Purpose: The purpose of this study was to measure the influence of job stress, critical thinking disposition, and clinical decision-making ability on clinical nurses’ medication safety competence. Methods: A descriptive survey was conducted among 140 nurses with more than 6 months of work experience in 4 general hospitals in Busan metropolitan city. Data were collected from August 15 to October 30, 2021 and analyzed using the independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Medication safety competence had significant correlations with job stress (r=.20, p=.021), critical thinking disposition (r=.63, p<.001), and clinical decision-making ability (r=.54, p<.001). Multiple regression analysis for medication safety competence revealed that the most powerful predictor was critical thinking disposition. Job stress and critical thinking disposition explained approximately 45% of the variance in medication safety competence. Conclusion This study confirms the need to make systematic efforts in clinical settings to improve nurses’ medication safety competence, and seeks ways to do so. To enhance clinical nurses’ medication safety competence in the future, programs that manage job stress and improve critical thinking disposition within the nursing department in particular and the hospital in general should be developed and implemented.

No abstract available.
Skin Neoplasms* ; Skin*

No abstract available.
Folliculitis ; Herpes Zoster ; Herpesvirus 3, Human

PURPOSE: The purpose of this study was to conduct a grounded theoretical analysis on the hospital accreditation experience of head nurses in order to understand their behavior on the adaption of this new system. METHODS: The participants were 8 head nurses with more than 3 years of experience. The data were collected through in-depth interviews using audiotape recording analyzed by the constant comparative method described in Strauss and Corbin's methodology. RESULTS: There were 113 concepts, 26 subcategories and 12 categories identified through the open coding process. In the axial coding, the following paradigm model was proposed: 1) the causal conditions were ‘hardware problem’ and ‘software problem’, 2) the contextual conditions were ‘vertical relationship’, ‘individual preference’, and ‘family support’, 3) the intervening conditions were ‘passive conditions’ and ‘active conditions’, 4) the action/interaction strategies were ‘leading role’ and ‘dependent role’, 5) the consequences were ‘positive acceptance’ and ‘negative acceptance’, 6) the central phenomenon was ‘difficult situation’ and 7) the core category was ‘leading in harmony’. CONCLUSION: The new system led head nurses having difficulties as the middleman between the hospital administration and general nurses, but they made a continuous effort to overcome and adapt to it through a number of strategies.
Accreditation* ; Clinical Coding ; Grounded Theory ; Head* ; Hospital Administration ; Hospitals, General* ; Methods ; Nursing, Supervisory* ; Tape Recording

A 9-month-old infant presented with cough, tachypnea, and grunting was admitted. The patient was revealed to have cardiomegaly, high NT-proBNP, and severe left ventricular dilation and dysfunction; she was subsequently diagnosed with acute myocarditis and congestive heart failure. Intravenous immunoglobulin, inotropics, diuretics, angiotensin converting enzyme inhibitors and beta blocker were used. However, left hemiparesis suddenly developed at 30-day after treatment. Brain MRI showed high signal intensity in the right middle cerebral arterial territory on diffusion weighted brain MRI and in the left parietal lobe with gyral enhancement. Echocardiogram revealed no definite intraventricular thrombus. The patient was started on an antiplatelet agent only without anticoagulant therapy for the treatment of cerebral infarct in respect of the risk to the infant. Four years after the cerebral ischemic stroke (CIS), she showed complete recovery from hemiparesis, with no more CIS. In conclusion, severe ventricular dilatation and dysfunction can lead to thromboembolic events in infants. We should keep in mind that anticoagulant or antiplatelet agents can be used in specific situations.
Angiotensin-Converting Enzyme Inhibitors ; Brain ; Cardiomegaly ; Cough ; Diffusion ; Dilatation ; Diuretics ; Heart Failure ; Humans ; Immunoglobulins ; Infant ; Myocarditis ; Natriuretic Peptide, Brain ; Paresis ; Parietal Lobe ; Peptide Fragments ; Platelet Aggregation Inhibitors ; Stroke ; Tachypnea ; Thrombosis

