants included 11 nurses with experience of providing EOL care for older residents in six nursing homes. Data were collected through one-on-one in-depth interviews using semi-structured questions from 27 December 2019 to 22 October 2020. Around 1-2 interviews were conducted for each participant, and each interview lasted between 40 min and two hours. The interview data were analyzed using qualitative content analysis. Eight sub-themes were identified and abstracted under three themes: (a) "feeling fulfilled for doing my best until the last day," (b) "defensive coping due to legal and institutional limitations," and (c) "requirements for effective EOL care." This study suggests that there are many challenges and issues regarding EOL care at nursing homes. In order to provide effective EOL care to older residents, the foundation of the EOL care system, as well as skills training, should be strengthened. Furthermore, securing qualified nursing manpower and achieving institutional improvement by reducing obstacles are warranted.

Effects of registered nurse staffing levels, work environment, and education levels on adverse events in nursing homes.

This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes. A cross-sectional study was conducted involving 216 nurses working in 62 nursing homes in South Korea, using self-reported questionnaires and data from the National Health Insurance Service of South Korea. A logistic regression model was used to investigate the effects of nurse staffing levels, work environment, and nursing education levels on the adverse events experienced by residents. An increase of one resident per nurse was significantly associated with a higher incidence of medication error, pressure ulcers and urinary tract infections. A poor work environment increased the incidence of adverse events. Compared to nurses with a bachelor's degree or higher, those with diplomas reported increased incidence rates of pressure ulcers. Improving the health outcomes of residents in nursing homes requires efforts that strengthen the nursing workforce in terms of numbers and educational level, and which improve their work environment at institutional and policy levels.

[Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19].

PURPOSE: This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19. METHODS: This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program. RESULTS: The perception of subjects toward quarantine measures was classified into the following six types: 'passive acceptance', 'social stigma perception', 'appreciation of daily life through awareness of the realities of illness', 'why me?', 'fearful perception', and 'positive meaning'. CONCLUSION: The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.

Development and Validation of the Nursing Home Care-related Quality of Life Scale.

OBJECTIVES: We developed an instrument to assess nursing home residents' quality of life (QOL), with a focus on QOL-related factors modifiable through nursing home care, within the South Korean context; then, we tested its validity and reliability. DESIGN: The scale was constructed through a literature review, qualitative interviews, expert panel review, and a focus group interview; then, it was validated through survey research. SETTING AND PARTICIPANTS: Residents (N = 667) from 42 nursing homes in South Korea participated in scale validation. METHODS: Ninety-nine items across 5 dimensions were initially drafted through a literature review and qualitative interview data. The expert panel review and a focus group interview yielded a scale with 31 items across 3 dimensions. Next, using survey data from nursing home residents, we examined the construct and concurrent validity and reliability (using Kuder-Richardson 20) of the 31-item QOL scale. RESULTS: Through a series of factor analyses, the 31 items were reduced to 17 items across 2 dimensions: Environment and Services (13 items) and Social Interaction (4 items). This 17-item scale was further examined for model fitness and reliability. The scale had acceptable to good fit (root mean square error of approximation = 0.07 and 0.07; comparative fit index = 0.83 and 0.98 for Environment and Services and Social Interaction, respectively), and good concurrent validity and internal consistency (Kuder-Richardson 20 = 0.72). CONCLUSIONS AND IMPLICATIONS: This 17-item scale is a valid and reliable tool to assess nursing home residents' QOL in South Korea, with a focus on factors modifiable through nursing home care. Through more research to test its usefulness, validity, and reliability, the scale can be used as an index of nursing home care quality and contribute to the development of strategies to improve nursing home residents' QOL.

Validation of the health literacy scale for diabetes as a criterion-referenced test with standard setting procedures.

OBJECTIVE: To develop and examine the psychometric properties of the Korean Health Literacy Scale for Diabetes Mellitus (KHLS-DM), and to establish reasonable cutoff scores. METHODS: Initially, 299 items were generated to measure diabetes-related words, numeracy, and information utilization. Content validity assessment and preliminary tests were conducted. After exploratory factor analysis (EFA) and Rasch analysis, the remaining 65 items were administered to a quota sample of 500 diabetic patients aged 40-74 years. The items were narrowed down to 58 items based on an item fit index. To obtain cutoff scores, Jaeger's method and the Bookmark method were employed. RESULTS: A confirmatory factor analysis (CFA) was performed, and a three-factor model was supported (χ2/df = 3.891, CFI = 0.92, TLI = 0.91, RMSEA = 0.04). The overall scores ranged from 0 to 58, and two cutoff points were established. The scale exhibited good internal consistency (Cronbach's α = 0.83). CONCLUSIONS: The KHLS-DM is a reliable and valid measure with cutoff points to classify individuals into three groups (adequate, marginal, and inadequate). PRACTICE IMPLICATIONS: The standard setting may be useful for researchers to validate health literacy measures in other countries and populations.

