Purpose: : This study aimed to identify the factors influencing the professional quality of life of intensive care unit (ICU) nurses working in university hospitals. Methods: : A survey was conducted on 171 ICU nurses in university hospitals in B City, South Korea. This study used the Professional Quality of Life instrument, which consists of three subscales, namely, compassion satisfaction, burnout, and secondary traumatic stress. Data were analyzed using stepwise multiple regression analysis. Results: : Compassion satisfaction was influenced by resilience, ICU job satisfaction, and innovation-oriented culture, and these variables explained 37.1% of the variance in compassion satisfaction. Burnout was influenced by resilience, a hierarchy-oriented culture, and ICU job satisfaction, and these variables explained 42.9% of the variance in burnout. Secondary traumatic stress was influenced by a task-oriented culture and resilience, and these variables explained 12.5% of the variance in secondary traumatic stress. Conclusion : These findings suggest the importance of improving resilience and job satisfaction to enhance the professional quality of life in ICU nurses. Moreover, creating an innovation-oriented culture rather than a hierarchical and task-oriented culture can effectively improve the professional quality of life of ICU nurses.

Early detection and proper management of kidney rejection are crucial for the long-term health of a transplant recipient. Recipients are normally monitored by serum creatinine measurement and sometimes with graft biopsies. Donor-derived cell-free deoxyribonucleic acid (cfDNA) in the recipient's plasma and/or urine may be a better indicator of acute rejection. We evaluated digital PCR (dPCR) as a system for monitoring graft status using single nucleotide polymorphism (SNP)-based detection of donor DNA in plasma or urine. We compared the detection abilities of the QX200, RainDrop, and QuantStudio 3D dPCR systems. The QX200 was the most accurate and sensitive. Plasma and/or urine samples were isolated from 34 kidney recipients at multiple time points after transplantation, and analyzed by dPCR using the QX200. We found that donor DNA was almost undetectable in plasma DNA samples, whereas a high percentage of donor DNA was measured in urine DNA samples, indicating that urine is a good source of cfDNA for patient monitoring. We found that at least 24% of the highly polymorphic SNPs used to identify individuals could also identify donor cfDNA in transplant patient samples. Our results further showed that autosomal, sex-specific, and mitochondrial SNPs were suitable markers for identifying donor cfDNA. Finally, we found that donor-derived cfDNA measurement by dPCR was not sufficient to predict a patient's clinical condition. Our results indicate that donor-derived cfDNA is not an accurate predictor of kidney status in kidney transplant patients.
Biopsy ; Creatinine ; DNA ; Humans ; Kidney Transplantation* ; Kidney* ; Monitoring, Physiologic ; Plasma ; Polymerase Chain Reaction* ; Polymorphism, Single Nucleotide ; Tissue Donors ; Transplant Recipients ; Transplants

BACKGROUND: The plasma levels of cell-free DNA (cfDNA) are known to be elevated under inflammatory or apoptotic conditions. Increased cfDNA levels have been reported in hemodialysis (HD) patients. The aim of this study was to investigate the clinical significance of cfDNA in HD patients. METHODS: A total of 95 patients on HD were enrolled. We measured their predialysis cfDNA levels using real-time EIF2C1 gene sequence amplification and analyzed its association with certain clinical parameters. RESULTS: The mean plasma cfDNA level in the HD patients was 3,884 +/- 407 GE/mL, and the mean plasma cfDNA level in the control group was 1,420 +/- 121 GE/mL (P < 0.05). Diabetic patients showed higher plasma cfDNA levels compared with nondiabetic patients (P < 0.01). Patients with cardiovascular complications also showed higher plasma cfDNA levels compared with those without cardiovascular complication (P < 0.05). In univariable analysis, the cfDNA level was associated with 3-month mean systolic blood pressure (SBP), white blood cell, serum albumin, creatinine (Cr), normalized protein catabolic rate in HD patients. In diabetic patients, it was significantly correlated with SBP, hemoglobin A1c, and serum albumin. In multivariate analysis, SBP was the independent determinant for the cfDNA level. In diabetic patients, cfDNA level was independently associated with hemoglobin A1c and SBP. CONCLUSIONS: In patients with HD, cfDNA is elevated in diabetic patients and patients with cardiovascular diseases. Uncontrolled hypertension and poor glycemic control are independent determinants for the elevated cfDNA. Our data suggest that cfDNA might be a marker of vascular injury rather than proinflammatory condition in HD patients.
Blood Pressure* ; Cardiovascular Diseases ; Creatinine ; Diabetes Mellitus ; DNA* ; Humans ; Hypertension ; Leukocytes ; Multivariate Analysis ; Plasma* ; Renal Dialysis* ; Serum Albumin ; Vascular System Injuries