Effects of neurofeedback training on the alpha activity in quantitative electroencephalography, cognitive function, and speech perception in elderly with presbycusis: a quasi-experimental study.

BACKGROUND: This study aimed to investigate the effects of neurofeedback training (NFT) on alpha activity in quantitative electroencephalography (QEEG), cognitive function, and speech perception in elderly with presbycusis. METHODS: This study was conducted from June 15 to November 30, 2020. The experimental group (n = 28) underwent NFT, while the control group (n = 31) was instructed to continue with their routine daily life. The NFT conducted for 40 min, two times a week, for a total of 16 sessions and was performed using Neuroharmony S and BrainHealth 2.7. The alpha activity was measured as alpha waves using QEEG. The cognitive function was measured using the Korean version of Mini-Mental Status Examination, digit span forward and backward (DSF and DSB). The speech perception was measured using the word and sentence recognition score (WRS and SRS) using an audiometer with the Korean Standard Monosyllabic Word Lists for Adults. RESULTS: The experimental group demonstrated improvement in the alpha wave of the left frontal lobe measured as alpha activity (t=-2.521, p = .018); MMSE-K (t=-3.467, p < .01), and DSF (t=-2.646, p < .05) measured as cognitive function; and WRS (t=-3.255, p = .003), and SRS (t=-2.851, p = .008) measured as speech perception compared to the control group. CONCLUSIONS: This study suggests that NFT could be considered an effective cognitive and auditory rehabilitation method based on brain and cognitive science for improving alpha activity, cognitive function, and speech perception.

Evaluation of a Virtual Reality Simulation to Improve Problem-Based Learning for Neurologic Examination in Nursing Students.

Background: In the era of the fourth industrial revolution, there is a requirement of innovative strategies to enhance nursing students' learning transfer. Virtual Reality Simulation Problem-Based Learning (VRS-PBL) has been validated to be an advantageous strategy that can improve knowledge, clinical performance, and self-efficacy. We aimed to identify the effectiveness of VRS-PBL for improving nursing students' neurologic examination. Methods: Data were collected in 2021. Seventy-six participants were recruited via the convenience sampling. Students in the control group underwent conventional lecture and demonstration of neurological assessment prior to practicum, whereas students in the experimental group underwent VRS-PBL once a week for 2 weeks (60 minutes per session). Results: Compared with the control group, the academic self-efficacy (t = -2.80, P = .007) and neurological examination performance (t = -11.62, P < .001) of the nursing students increased significantly in the experimental group. On the other hand, there was no significant difference between the two groups of the transfer motivation (t = -1.76, P = .082). Conclusion: The nursing students integrated the knowledge and skills learned through VRS-PBL, and improved the effectiveness and efficiency of their learning. VRS-PBL that reflects various clinical situations can be used as a foundation for establishing effective teaching strategies to improve nursing competency from novice to expert nurses.

Effects of simulation with problem-based learning (S-PBL) on nursing students' clinical reasoning ability: based on Tanner's clinical judgment model.

BACKGROUND: Clinical reasoning ability, a complex cognitive and metacognitive process, is a crucial core competency required in nursing practice. Therefore, undergraduate nursing students should be provided with nursing education to strengthen their clinical reasoning ability based on real-life nursing scenarios. METHODS: This study was conducted using a quasi-experimental single-group pretest-posttest design. Three sessions (lasting three hours each) of Simulation with Problem-Based Learning (S-PBL) using high-risk obstetrics-gynecology scenarios were provided to 71 third-year nursing students of a university. The sessions were conducted from September to December 2022, and they aimed to strengthen their clinical reasoning ability. For data collection, an online survey was conducted using Rubric for Clinical Reasoning and learning satisfaction evaluation tool. Data were analyzed using descriptive statistics and repeated measures analysis of variance in SPSS. RESULTS: The mean score of clinical reasoning ability significantly increased from 29.42 (standard deviation: 4.62) out of 40 points in the pre-test to 32.28 (4.36), 33.44 (5.35), and 33.80 (5.91) after the first, second, and third S-PBL sessions, respectively (F = 61.668, p < .001). The learning satisfaction score was as high as 107.04 (12.66) out of 120 points. CONCLUSION: This S-PBL program is an effective nursing education strategy to strengthen nursing students' clinical reasoning ability. Future studies must examine learner variables and standardize the S-PBL design and operation process by comparison to a traditional teaching approach and a higher range of clincal reasoning ability.

