PURPOSE: In this study self-efficacy, emotional labor, pediatric nurse-parent partnership and job stress of pediatric nurses were examined. Factors affecting job stress of pediatric nurses were also investigated. METHODS: The study was done between June and September 2014, with a convenience sample of 145 nurses from 3 advanced general hospitals, 5 general hospitals and 2 children's hospitals. Research data were collected via questionnaires and analysed using SPSS version 18.0. RESULTS: Average levels of self-efficacy, emotional labor and job stress were similar to other general nurses and the average level of pediatric nurse-parent partnership was also similar to other pediatric nurses. Job stress of pediatric nurses showed a positive correlation with emotional labor and negative correlations with self-efficacy and pediatric nurse-parent partnership. The most significant factor affecting job stress in pediatric nurses was emotional labor (beta=0.372, p<.001). The combination of emotional labor, pediatric nurse-parent partnership and self-efficacy accounted for 25.4% of job stress in pediatric nurses. CONCLUSION: These results suggest that nursing management strategies to decrease emotional labor and improve pediatric nurse-parent partnerships and self-efficacy are critical to decrease job stress for pediatric nurses. Continued development of nursing management interventions to decrease job stress in pediatric nurses is suggested.
Child ; Hospitals, General ; Humans ; Nursing ; Parents ; Professional-Family Relations

Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

Total body irradiation (TBI) is included in the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT), with unique advantages such as uniform distribution over the whole body and decreased exposure to cytotoxic chemotherapeutic agents. For individuals who lack matched sibling or matched unrelated donors, the use of haploidentical donors has been increasing despite challenges such as graft rejection and graft-versus-host disease (GVHD). Although a limited number of studies have been performed to assess the clinical role of TBI in haploidentical HSCT, TBI-based conditioning showed comparable results in terms of survival outcomes, rate of relapse, and GVHD in diverse hematologic malignancies such as leukemia, lymphoma, and multiple myeloma. Advances in supportive care, along with recent technical improvements such as restriction of maximum tolerated dose, appropriate fractionation, and organ shielding, help to overcome diverse adverse events related to TBI. Post-transplantation cyclophosphamide was used in most studies to reduce the risk of GVHD. Additionally, it was found that post-transplantation rituximab may improve outcomes in TBI-based haploidentical HSCT, especially in patients with B-cell lymphoma. Along with the advances of techniques and strategies, the expansion of age restriction would be another important issue for TBI-based haploidentical HSCT considering the current tendency toward increasing age limitation and lack of matched donors. This review article summarizes the current use and future perspectives of TBI in haploidentical HSCT.

OBJECTIVE: Decompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety. METHODS: In the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B). Two groups were compared in the terms of the decompressed area of the craniectomy, protruded brain volume out of the skull layer, the operation time from skin incision to bone flap removal, and modified Rankin Scale (mRS) which was evaluated for 3 months after surgery. RESULTS: The decompressed area of craniectomy (389.1 cm² vs. 318.7 cm², p=0.041) and the protruded brain volume (151.8 cm³ vs. 116.2 cm³, p=0.045) were significantly larger in Group A compared to the area and the volume in Group B. The time interval between skin incision and bone flap removal was much shorter in Group A (23.3 minutes vs. 29.5 minutes, p=0.013). But, the clinical results were similar between 2 groups. Group A showed more favorable outcome proportion (mRS 0-3, 6/15 patients vs. 5/23 patients, p=0.225) and lesser mortality cases proportion 1/15 patients vs. 4/23 patients, but these differences were not significantly observed (p=0.225 and 0.339). CONCLUSION: DC using n-shaped skin incision was a feasible and safe surgical technique. It may be an easier and faster method for the purpose of training neurosurgeons.
Brain ; Decompression ; Decompressive Craniectomy* ; Dermatologic Surgical Procedures ; Humans ; Methods ; Mortality ; Neurosurgeons ; Skin* ; Skull ; Surgical Flaps ; Surgical Procedures, Operative

The vast majority of malignant tumors involving the vagina are secondary spread from primary malignant lesion of the cervix uteri, the sigmoid colon, the bladder and the vulva. Primary invasive carcinoma of the vagina remains among the rare gynecologic malignant tumor. The diagnosis of primary carcinoma of the vagina requires that the cervix and the vulva be intact and no clinical evidence of other primary tumors exist. Greater than 80-90% of all vaginal tumors are squamous cell type. We experienced two cases of primary vaginal cancer of 68 years old woman without any other gynecologic disease and 67 years old woman after hysterectomy for benign desease. We presented these cases with a brief review of related literatures.
Aged ; Cervix Uteri ; Colon, Sigmoid ; Diagnosis ; Female ; Genital Diseases, Female ; Humans ; Hysterectomy ; Neoplasms, Squamous Cell ; Urinary Bladder ; Vagina ; Vaginal Neoplasms* ; Vulva

