PURPOSE: The purpose of the study was to explore the levels of self-awareness, assertiveness, life stress, and empathy in nursing students and identify influential factors on empathy. METHODS: A predictive correlational design was used. The data was collected by questionnaires from a convenience sample of 319 nursing students in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean items scores of self-awareness, assertiveness, life stress, and empathy were 3.49, 3.02, 2.20 and 3.58, respectively, of a possible score ranging from 1 to 5. Empathy significantly differed by gender, grade, satisfaction with nursing as a major, and clinical practice experience. Empathy was correlated with self-awareness and interpersonal relationship stress. As a result of multiple regression analysis, empathy accounted for 20.1% of the variance by self-awareness, gender, clinical practice experience and interpersonal relationship stress. The most important factor was self-awareness, which explained 11.6% of the variation. CONCLUSION: The results of the study reveal that strengthening self-awareness and relieving interpersonal relationship stress ought to be integrated in developing effective educational intervention for enhancing empathy in nursing students.
Assertiveness ; Empathy* ; Humans ; Korea ; Nursing ; Surveys and Questionnaires ; Stress, Psychological ; Students, Nursing*

Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, 1H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed 1H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parietooccipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using 1H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.

Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, 1H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed 1H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parietooccipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using 1H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

Purpose: This study aimed to identify the actor and partner effects of human papillomavirus (HPV) vaccination knowledge, health beliefs, and self-efficacy on parental intentions to vaccinate adolescent sons against HPV. Methods: The participants were 191 couples who met the eligibility criteria. Data were collected from June 2024 through internet communities in Gyeongsangnam Province. The actor-partner interdependence model was used to analyze the parent's actor and partner effects of HPV vaccination knowledge, health beliefs, and self-efficacy on parents' intentions to vaccinate their adolescent sons against HPV. Results: The actor effects of fathers' intentions to vaccinate their adolescent sons against HPV were perceived benefits and self-efficacy; however, the partner effect was not significant. The actor effects of mothers' intentions to vaccinate their adolescent sons against HPV were perceived susceptibility, perceived severity, perceived benefits, and self-efficacy, and the partner effects were fathers' perceived severity and benefits. Conclusion This study indicates that fathers' intentions to vaccinate their adolescent sons against HPV may play an essential role in increasing HPV vaccination rates among adolescent sons.

PURPOSE: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. METHODS: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). RESULTS: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. CONCLUSION: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.
Caregivers ; Dementia* ; Diagnosis ; Emigrants and Immigrants ; Humans ; Methods ; Qualitative Research ; Shock

