OBJECTIVE

The competence of health workers to attend to vulnerable and marginalized populations is critical to health equity. The study determines the competence of physicians in providing health care to LGBT adolescents in a national tertiary hospital.

All physicians from the departments of Pediatrics and Family and Community Medicine were recruited. An electronic form collected demographic data and responses to the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBTDOCSS).Theresponsesweresummarizedandanalyzed.

Most respondents are male, with a mean age of 34.21 years. They are mainly staff of the Department of Pediatrics and post- residency fellows. Not all recall their participation in gender sensitivity training. They report scores towards the higher end of the scale: an overall score of 5.27 and mean subscale scores of 4.43 for clinical preparedness, 6.13 for attitudinal awareness, and 5.24 for basic knowledge. The heterogeneity and pertinacity of their experiences with LGBT individuals mediate their attitudinal awareness. Attaining the level of consultant suggests a better understanding of barriers and disparities against LGBT individuals. The tool has good internal reliability.

The demographic profile of the respondents suggests their involvement in healthcare, continuing education, and staff development. They report adequate competence in providing health care to LGBT adolescents.

PURPOSE: This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness.METHODS: A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0.RESULTS: This study showed improvement in the basic psychological needs (F=3.90, p =.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p =.035), relatedness (F=2.89, p =.045), and self-regulatory ability (F=3.11, p =.028) improved significantly.CONCLUSION: Study findings indicate thatthe smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.
Humans ; Mental Competency ; Personal Autonomy ; Self-Control ; Smartphone

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

PURPOSE: The purpose of this study was to investigate whether the effects of emotional intelligence and working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.METHODS: The data was collected between Aug. 1 and Aug. 30, 2018 from 240 nurses caring for cancer patients from 11 small and medium hospitals in B city. Variables included in this study were the Wong and Law Emotional Intelligence Scale (WLEIS), the Practice Environment Scale of Nursing Work Index (PES-NWI), the Global Interpersonal Communication Competence (GICC), and nursing performance. The collected data were analyzed by t-tests, ANOVA and Scheffe's test, Pearson's correlation coefficients, and 3 step multiple regression using SPSS/WIN 24.0 and the Sobel test.RESULTS: Communication competence, in the relationship between emotional intelligence and nursing working environment on nursing performance in nurses caring for cancer patients in small and medium hospitals, showed a partial mediating effect (Z=5.24, p < .001; Z=2.44, p=.001 respectively).CONCLUSION: The results of this study showed the effects of emotional intelligence and nursing working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.
Emotional Intelligence ; Humans ; Jurisprudence ; Mental Competency ; Negotiating ; Nursing

OBJECTIVE: We aimed to evaluate the effects of different oxygen conditions (20% [high O₂], 5% [low O₂] and 5% decreased to 2% [dynamic O₂]) on mouse pre- and peri-implantation development using a novel double-channel gas supply (DCGS) incubator (CNC Biotech Inc.) to alter the oxygen concentration during in vitro culture.METHODS: The high-O₂ and low-O₂ groups were cultured from the one-cell to the blastocyst stage under 20% and 5% oxygen concentrations, respectively. In the dynamic-O₂ group, mouse embryos were cultured from the one-cell to the morula stage under 5% O₂ for 3 days, followed by culture under 2% O₂ to the blastocyst stage. To evaluate peri-implantation development, the blastocysts from the three groups were individually transferred to a fibronectin-coated dish and cultured to the outgrowth stage in droplets.RESULTS: The blastocyst formation rate was significantly higher in the low-O₂ and dynamic-O₂ groups than in the high-O₂ group. The total cell number was significantly higher in the dynamic-O₂ group than in the low-O₂ and high-O₂ groups. Additionally, the apoptotic index was significantly lower in the low-O₂ and dynamic-O₂ groups than in the high-O₂ group. The trophoblast outgrowth rate and spread area were significantly higher in the low-O₂ and dynamic-O₂ groups than in the high-O₂ group.CONCLUSION: Our results showed that a dynamic oxygen concentration (decreasing from 5% to 2%) had beneficial effects on mouse pre- and peri-implantation development. Optimized, dynamic changing of oxygen concentrations using the novel DCGS incubator could improve the developmental competence of in vitro cultured embryos in a human in vitro fertilization and embryo transfer program.
Animals ; Apoptosis ; Blastocyst ; Cell Count ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Humans ; In Vitro Techniques ; Incubators ; Mental Competency ; Mice ; Morula ; Oxygen ; Trophoblasts

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: ‘postpartum hemorrhage and shock,’ ‘cardiopulmonary resuscitation (CPR) for neonate,’ ‘CPR during pregnancy,’ ‘disseminated intravascular coagulation,’ ‘sepsis,’ and ‘mechanical ventilation during pregnancy.’ CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.
Clinical Competence ; Critical Care ; Education ; Hemorrhage ; Humans ; Infant, Newborn ; Intensive Care Units ; Korea ; Maternal Age ; Mental Competency ; Mothers ; Nursing ; Resuscitation ; Ventilation

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
Caregivers ; Curriculum ; Drug-Related Side Effects and Adverse Reactions ; Education ; Education, Medical, Undergraduate ; Ethics, Medical ; Follow-Up Studies ; Humans ; Korea ; Learning ; Medical Errors ; Mental Competency ; Patient Safety ; Professionalism ; Quality Improvement ; Schools, Medical ; Students, Medical