An Analysis of Menstrual Symptoms, Menstrual Attitudes, Physical Stress and Psychological Stress According to the Menstrual Cycle Phase.

Background: Women undergo an array of menstrual symptoms, depending on the menstrual cycle period. This study aimed to gain a more objective understanding of the impact of menstruation by examining differences in menstrual symptoms, menstrual attitude, physical stress, and psychological stress across the menstrual cycle. Methods: This study was conducted from Apr to Jun 2021 in the Gyeonggi Province of Korea. Women aged ≥20 yr were divided into premenstrual (n=17), menstrual (n=8), and postmenstrual periods (n=23). Menstrual symptoms and menstrual attitudes were assessed using questionnaires. Quantitative electroencephalography was used to assess the physical stress indices (left and right), and the psychological stress indices (left and right), with brainwave parameters quantified by frequency series power spectrum analysis. Data were compared using the non-parametric tests. Results: More menstrual symptoms were experienced in the menstrual period than in the premenstrual period (Z=2.16, P=.031). Menstrual attitudes did not significantly differ among menstrual periods (Z=1.20, P=.231). Physical stress indices were high (≥10 µV) throughout the menstrual cycle and there were significant differences among the three periods (left: χ2=4.00, P=.035, right: χ2=5.78, P=.046). Psychological stress indices were >1 µV during the premenstrual and menstrual periods. Conclusion: Women experience more severe and diverse menstrual symptoms in the menstrual period than in other periods. Objective investigations are needed to inform an effective approach for addressing negative menstruation-related experiences.

Effects of electronic fetal monitoring simulation with problem-based learning on nursing students' performance confidence, clinical judgment, and knowledge.

AIM: This study aimed to determine the effects of an electronic fetal monitoring simulation with problem-based learning (EFM SPBL) program based on the Clinical Judgment Model. METHODS: Third-year nursing students were randomly allocated to the control (n = 46) or experimental groups (n = 46). The control group participated in the conventional clinical practice, while the experimental group participated in the EFM SPBL program. The students completed a structured questionnaire on Google surveys. RESULTS: Nursing performance confidence (t = 10.72, p < .001) and clinical judgment (t = 2.53, p = .015) increased significantly in the experimental group. CONCLUSIONS: This study recognized improvement in students' clinical judgment in the context of learning transfer. A standardized SPBL with various cases is recommended.

Effects of simulation problem-based learning based on Peplau's Interpersonal Relationship Model for cesarean section maternity nursing on communication skills, communication attitudes and team efficacy.

BACKGROUND: In the coronavirus disease-impacted era, many medical institutions have not permitted clinical practice at hospitals or have operated their training on a restricted basis. The effective strategy for improving therapeutic communication and team cooperation as a nursing core competency is required. OBJECTIVES: The study aimed to verify the effects of simulation problem-based learning on nursing students' communication skills, communication attitudes, and team efficacy. DESIGN: Non-equivalent control group pretest-posttest design. SETTINGS: A university in South Korea. PARTICIPANTS: Nursing students who were classified as advanced beginners were randomly allocated to the control group (n = 46) or the experimental group (n = 47). METHODS: The experimental group's students participated in the simulation problem-based learning for cesarean section maternity nursing. The control group's students participated in a conventional type of maternity nursing clinical practice. The communication skills, communication attitudes, and team efficacy were measured by using a self-reported questionnaire. RESULTS: As compared with the pretest, the communication attitudes increased significantly (t = 2.41, p = .020) in the posttest for the experimental group. The communication skills (t = 1.47, p = .150) and team efficacy (F = 3.30, p = .073) were not statistically significant. CONCLUSIONS: The simulation problem-based learning in clinical practice is recommended to improve communication attitudes for nursing students and to apply the learned knowledge in simulated nursing situations through experiential learning. Future research is particularly needed the standardized educational program to identify the long-term effects in various cases and settings.