BACKGROUND AND PURPOSE: Although subjective cognitive impairment (SCI) is often accompanied by Parkinson's disease (PD) and may predict the development of mild cognitive impairment or dementia, longitudinal brain perfusion changes in PD patients with SCI remain to be elucidated. The current prospective study examined cerebral perfusion changes in PD patients with SCI using technetium-99m hexamethylpropylene amine oxime single photon emission computed tomography (SPECT). METHODS: Among 53 PD patients at baseline, 30 patients were classified into the PD with SCI group and 23 patients were assigned to the PD without SCI group. The mean follow-up interval was 2.3±0.9 years. The Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale were used to assess impairments in cognitive function. Brain SPECT images were acquired at baseline and follow-up. RESULTS: Significant differences between the two groups were not found for demographic variables, PD severity, or cognitive function at either baseline or follow-up. At baseline, the PD with SCI group showed decreased perfusion in the left angular gyrus compared to the PD without SCI group. Longitudinal analysis revealed widespread perfusion reductions primarily in the bilateral temporo-parieto-occipital areas and cerebellum in the PD with SCI group. Relative to the PD without SCI group, an excessive decrease of perfusion was found in the left middle frontal gyrus of the PD with SCI patients. CONCLUSIONS: Our findings suggest that perfusion deficits in the middle frontal area may play an important role in the pathophysiology of SCI in PD.
Brain ; Cerebellum ; Cognition ; Cognition Disorders* ; Dementia ; Follow-Up Studies ; Humans ; Mild Cognitive Impairment ; Parietal Lobe ; Parkinson Disease* ; Perfusion* ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Healthcare workers (HCWs) have a high risk of tuberculosis (TB) infection. Since August 2017, Korea has mandated the testing of latent TB infection (LTBI) and recommended treatment from HCWs at medical institutions. However, the acceptance/completion rate and adverse events of LTBI treatment have not been analyzed. MATERIALS AND METHODS: From February to August 2017, we conducted a retrospective study at a referral university hospital in Korea, to screen the interferon-gamma release assay (IGRA) tests conducted for all HCWs for detecting and treating LTBI. HCWs diagnosed with LTBI were offered a 9-month isoniazid (9H), 3-month isoniazid/rifampin (3HR), or 4-month rifampin regimen. We investigated the acceptance/completion rate, adverse events, and causes of discontinuation or change in LTBI medication. A major adverse event was one wherein a patient had any adverse event ≥grade 3 causing LTBI treatment interruption. RESULTS: Of the 1,538 HCWs, 1,379 underwent IGRA testing for LTBI. Among them, 13.6% (187/1,379) tested positive and 73.3% (137/187) received treatment. The overall completion rate was 97.8% (134/137). HCWs were significantly more likely to complete first-line therapy with 3HR than with 9H (91.4% vs. 76.7%, P = 0.02). The most common major adverse event was hepatotoxicity (n = 7), followed by thrombocytopenia (n = 1) and anaphylactic shock (n = 1). Hepatotoxicity and hepatotoxicity (≥ grade 2) were more frequent in 9H than in 3HR (39.5% vs. 17.2%, P = 0.006 and 18.6% vs. 3.7%, P = 0.005, respectively). The median time to hepatotoxicity was 96 days (interquartile range, 20 – 103 days). CONCLUSION Completion of first-line therapy for LTBI is more likely with 3HR than with 9H. This might be related to the development of hepatotoxicity after around 3 months of treatment. Anaphylactic shock and platelet count should be carefully monitored in those receiving rifampin-containing regimens.

Purpose: This study aims to determine nursing students’ orientation toward patient-centered care (PCC) and identify its influencing factors: their personality traits, empathy, and psychological capital (PsyCap). A mediating model was used to test the role of PsyCap in the association between empathy and PCC. Methods: This cross-sectional study included 300 nursing students from seven universities in South Korea. Their orientation toward PCC was measured using the Patient-Practitioner Orientation Scale (PPOS). Moreover, we analyzed the data using independent t-tests, ANOVA, Pearson's r, and SPSS PROCESS macro. Results: The overall mean score on the PPOS was 3.82±0.43, with the Caring and Sharing subscales accounting for 3.95±0.68 and 3.69±0.50, respectively. Nursing students’ satisfaction with their majors, practicums, and motivation for choosing this profession was significantly related to Caring-not Sharing. Nevertheless, PsyCap positively influenced both Caring (β=.24, p<.001) and Sharing (β=.18, p=.002). While empathy failed to significantly impact both Caring (β=.12, p=.087) and Sharing (β=.01, p=.931). PsyCap mediated the association of empathy with Caring (β=.20, p=.004); however, the same was not true for Sharing (β=.07, p=.366). Conclusion The findings indicate that the orientation of Korean nursing students toward PCC is not high. Therefore, to improve the PPOS Caring subscale, nurse educators should formulate better strategies to enhance nursing students’ satisfaction with their major and practicums, empathy, and PsyCap. The importance of sharing health-related information with patients and family caregivers should be emphasized in the nursing curriculum.

PURPOSE: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. MATERIALS AND METHODS: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. RESULT: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P =0.009, P =0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P =0.001). MCS was significantly related to whether patient was affected by cancer (P =0.043) and has occupation (P = 0.008) or not in multivariable analysis. CONCLUSION: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
Anxiety ; Breast ; Depression ; Genetic Counseling ; Genetic Testing ; Health Surveys ; Humans ; Occupations ; Orientation ; Ovarian Neoplasms ; Quality of Life

PURPOSE: This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS: The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS: The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION: Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.
Caregivers ; Databases, Factual ; Dissertations, Academic as Topic ; *Education, Nursing, Graduate ; Hospitals ; Humans ; Nursing Research/*trends ; Patients ; Republic of Korea ; Research Design/trends ; Residence Characteristics ; Schools