The Effects of an App-Based Physical Activity Program on Colorectal Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

BACKGROUND: Colorectal cancer is one of the most common malignancies worldwide. Oxaliplatin, which is used as adjuvant chemotherapy, affects quality of life by causing oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. OBJECTIVES: This study examined the effects of an application (app)-based physical activity program for alleviating peripheral neuropathy symptoms in colorectal cancer patients undergoing chemotherapy. METHODS: This was a randomized controlled study that included 34 patients undergoing chemotherapy after being diagnosed with colorectal cancer. Outcomes were compared between patients who participated in a 6-week app-based physical activity program (experimental group; n = 17) and who received standard booklet education (control group; n = 17). Data were collected using questionnaires, and exercise time was recorded to evaluate intervention adherence. RESULTS: Significant differences were observed between the groups in peripheral neuropathy symptoms (F = 8.93, P = .002), interference with activities (Z = -2.55, P = .011), and quality of life (F = 7.65, P = .003). The experimental group showed significantly higher average exercise times at 1 to 4 weeks (Z = -2.10, P = .026), 5 to 6 weeks (Z = -4.02, P < .001), and 1 to 6 weeks (Z = -3.40, P = .001) than the control group. CONCLUSIONS: The app-based physical activity program had a positive effect on participants' exercise adherence and reduced peripheral neuropathy symptoms. Thus, we propose the adoption of a mobile health app that can be used at any time or place as an intervention for preventing or alleviating adverse effects during the treatment of cancer patients. IMPLICATIONS FOR PRACTICE: An app-based physical activity program using the mobile health app can be used as a nursing intervention to manage symptoms and increase the health behavior adherence in cancer patients.

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea.

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

Learning effects of virtual versus high-fidelity simulations in nursing students: a crossover comparison.

BACKGROUND: Simulation is an alternative or complementary method for students who cannot obtain sufficient direct care experience, as they allow students to experience various clinical situations. Mixed learning is becoming increasingly common as a way to provide students with opportunities to experience real-life clinical scenarios. This study compared the learning effects of a virtual simulation and a high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. Through this comparison, this study aimed to obtain evidence to support decision-making regarding the most effective way to utilize mixed simulation strategies. METHODS: A quasi-experimental, crossover-design study was performed with two randomly allocated groups of 26 junior nursing students each. The virtual simulation used the vSim® for nursing, and the high-fidelity simulation used a scenario developed by the research team. The learning effects were measured in terms of the problem-solving process, clinical reasoning, reflective thinking, satisfaction with the practicum, and self-confidence. The data collected with a structured questionnaire were analyzed using the Mann-Whitney test. RESULTS: The virtual simulation-first, high-fidelity simulation-second order led to significantly higher scores for reflective thinking (z = 3.53, p < .001) and self-confidence (z = 2.47, p = .013) than the other order. CONCLUSIONS: The initial application of virtual simulation seemed to improve students' thought processes, and then high-fidelity simulation seemed to allow them to perform actual practice better. Further trials of mixed learning methods are necessary to maximize learning effects in nursing education. TRIAL REGISTRATION: KCT0005767  at 2021-01-12 registered.

[Development and Testing of a Mastery Learning Program of Nursing Skills for Undergraduate Nursing Students].

PURPOSE: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. METHODS: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. RESULTS: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. CONCLUSION: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.

Effectiveness of a brief self-care support intervention for pulmonary rehabilitation among the elderly patients with chronic obstructive pulmonary disease in Korea.

PURPOSE: This study assessed effects of a brief self-care support intervention (SCSI) to promote health-related quality of life (HRQoL) and self-care adherence among elderly patients with COPD in Korea. DESIGN: A single-blinded, randomized pre-/posttest design METHODS: A total of 40 participants were consecutively recruited from eligible patients admitted with an exacerbation of COPD to a department of pulmonology at a university hospital. Twenty participants were randomly divided into two groups: an experimental group and a control group. The experimental group received an SCSI utilizing a motivational interview. All participants were assessed with peak expiratory flow rate and 6-minute walking distance test, and answered Saint George's Respiratory Questionnaire (SGRQ) and a questionnaire on self-care adherence at pre-intervention and 2 months postintervention. FINDINGS: After the intervention, SGRQ scores for symptom, activity, impact, and total were significantly lower and self-care adherence scores of medication and exercise were significantly higher in the experimental group. CONCLUSIONS: This study confirmed the short-tem effectiveness of a nurse-led self-management intervention for pulmonary rehabilitation on quality of life and self-care adherence among elderly patients with COPD. Further studies are warranted to verify effective strategies to improve exercise capacity for this population. CLINICAL RELEVANCE: Our findings suggest a brief intervention for rehabilitation nursing with more retainable, feasible, and cost-effective strategies to enhance self-management among the elderly patients with COPD.