The Effects of Simulation Problem-Based Learning on the Empathy, Attitudes toward Caring for the Elderly, and Team Efficacy of Undergraduate Health Profession Students.

Undergraduate students studying health professions receive a uniprofessional education in an isolated educational environment within the university curriculum, and they have limited opportunities to experience collaborative learning through interactions with other professions. This study adopted a one-group, pretest-posttest, quasi-experimental design to investigate the effect of an undergraduate course that applied simulation problem-based learning (S-PBL) on nursing and dental hygiene students' empathy, attitudes toward caring for the elderly, and team efficacy. The S-PBL was designed based on the ARCS model of motivation proposed by Keller, and the subjects (n = 24) participated in a small group activity of identifying and checking for medical errors that may pose a threat to patients' safety. The results showed that there was a statistically significant increase in the subjects' attitudes toward caring for the elderly (t = 3.11, p = 0.01) and team efficacy (t = 2.84, p = 0.01) after participating in the S-PBL. The teaching method developed by this study aims to counteract the problems of the limited experience available to undergraduate health profession students during clinical practicum in the context of the COVID-19 pandemic and the limitations of interprofessional education, and it has established the groundwork for further exploration of the learning transfer effect of S-PBL.

Comparison of Learning Transfer Using Simulation Problem-Based Learning and Demonstration: An Application of Papanicolaou Smear Nursing Education.

The purpose of this study was to compare the effects of simulation problem-based learning (S-PBL), a type of learning that reflects various clinical situations, and demonstration-based learning, a conventional type of learning that shows clinical skill performance, of Papanicolaou smear education on the self-confidence, learner satisfaction, and critical thinking of nursing students. A quasi-experimental control group pretest-posttest design was used. Nursing students who were classified as advanced beginners were randomly allocated to the control group (n = 53) or the experimental group (n = 52). Students in the control group participated in a conventional demonstration of a Papanicolaou smear, while students in the experimental group participated in S-PBL. The students' self-confidence, learner satisfaction, and critical thinking were measured via a self-reported questionnaire. Compared with the control group, self-confidence, learner satisfaction, and critical thinking increase significantly more (p < 0.001) in the experimental group. S-PBL was found to be an effective strategy for improving learning transfer, applying learned nursing knowledge to simulated nursing situations. Thus, S-PBL is recommended to improve training in nursing education.

Factors affecting suicidal ideation among premenopausal and postmenopausal women.