Comprehensive Analysis of the Jellyfish Chrysaora pacifica (Goette, 1886) (Semaeostomeae: Pelagiidae) with Description of the Complete rDNA Sequence.

Jinho Chae, Yoseph Seo, Won Bae Yu, Won Duk Yoon, Hye Eun Lee, Soo-Jung Chang, and Jang-Seu Ki (2018) The Scyphomedusae genus Chrysaora consists of highly diversified jellyfishes. Although morphological systematics of the genus has been documented over the past century, characterization of molecular taxonomy has been attempted only recently. In the present study, we sequenced an 8,167 bp region, encompassing a single ribosomal DNA (rDNA) repeat unit, from Chrysaora pacifica, and used it for phylogenetic analyses. The tandemly repeated rDNA units turned out to consist of both coding and noncoding regions, whose arrangement was found to be the same as that of a typical eukaryote. None of the 5S rRNA sequences were found among the repeat units. Comparative analyses of jellyfish rDNA sequences showed that the 28S locus is highly informative and divergent compared to the 18S locus. Phylogenetic analyses of the 18S and 28S loci revealed that the Semaeostomeae order of jellyfish is separated into taxonomic groups by families and genera, with a few exceptions. The family Pelagiidae was in a clade separate from other groups, thus forming a monophyletic lineage. All Chrysaora included here formed a strongly supported clade within the family Pelagiidae, and Pelagiidae manifested a sister relationship with Cyanea. Nonetheless, Chrysaora was found to be paraphyletic in both 18S and 28S phylogenies. Chrysaora pacifica was clearly distinct from close relatives C. melanaster and C. quinquecirrha. These results provide a special reference for the DNA taxonomy of Pelagiidae jellyfishes in terms of nuclear cistron rDNA sequences and improve our understanding of the molecular phylogenetic relationships among Semaeostomeae jellyfishes.

Older Adult Residents' Perceptions of Daily Lives in Nursing Homes.

PURPOSE: This study aimed to explore older adults' perceptions of their daily lives in South Korean nursing homes. DESIGN: We employed a qualitative descriptive study using semistructured interviews. METHODS: We conducted individual, semistructured interviews with 21 older adult residents from five nursing homes in South Korea and analyzed the data using thematic analysis. FINDINGS: Five themes related to older adults' perceptions of their daily lives in nursing homes emerged: enhanced comfort, aspiring to maintain physical and cognitive functions as human beings, desire for meaningful interpersonal relationships, feelings of confinement and limited autonomy, and acceptance of and adaptation to life in a facility. These themes indicated the positive and negative aspects of nursing home residence, and facilitators and challenges to enhancing older adult residents' quality of life (QOL). CONCLUSIONS: Policy, practice, and research endeavors are required to improve older adult residents' QOL, such as adequate professional nursing care for physical and psychological comfort and residents' health and functional status, sufficient activity programs and meaningful relationships, person-centered care to enhance residents' autonomy, and homelike environments. CLINICAL RELEVANCE: This study demonstrates that healthcare providers, researchers, and policymakers should consider nursing home residents' QOL to examine the quality of care within the setting and facilitate the development of appropriate strategies to improve QOL among this population.

Effect of an Integrated Health Management Program Based on Successful Aging in Korean Women.

OBJECTIVES: This study evaluates the efficacy of an integrated health management program (IHMP) based on successful aging in older women. DESIGN AND SAMPLE: A single group pretest and posttest research design was employed, with a sample of 33 older Korean women over 60 years registered in a public health center. The intervention, including exercise, health education, and social activities, was performed 3 hr per week for 12 weeks. MEASURES: Demographic characteristics, body composition, physical fitness, biomarkers, depression, and social support were measured. Data were analyzed with a Wilcoxon signed-rank test, statistical significance levels were set at p < .05. RESULTS: After the intervention, body mass index was significantly decreased (p = .003) and skeletal muscle mass was significantly increased (p = .002). Chair stand (p = .023) and straight walking test (p < .001) were significantly improved. Systolic blood pressure (p < .003), diastolic blood pressure (p = .030), and blood cholesterol (p = .011) were significantly decreased. Depression (p = .043) was significantly decreased, and social support (p < .001) was significantly increased. CONCLUSIONS: Adopting and maintaining an IHMP can be useful to promote physical, psychological, and social functioning that lead to successful aging in older Korean women.

Lived experiences of nursing home residents in Korea.