The effects of an animation distraction intervention on pain response of preschool children during venipuncture.

OBJECTIVE: The purpose of this study was to identify the effects of an animation distraction intervention on pain response of preschoolers during venipuncture. METHOD: The research employed a nonequivalent control group pretest-posttest quasi-experimental design. The experimental group (n = 20) was provided with an animation distraction intervention using a laptop computer during their first venipuncture, and the control group (n = 20) received standard treatment. RESULTS: There were statistically significant differences in self-reported pain response, behavioral pain response, blood cortisol, and blood glucose between the experimental group and the control group. CONCLUSION: This intervention requires minimum effort and time and may be a cost-effective and convenient nursing intervention that could be used easily in clinical settings.

[Women's cancer screening according to Body Mass Index in a cohort of rural Korean women].

PURPOSE: This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI). METHODS: The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI. RESULTS: The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI. CONCLUSION: Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.

Effects of a cognition-oriented breast self-examination intervention for Korean women and their spouses.

OBJECTIVE: This study evaluated the effectiveness of a cognition-oriented breast self-examination (BSE) intervention program that is based on the Transtheoretical Model and reflects individual characteristics according to BSE stage among Korean women and their spouses. DESIGN: A time-series nonequivalent control group design was used. SAMPLE AND MEASUREMENT: Twenty-four couples in each of 2 groups completed a preintervention test and were evaluated 1, 3, and 6 months later for their knowledge of breast cancer and BSE, spousal encouragement for BSE, perceived confidence in BSE methods, change in BSE stage, and perceived benefits and barriers to BSE. The intervention involved husbands as well as women, and consisted of lectures on breast cancer and BSE, demonstrations and practice with models while being videotaped, and feedback. RESULTS: There were significant differences between the control and experimental groups for all variables. Change of BSE stage in experimental group showed significantly advancement over time. CONCLUSIONS: This intervention program was effective in promoting regular BSE practice and in enhancing confidence in BSE. The intervention also raised awareness among husbands of the importance of breast health for their wives. Educational interventions for breast cancer prevention should be specified to an individual's stage of BSE.

Knowledge, barriers, and facilitators of Korean women and their spouses in the contemplation stage of breast self-examination.

The aim of this study was to identify the knowledge, barriers, and facilitators of breast self-examination (BSE) in Korean couples in the contemplation stage. The study design was based on assumptions from the Health Belief Model and Transtheoretical Model that contemplators perceiving benefits as greater than barriers are likely to move to the next stage. Participant couples, with wives having never practiced BSE but with an intention to do so, were drawn from churches. Qualitative research was conducted with focus group methodology including both husbands and wives in the groups. Data transcribed from audiotapes were analyzed to identify common themes. Knowledge of breast cancer and BSE included "perceiving risks of getting breast cancer," "behaviors used to stay healthy and detect breast cancer," and "skills in BSE"; barriers to BSE included "lack of sensitivity to breast cancer," "fear of getting bad news," "lack of information," and "shortage of time"; and facilitators of BSE included "making BSE a monthly routine," "continuous systematic interaction from healthcare professionals reaching out to the community," and "encouragement and help from husbands." To improve compliance with BSE, women in the contemplation stage need specific and correct knowledge delivered by diverse materials, reminders, and the inclusion of husbands as facilitators.

[The effects of psychosocial interventions to improve stress and coping in patients with breast cancer].

PURPOSE: The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer. METHODS: A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group (N=18). We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response. RESULTS: Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased. CONCLUSIONS: These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.

Exercise self-efficacy, exercise benefits and barriers, and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis.

This study compared perceived exercise self-efficacy, exercise benefits, exercise barriers, and commitment to a plan for exercise between Korean women with a diagnosis of either osteoporosis or osteoarthritis. The influence of exercise self-efficacy, exercise benefits and barriers on commitment to a plan for exercise was also assessed in each group. Participants in the study were 154 Korean women over 40 years of age who were recruited from hospitals, health centers or a nursing home. The two groups differed on commitment to a plan for exercise with commitment greater among women with osteoporosis. Exercise self-efficacy was the most influential variable on commitment to a plan for exercise accounting for 27% of the variance in commitment among osteoporosis patients and 53% of the variance among osteoarthritis patients. This study generated information relevant to tailoring exercise interventions to the differing needs and perceptions of Korean women with osteoporosis and osteoarthritis.