WHAT IS KNOWN ON THE SUBJECT?: Pre- and postmenopausal women (PPW) experience changes in physical, psychological and social health. South-East Asia's female suicide rate is the highest compared with other countries, and the suicide rate of PPW in these countries continues to increase. The most influential factor in Asian women's suicidal ideation is family conflict; specifically, if PPW in South Korea cannot express their anger, it results in a culture-bound syndrome called "Hwa-Byung." However, there is a lack of research on Asian PPW. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study found differences in individual- and community-level factors affecting suicidal ideation between pre- and postmenopausal women. Individual factors that commonly affected suicidal ideation were experiencing violence, stress and depression. Individual factors that affected the suicidal ideation of premenopausal women more than postmenopausal women were religious beliefs, alcohol use and chronic disease. Community level factors affecting suicidal ideation were locational depression and locational counselling for stress in premenopausal women and locational counselling for depression in postmenopausal women. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses could help prevent suicide by developing and applying community-based programmes for PPW, considering the specific socio-economic and cultural context and characteristics of Asian women. Mental health nurses could help PPW participate in programmes by preparing various interventions such as case management, personal counselling, physical activity, home-based mental health services, cognitive behavioural therapy and digital interventions for self-management. Mental health nurses need to prepare various methods such as online, offline, individual and group methods to work effectively in any social situation. ABSTRACT: Introduction Pre- and postmenopausal women (PPW) experience physical and psychological changes with hormonal changes. Among Asian middle-aged women, family and culture affect suicidal ideation, and the suicide rate among this population is increasing. There are few existing research on suicidal ideation among Asian PPW. Aim We examined individual- and community-level factors that predict suicidal ideation among PPW. Method Large-scale panel data from 5,154 South Korean PPW aged 35-64 years were used in a series of multilevel logistic regression analyses to examine factors associated with suicidal ideation at individual and community levels. Results Among premenopausal women, religious beliefs, alcohol use, chronic disease, experience of violence, stress and depression were individual-level factors. Locational depression and locational counselling for stress were community-level factors. Among postmenopausal women, experience of violence, stress, depression and perceived health status were individual level factors, and locational counselling for depression was a community level factor. Discussion Suicidal ideation among PPW is affected by both individual and community level factors. Nurses must comprehensively determine what risk factors affect suicidal ideation through various intervention methods-including online, offline, individual and group methods-while considering socio-economic situations. Implications for Practice Mental health nurses should provide targeted biopsychosocial interventions targeting psychosocial and physical problems and promoting the use of community resources to reduce PPW's suicidal ideation.

Correlates of the Mental Fitness of Female High School Freshmen: Focus on Multidimensional Empathy and Brain Function.

We examined the association between multidimensional empathy, brain function, and mental fitness and identified correlates of mental fitness. In total, 146 female high school freshmen from a South Korean school participated in this cross-sectional study. Data were collected from March to April 2019, using a self-report questionnaire and quantitative electro-encephalographic data (QEEG). Instruments included the Interpersonal Reactivity Index and the Mental Fitness Scale, to access multidimensional empathy and mental fitness. Prefrontal cortex brain function was assessed with the brain quotient measure from the QEEG during free time after school. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, and multiple regression analysis. Mental fitness had statistically significant relationships with multidimensional empathy (r = 0.36, p < 0.001) and brain quotient (r = 0.23, p = 0.005). Demographic factors affecting mental fitness included satisfaction with school life (ß = 0.23, p = 0.001) and economic status (ß = 0.17, p = 0.024). Factors from the subscales of multidimensional empathy included perspective taking (ß = 0.26, p = 0.001), fantasy (ß = 0.22, p = 0.004), and personal distress (ß = -0.19, p = 0.010); and the brain function factor was brain quotient (ß = 0.14, p = 0.038). The explanatory power of the model was 49.4% (F = 14.44, p < 0.001). There is a need for a concrete and objective understanding of mental fitness in adolescents to develop intervention programs for freshmen with various maladaptation problems.

Effects of S-PBL in Maternity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi-Experimental Design.

Due to the coronavirus disease (COVID-19) pandemic, there are many restrictions in effect in clinical nursing practice. Since effective educational strategies are required to enhance nursing students' competency in clinical practice, this study sought to evaluate the effectiveness of simulation problem-based learning (S-PBL). A quasi-experimental control group pretest-post-test design was used. Nursing students were allocated randomly to the control group (n = 31) and the experimental group (n = 47). Students in the control group participated in a traditional maternity clinical practicum for a week, while students in the experimental group participated S-PBL for a week. The students in the experimental group were trained in small groups using a childbirth patient simulator (Gaumard® Noelle® S554.100, Miami, USA) based on a standardized scenario related to obstetric care. The students' learning attitude, metacognition, and critical thinking were then measured via a self-reported questionnaire. Compared with the control group, the pre-post difference in learning attitude and critical thinking increased significantly (p < 0.01) in the experimental group. S-PBL was found to be an effective strategy for improving nursing students' learning transfer. Thus, S-PBL that reflects various clinical situations is recommended to improve the training in maternal health nursing.

Hair Cortisol Concentrations as a Biological Marker of Maternal Prenatal Stress: A Systematic Review.