PURPOSE: The goal of the study was to understand the experiences of life among nursing home residents. METHODS: Qualitative study was conducted using Colaizzi's phenomenological method. The participants were 11 people aged 76-96 years in two nursing homes in Korea. RESULTS: Nine themes were identified: giving up on one self, growing apart from familiar relationships, perceiving the monotony of daily life as suffering, feeling anxious about one's future upon observing other residents, being dissatisfied with the lack of consideration for individualized care, developing interpersonal skills for communal life, missing the daily routines of their past lives, feeling optimistic about living in a nursing home, and having a strategy for the remainder of life in the nursing home. CONCLUSION: The results of this study confirmed the positive and negative emotions that elderly people typically experience while in nursing homes. Nurses should educate the families of nursing home residents, so that the family can better respect elderly people's opinions and provide them with adequate support. Furthermore, nurses must not only provide reliable support, resources and serve as advocates, but they must also pay more attention to the environment of the nursing home to make it feel like home to the elderly residents.

Reversible Symptomatic Myocarditis Induced by All-Trans Retinoic Acid Administration during Induction Treatment of Acute Promyelocytic Leukemia: Rare Cardiac Manifestation as a Retinoic Acid Syndrome

Treatment by All-trans retinoic acid (ATRA) followed by anthracycline-AraC chemotherapy has improved the outcome of acute promyelocytic leukemia. ATRA is usually well tolerated, but a few major side effects can be observed. Retinoic acid syndrome (RAS) often occurs during the induction chemotherapy of acute promyelocytic leukemia. A pericardial effusion is a common cardiac manifestation but myocarditis has been rarely documented. Here we reports a very rare case of fully recovered myocarditis as a result of RAS related to ATRA administration during induction treatment of acute promyelocytic leukemia which documented by echocardiographic evidence.

Development and validation of a scale for the end of life caregiving appraisal.

PURPOSE: End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS: The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS: The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbach's alpha for the entire scale was .84 indicating adequate reliability. However, Cronbach's alpha of subscales was varied. CONCLUSION: Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.

[Development of a stress scale for Korean nursing students].

PURPOSE: The purpose of this study was to develop a stress measurement scale for Korean nursing students. METHODS: Sixty preliminary items were selected by classifying 229 basic items extracted via literature review and Q-sorting method. In order to verify the reliability and validity of the preliminary instrument, data were collected from 617 nursing students in 2 colleges of nursing in Korea. RESULTS: As a result of the item analysis, 58 items were selected. They consisted of 2 types of stress which were college-based stress (38 items) and clinical-based stress (20 items). Ten factors in college-based stress and four factors in clinical-based stress were extracted by factor analysis, and each had a total variance of 63.01%, and 64.93%. Cronbach's Alpha of those 58 items were .937 in college-based stress and .922 in clinical-based stress, which was high. CONCLUSION: This paper is meaningful in a way that it has developed a tool capable of measuring stress for nursing students, which reflects the characteristics of our country. It is recommended for further study to re-verify the relevance and stability of this measurement.

Older Korean people's desire to participate in health care decision making.

The purpose of this study was to identify how older Korean people seek information and their desire to participate in decision making about their health care. A total of 165 elderly people living in Seoul, South Korea, participated in the study. Data were collected during individual interviews using the Autonomy Preference Index. The mean information-seeking score was high. The mean score for their desire to participate with a physician in decision making was lower, but this was higher when family members were involved. The study indicates that many older people want to receive information about their health care. Families (or guardians), as well as older people themselves, should be included in the decision-making process. Nurses can encourage older people to express their wishes, while treating each individual with respect.

Family Experiences in End-of-Life Care: A Literature Review.

PURPOSE: The purpose of this study was to summarize and analyze families' experiences of end-of-life care by conducting a systematic review of peer reviewed journals both in Korea and abroad. BACKGROUND: Families play an increasingly important role in care and medical treatment, acting as caregivers or decision makers rather than just being passive observers. It is necessary to understand the experiences of family members in order to provide appropriate care for them. METHODS: A systematic search of the literature was performed using the Cumulative Index for Nursing and Allied Health Literature (CINAHL) and the Korea Education & Research Information Service (KERIS) for the period of January 1990 through to December 2006. A total of 35 studies met the inclusion criteria. RESULTS: Seventeen studies used a quantitative design, while 18 studies used qualitative methods. Quantitative studies reported that the family's quality of life was relatively low when the patient was in need of high medical/nursing services. The perceived burden levels were moderately high, and depression levels were high among family caregivers. Various concepts emerged from the 18 qualitative studies, including psychological issues, physical problems, burdens, needs and interpersonal relationships. CONCLUSION: This study found that most previous research findings were focused on negative and neutral experiences. A few studies identified positive experiences. Based on the study results, we suggest that nurses need to be more aware of the experiences of patients' families and their potential needs.

Clinical significance of serum CA 125 in patients with pelvic masses / 대한산부인과학회잡지

No abstract available.