Activity intolerance and impaired physical mobility in elders.

PURPOSE: To clarify the use of two nursing diagnoses, activity intolerance and impaired physical mobility, with elderly patients. METHOD: Ninety-two elders from a long-term care facility in Wonju, Korea. A checklist developed by the researchers was used for data collection. FINDINGS: Defining characteristics from this study related to psychological components of activity intolerance are significant in differentiating between the two diagnoses. Using a decision-making tree based on data from this study, each nursing diagnosis can be correctly identified. CONCLUSIONS: The results of this study are significant in broadening the defining characteristics to be used in differentiating between two nursing diagnoses. PRACTICE IMPLICATIONS: Clarification of nursing diagnoses serves to direct students and nurses to choosing appropriate interventions.

Predictors of mammography participation among rural Korean women age 40 and over.

PURPOSE: The study was conducted to identify predictors of mammography screening for rural Korean women according to 'Stage of Change' from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. METHODS: A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed by Rakowski, et al. (1992). RESULTS: The most frequent stage of mammography adoption was 'contemplation' (40.5%). Predictors of stage of mammography adoption included 'mammogram recommended by health professional' (beta=0.59, t=16.12, p=.000), 'perceived benefits' (beta=0.09, t=2.21, p=.050), 'perceived susceptibility' (beta=0.09, t=1.98, p=.050), and 'perceived barriers' (beta= 0.07, t= -2.05, p=.041). 'Mammogram recommended by health professional' demonstrated the greatest association with having a mammogram. CONCLUSION: Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.

[Developing and testing the effects of a psychosocial intervention on stress response and coping in Korean breast cancer survivors: a pilot study].

PURPOSE: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. METHODS: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly (90 min) for 6 weeks. RESULTS: There was a significant decrease in stress scores following the intervention (Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. CONCLUSIONS: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.

[Validation of Quality of Life Index-Cancer among Korean patients with cancer].

PURPOSE: The purpose of this study was to validate Quality of Life Index-Cancer (Q.L.I.-C) developed by Ferrans (1990) among Korean cancer patients. METHOD: This study design was exploratory factor analysis methodology. Q.L.I.-C was translated into Korean and reverse-translated into English. The subjects were 357 Korean patients with various cancers. Data were collected by questionnaires from May to August, 2000 and was analyzed by descriptive statistics, Principal Component Analysis for construct validity and Cronbach's alpha coefficient for reliability. RESULT: The range of factor loadings was .446 approximately .841. The explained variance from the 5 extracted factors was 63.7% of the total variance. The first factor 'family' was 35.5%, and 'health & physical functioning', 'psychological', 'spiritual', and 'economic' factors were 11.5%, 6.9%, 5.6%, and 4.2% respectively. Because of cultural difference between Americans and Koreans, certain items such as sexuality, job status, and education were deleted from the extraction of factors in this study. The Cronbach's alpha coefficient was .9253 among the 28 items. CONCLUSION: Q.L.I.-C could be applied in measuring quality of life of Korean cancer patients. It also recommend to do further studies for validation of Q.L.I.-C American and Korean versions relating to cultural differences.

[Content analysis of the experience of preceptors in clinical education for senior student nurses].

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

[The relationships of treatment side effects, family support, and quality of life in patient with cancer].

PURPOSE: The study was done to identify the relationship of treatment side effects, family support, and quality of life in patients with cancer, and factors influencing quality of life. METHOD: A convenience sample of 106 patients who were receiving cancer treatment at W hospital were interviewed using the Side Effects scale by Hur, Family Support scale by Kang, and QOL scale by Ro. RESULT: Results indicate that women experienced more severe side effects than men. There was a negative relationship between side effects and quality of life, and a positive relationship between family support and quality of life. The most bothersome side effects were changes in taste and appetite, followed by general weakness and fatigue. Side effects such as loss of hair, nausea, dizziness, numbness, pins and needles in fingers and toes, and dry mouth were also experienced. General weakness and family support were analysed as to whether they were factors influencing quality of life. CONCLUSION: The results revealed that relieving general weakness should be given high priority in nursing interventions for patients undergoing cancer treatment. In addition, nursing programs should be developed that can reinforce family support.