Recently, biological markers of maternal prenatal stress, hair cortisol, along with saliva, blood, and urine cortisol, have received attention. However, it is necessary to validate measuring hair cortisol concentrations (HCC) as a biomarker of perceived stress among healthy and high-risk pregnant women. This study aimed to confirm the correlation between HCC and the perceived stress of pregnant women over 18 years of age. In this systematic review, we used various search engines to extract relevant articles using specific keywords related to pregnancy, hair cortisol, and psychological stress. Four out of 3639 studies met the inclusion criteria. We conducted a quality assessment with the help of three independent reviewers using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The correlation between HCC and perceived stress was confirmed in one study. There was only one study on hair washing, shampoo, conditioner, and hair structure that could affect hair samples. In four studies, hair samples differed in length, methods of storage, and laboratory analysis. The review was limited to confirming the relationship between HCC and perceived stress in pregnant women based on the current evidence. Studies on hair cortisol need regulated and standardized methods for collection, storage, and analysis of hair samples.

Effects of Aromatherapy Combined with Music Therapy on Anxiety, Stress, and Fundamental Nursing Skills in Nursing Students: A Randomized Controlled Trial.

PURPOSE: Nursing students often experience anxiety and stress when taking exams that test their fundamental nursing skills. Complementary alternative methods, such as aromatherapy and music therapy, have effectively alleviated such negative emotions among nursing students. However, few studies have examined the effects of combined therapy interventions or compared the effects of different interventions. This study identified the individual and combined effects of aromatherapy and music therapy on test anxiety, state anxiety, stress, and fundamental nursing skills among nursing students in Korea. METHODS: A double-blinded, randomized, controlled trial design was used. The study was conducted at the nursing college at Sungshin Women's University, Seoul, Republic of Korea. Ninety-eight sophomore female nursing students participated in the study. Subjects were randomly categorized under three groups: aromatherapy (n = 32), music therapy (n = 32), and aromatherapy combined with music therapy (n = 34). Aromatherapy was carried out through the inhalation method using an aroma lamp and three drops of Origanum majorana and Citrus sinensis. Music therapy was carried out using Beethoven's Moonlight Sonata. Twenty-minute interventions were performed in separate rooms before an exam was administered. Data were collected through self-report questionnaires, including demographics, test anxiety, state anxiety, and stress. Participants' Foley catheterization skill was likewise evaluated. RESULTS: Aromatherapy combined with music therapy had a significant effect on test anxiety (F = 4.29, p = 0.016), state anxiety (F = 4.77, p = 0.011), stress (F = 4.62, p = 0.012), and performance of fundamental nursing skills (F = 8.04, p = 0.001) compared with aromatherapy and music therapy as separate interventions. CONCLUSIONS: The results suggest that nursing education that includes aromatherapy combined with music therapy may be effective for improving the performance of fundamental nursing skills and reducing anxiety and stress among nursing students.

Effect of SEGUE-based communication education on nursing simulation practice: a quasi-experimental design.

Background: Effective educational approaches are required to enhance nursing students' communication competency.Objectives: To  evaluate the effectiveness of SEGUE ('set the stage,' 'elicit information,' 'give information,' 'understand the patient's perspective,' and 'end the encounter')-based communication education.Design: A non-equivalent control group pretest-posttest design.Methods: Students were randomized into the control group (n = 41) and experimental group (n = 57). Communication competency and efficacy were measured via a self-report questionnaire and via ratings of the students from professor and standardized patient.Results: Scores by students (self-evaluations; p < .001), professor (p < .001), and standardized patient (p < .042) showed higher communication competency in the experimental group. Compared with the control group, the pre-post difference in communication efficacy in the experimental group was increased (p = .004).Conclusions: Simulation practice to reflect the various clinical situation is recommended to improve students' communication.Impact statement: SEGUE-based communication education in nursing simulation practice with the standardized patient was an effective strategy for improving nursing students' communication.

Family management of childhood atopic dermatitis.