PURPOSE: The aim of this study was to investigate how type I diabetes mellitus (T1D) affects the folliculogenesis and oocyte development, fertilization, and embryo development. MATERIALS AND METHODS: A comparative animal study was conducted using two different mouse models of T1D, a genetic AKITA model and a streptozotocin-induced diabetes model. Ovarian function was assessed by gross observation, immunoblot, immunohistochemistry, oocyte counting, and ELISA for serum hormones (insulin, anti-Mullerian hormone, estradiol, testosterone, and progesterone). Maturation and developmental competence of metaphase II oocytes from control and T1D animals was evaluated by immunofluorescent and immunohistochemical detection of biomarkers and in vitro fertilization. RESULTS: Animals from both T1D models showed increased blood glucose levels, while only streptozotocin (STZ)-injected mice showed reduced body weight. Folliculogenesis, oogenesis, and preimplantation embryogenesis were impaired in both T1D mouse models. Interestingly, exogenous streptozotocin injection to induce T1D led to marked decreases in ovary size, expression of luteinizing hormone/chorionic gonadotropin receptor in the ovaries, the number of corpora lutea per ovary, oocyte maturation, and serum progesterone levels. Both T1D models exhibited significantly reduced pre-implantation embryo quality compared with controls. There was no significant difference in embryo quality between STZ-injected and AKITA diabetic mice. CONCLUSION: These results suggest that T1D affects folliculogenesis, oogenesis, and embryo development in mice. However, the physiological mechanisms underlying the observed reproductive effects of diabetes need to be further investigated.
Animals ; Anti-Mullerian Hormone ; Biomarkers ; Blood Glucose ; Body Weight ; Corpus Luteum ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Embryonic Development ; Embryonic Structures ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Female ; Female ; Fertility ; Fertilization ; Fertilization in Vitro ; Gonadotropins ; Humans ; Immunohistochemistry ; Lutein ; Mental Competency ; Metaphase ; Mice ; Oocytes ; Oogenesis ; Ovary ; Pregnancy ; Progesterone ; Reproduction ; Streptozocin ; Testosterone

PURPOSE: In the present study, human neural stem cells (hNSCs) with tumor-tropic behavior were used as drug delivery vehicle to selectively target melanoma. A hNSC line (HB1.F3) was transduced into two types: one expressed only the cytosine deaminase (CD) gene (HB1.F3. CD) and the other expressed both CD and human interferon-β (IFN-β) genes (HB1.F3.CD. IFN-β). MATERIALS AND METHODS: This study verified the tumor-tropic migratory competence of engineered hNSCs on melanoma (A375SM) using a modified Boyden chamber assay in vitro and CM-DiI staining in vivo. The antitumor effect of HB1.F3.CD and HB1.F3.CD.IFN-β on melanoma was also confirmed using an MTT assay in vitro and xenograft mouse models. RESULTS: A secreted form of IFN-β from the HB1.F3.CD.IFN-β cells modified the epithelial-mesenchymal transition (EMT) process and metastasis of melanoma. 5-Fluorouracil treatment also accelerated the expression of the pro-apoptotic protein BAX and decelerated the expression of the anti-apoptotic protein Bcl-xL on melanoma cell line. CONCLUSION: Our results illustrate that engineered hNSCs prevented malignant melanoma cells from proliferating in the presence of the prodrug, and the form that secreted IFN-β intervened in the EMT process and melanoma metastasis. Hence, neural stem cell-directed enzyme/prodrug therapy is a plausible treatment for malignant melanoma.
Animals ; Cell Line ; Cytosine Deaminase ; Epithelial-Mesenchymal Transition ; Flucytosine ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Melanoma ; Mental Competency ; Mice ; Neoplasm Metastasis ; Neural Stem Cells ; Stem Cells

PURPOSE: The purpose of this study was to examine the frequency, perceived importance and competence of pediatric emergency nursing practice (PENP) in nurses who cared for pediatric patients in the emergency department. METHODS: This cross-sectional descriptive study analyzed 175 emergency department nurses caring for pediatric patients at 7 university hospitals with more than 500 beds, located in Seoul and Gyeonggi Province. The measurement tool was modified from the Classification of Standard Nursing Activities to measure the frequency, importance of PENP, and nursing competence. It comprised 143 items in 16 domains of PENP. RESULTS: The most frequent nursing practice was the domain of ‘nursing records and environmental management’ and the least frequent practice was the ‘research and consulting’ domain. The nursing care domain perceived to be most important by nurses was ‘specialized intensive nursing care’. The nursing care domain with the highest level of nursing competence was ‘hygiene care’, and the domain with the least level of nursing competence was the ‘research and consulting’. CONCLUSION: These results will be utilized as basic data for future pediatric emergency nursing education initiatives and for establishing priorities of nursing policy to improve health care for children admitted to the emergency department.
Child ; Child Care ; Classification ; Delivery of Health Care ; Education ; Emergencies ; Emergency Nursing ; Emergency Service, Hospital ; Gyeonggi-do ; Hospitals, University ; Humans ; Mental Competency ; Nurse's Role ; Nursing Care ; Nursing ; Professional Competence ; Seoul