Purpose: To investigate the effect of preemptive systemic analgesia using patient-controlled analgesia (PCA) on postoperative pain after evisceration. Methods: Of the patients who underwent evisceration under general anesthesia in our hospital, 55 who were able to evaluate pain using a numeral rating scale (NRS) were included. The patients were divided into two groups: group 1 used PCA after surgery, and group 2 used PCA preemptively before surgery. We compared the two groups in terms of the NRS pain scores on the day of surgery and 1, 2, and 3 days after surgery, and according to whether additional analgesics were used. Results: The 55 patients included 17 in group 1 and 38 in group 2. The NRS at 3, 5, and 7 hours on the day of surgery tended to be lower in group 2, but not significantly (p > 0.05). The NRS on days 1 and 2 after surgery was significantly lower in group 2 (p = 0.014 and p = 0.027, respectively), and the NRS on day 3 after surgery was also lower, although not significantly (p = 0.059). Significantly fewer cases required additional analgesics in group 2 compared to group 1 on the day of surgery and 1, 2, and 3 days after surgery (p = 0.001, p < 0.001, p < 0.001, and p = 0.008, respectively). Conclusions Using preemptive systemic PCA in evisceration significantly reduced the postoperative pain, and PCA itself was an effective administration method due to the high rate of pain control without the need for additional analgesics.

Purpose: We investigated the effect of preoperative administration of analgesics and sedatives on pain levels during silicone tube intubation conducted under local anesthesia in patients with acquired nasolacrimal duct stenosis. Methods: We retrospectively reviewed the medical records from 121 patients at the ophthalmology department of our hospital from July 2016 to May 2022. In total, 71 patients were administered acetaminophen and diazepam orally, while the remaining 50 were not. Postoperative pain (measured using the visual analogue scale [VAS] score [0 = no pain, 10 = severe pain] immediately after operation), operative duration, and improvement in epiphora symptoms were compared between the two groups. Results: The premedication group had significantly lower VAS scores than the non-premedication group (5.23 ± 2.75 vs. 6.34 ± 2.33, p = 0.02). It also had a notably shorter (p < 0.01) operation duration and higher subjective improvement rate of epiphora symptoms. However, premedication did not influence the tube retention period post-surgery (p = 0.86). Conclusions The administration of analgesics and sedatives prior to silicone tube intubation effectively mitigates operative pain and reduces operation duration. Furthermore, it may help improve postoperative epiphora symptoms.

No abstract available.
Carcinoma, Adenoid Cystic* ; Histiocytoma, Benign Fibrous*

Background: Prurigo nodularis (PN) is a severely pruritic chronic skin disease, and its management is challenging.Although some studies have described the natural course and demographics of PN, there are few studies on the quality of life (QOL) or psychological problems in patients with PN. Objective: This study aimed to evaluate the QOL and psychological problems of PN patients and identify the factors which effect on the QOL and psychological problems of these patients. Methods: We performed a cross-sectional study of 41 patients with PN who visited the Department of Dermatology at Konyang University Hospital between November 2022 and March 2023. Age, sex, clinical features, itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Beck Anxiety Inventory (BAI) were evaluated through the questionnaire. Results: PN patients had mean DLQI, BDI, ISI, and BAI scores of 13.9, 15.0, 8.9, and 13.0, respectively. There were no significant differences in the DLQI, BDI, ISI, or BAI scores with respect to sex, smoking, alcohol, drug history, disease duration, or treatment duration. Patients with systemic diseases or other dermatologic diseases were more likely to have higher DLQI scores than those without any associated disease (p=0.043 and p=0.015). Moreover, patients with higher itch NRS scores had higher DLQI and ISI scores (p=0.002 and p=0.030). Conclusion We found that PN had a large impact on QOL and mental health. Therefore, we recommend that dermatologists pay close attention to the psychological aspects when treating and educating patients with PN.

PURPOSE: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). METHODS: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. RESULTS: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepam-trial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). CONCLUSION: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.
Abdomen, Acute ; Aerophagy ; Child* ; Clonazepam* ; Diagnosis ; Female ; Humans ; Intellectual Disability* ; Intestinal Volvulus ; Mentally Disabled Persons ; Retrospective Studies