AIMS: To identify the variables that affect family management of childhood atopic dermatitis and establish a prediction model based on Bandura's self-efficacy theory. BACKGROUND: Atopic dermatitis is a chronic recurrent skin disease and common health problem in childhood. It is necessary to use an approach that includes parental factors when considering the effective management of childhood atopic dermatitis. DESIGN: A cross-sectional study design. METHODS: A convenience sample, comprising 168 Korean mothers caring for a child with atopic dermatitis under the age of 13, was recruited from the paediatric outpatient departments of two general hospitals in Seoul, South Korea. Data were collected using structured self-reported questionnaires including severity, antecedents, effort, self-efficacy and family management of childhood atopic dermatitis from 1 November 2015-28 February 2016. Descriptive statistics about the participants and variables were examined and data were analysed using structural equation modelling. RESULTS: The hypothetical model had an adequate fit to the data, indicating that severity, antecedents, effort and self-efficacy influenced family management of childhood atopic dermatitis. CONCLUSION: These results suggest that strategies to support children with atopic dermatitis and their family should consider the influence of such variables.

Reliability and Validity of the Korean-Parental Self-Efficacy with Eczema Care Index.

BACKGROUND: Atopic dermatitis is a global problem affecting children, and its prevalence in Korea is steadily increasing. Since it is a chronically relapsing inflammatory skin disease, caregiver management of young children's atopic dermatitis is crucial for positive treatment outcomes. A factor that contributes to adherence to recommended prescriptions is parents' self-efficacy. However, accurate measurements of parental self-efficacy in relation to disease-specific task management are scarce. OBJECTIVES: This study examined the psychometric properties of the Korean language version of the Parental Self-Efficacy with Eczema Care Index (K-PASECI). METHODS: One hundred twenty five mothers of children younger than 13 years old who had atopic dermatitis were recruited from three tertiary hospitals across Korea. The K-PASECI was developed in accordance with the published guidelines. Psychometric testing included factor analysis, internal consistency testing, and concurrent validity analysis by comparing K-PASECI domains with parenting self-efficacy subscales. RESULTS: Factor analysis revealed a four-factor structure that explained 69.4% of the variance. The four factors were as follows; managing a child's symptoms and behaviour, communicating with medical staff, managing medication, and using moisturizer as part of routine management. The findings showed acceptable internal consistency (α=.94) and a moderate positive correlation with parenting self-efficacy (r=.48, p<.001). CONCLUSION: The K-PASECI, a reliable and valid scale for measuring self-efficacy in parents caring for children with atopic dermatitis, may be used in clinical and research settings to measure parents' self-efficacy in Korea, as well as in other English-speaking countries.

The effect of a Web-based education programme (WBEP) on disease severity, quality of life and mothers' self-efficacy in children with atopic dermatitis.

AIMS: To develop and evaluate the effects of a web-based education programme in early childhood for children with atopic dermatitis. BACKGROUND: The prevalence rate of atopic dermatitis is highest in early childhood. A holistic approach is urgently needed for young children with respect to disease severity, quality of life and management, particularly parental knowledge about atopic dermatitis and adherence to treatment. DESIGN: A quasi-experimental study design was used. METHODS: A total of 40 mother-child dyads participated in the study from 1 July-30 November 2011 in Korea. All children were under 3 years of age. The programme was based on the Network-Based Instructional System Design model, which consists of five phases: analysis, design, development, implementation and evaluation. The experimental group participated in the programme for 2 weeks. Participants took part in a learning session during the first week and then conducted the practice session at home during the second week. Participant knowledge and compliance were evaluated through online quizzes and self-checklists. Statistical analyses (chi-square test and t-test) were performed using the Statistical Analysis System, Version 9.13. RESULTS/FINDINGS: There was a significant improvement in disease severity, quality of life and mothers' self-efficacy in the experimental group; thus, the web-based education programme was effective. CONCLUSION: The web-based education programme as an advanced intervention may be useful in providing basic data for future atopic dermatitis-related studies. Moreover, the programme may serve as a nursing educational intervention tool for clinical nursing practices.