PURPOSE: Typical pathologic lesions of chronic allograft rejection or transplant vascular sclerosis are similar to arteriosclerotic vascular lesion of non-transplant patients, or vascular remodeling process after vascular injury. Abnormal and excess proliferation of vascular smooth muscle cells (VSMC) which are triggered by endothelium-derived cytokines or growth factors, play a major role during these process. Effective prophylactic or therapeutic strategies against chronic rejection or transplant vasculopathy is not yet clearly established. Recent in vitro cell culture study showed that carvedilol, a novel antihypertensive agent has the significant inhibitory activities against the proliferation of VSMC. METHODS: Using in vitro VSMC culture techniques, we measured anti-proliferative activity of carvedilol alone, or in combination of cyclosporine, a basic immunosuppressive agent for transplantation. Growth-arrested early passage (3-5) cultured VSMC from the aorta of rat (Sprague-Dawley) were exposed to platelet derived growth factor (PDGF), endothelin-l, or antiotensin-ll, respectively. Carvedilol and/or cyclosporine was added as inhibitors. Proliferation was assessed by incorporated [(3)H]-thymidine activity. RESULTS: PDGF stimulated mitogenesis most effectively. Carvedilol inhibited mitogenesis in dose-dependent manner in the presence of PDGF(10ng/ml). Compared to control, proliferation was significantly decreased to 60.3 (+/-10.4)% and 18.3 (+/- 5.9)% in the presence of 1 micro M and 10 micro M of carvidilol, respectively (p<0.05, each). Carvedilol also produced significant concentration-dependent inhibitory activities against VSMC stimulated by endothelin-1 (10 nM) and angiotensin-II (100 nM). The IC50 of carvedilol in PDGF-, endothelin-l, and angiotensin-ll-stimulated VSMC were 1-10 micro M. Cyclosporine (100 nM) did not show significant inhibition of VSMC regardless of the kinds of cytokines. However, combined addition of carvedilol and cyclosporine produced significant VSMC inhibition. The pattern of inhibition in c very similar with that of carvedilol alone group regardless of the kinds of cytokines. CONCLUSION: We demonstrated that carvedilol significantly inhibited the proliferation of VSMC regardless of the kind of cytokines, and even under the presence of cyclosporine in VSMC cultures. These indicated that carvedilol has the unique potential to reduce the development of transplant vasculopathy when used with cyclosporine in hypertensive renal transplant recipients.
Allografts ; Animals ; Aorta ; Cell Culture Techniques ; Culture Techniques ; Cyclosporine* ; Cytokines ; Endothelin-1 ; Humans ; Inhibitory Concentration 50 ; Intercellular Signaling Peptides and Proteins ; Muscle, Smooth, Vascular* ; Platelet-Derived Growth Factor ; Rats* ; Sclerosis ; Transplantation ; Vascular System Injuries

PURPOSE: Excessive proliferation and migration of vascular smooth muscle cells (VSMCs), which are triggered by endothelium-derived cytokines or growth factors, play a major role in the chronic transplant vasculopathy or vascular remodeling process after vascular injury. We have reported that carvedilol, a new anti-hypertensive agent, inhibits cytokine-triggered proliferation of cultured rat VSMCs. In this study, we investigate the effect of carvedilol on the migration of rat VSMCs. METHODS: Growth-arrested cultured VSMCs (passage 8-11) from the aorta of rat (Sprague-Dawley) were used. Migration was measured using a microchemotaxis chamber with a polycarbonate membrane. Platelet derived growth factor (PDGF) or angiotensin-II (ANG-II) was used as a stimulator and was added into the lower well of the chamber. A density of 1X104 cells per well with carvedilol and/or cyclosporine A (CsA) was seeded into the upper well of chamber. Degree of migration was assessed by using the number of migrated cells per high power field of light microscopy. RESULTS: PDGF and ANG-II stimulated VSMC chemotaxis effectively. Carvedilol decreased PDGF-induced migration to 88.9 (+/-16.0)% and 37.4 (+/-10.5)% at 1 microM and 10 microM, respectively. Carvedilol inhibited both PDGF and ANG-IIinduced chemotaxis in a concentration-dependent manner. The IC50 of carvedilol in PDGF and ANG-ll-induced VSMC migration was around 10 microM. CsA (100 nM) neither significantly inhibited the migration of VSMC, regardless of the kinds of cytokines, nor affected the inhibitory activities of carvedilol. The pattern of inhibition in the group with a combined addition of carvedilol and CsA was very similar to that of carvedilol alone group, regardless of the kinds of cytokines. CONCLUSION: We demonstrated that carvedilol alone or in the presence of CsA significantly inhibited the cytokine- induced migration of VSMC. These data indicate that carvedilol has a unique potential to reduce the development of chronic transplant vasculopathy when used with CsA in hypertensive renal transplant recipients.
Animals ; Aorta ; Chemotaxis ; Cyclosporine* ; Cytokines ; Inhibitory Concentration 50 ; Intercellular Signaling Peptides and Proteins ; Membranes ; Microscopy ; Muscle, Smooth, Vascular* ; Platelet-Derived Growth Factor ; Rats* ; Transplantation ; Vascular System Injuries