PURPOSE: This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. METHODS: A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7-point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. RESULTS: Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, "SARS-patient caring would be a new experience", "during SARS-patient caring, I should be apart from my family", "after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event" and "with my SARS-patient caring, patients could recover from SARS" were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, "SARS-patient caring would be a challenge" "SARS-patient caring is a professional responsibility", "tension during the care of SARS patients" and "support from team members" were the significant determinants of the intentions. CONCLUSIONS: Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.
Adult ; *Attitude of Health Personnel ; Female ; Humans ; *Intention ; Korea ; Middle Aged ; Multivariate Analysis ; Nursing Staff, Hospital/*psychology ; Psychological Theory ; Regression Analysis ; Severe Acute Respiratory Syndrome/*nursing

PURPOSE: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. METHOD: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. RESULT: Principal component analysis verified the hypothesized 6-factor solution, explaining 68.2% of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. CONCLUSION: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.
Severe Acute Respiratory Syndrome/*nursing ; Reproducibility of Results ; *Questionnaires ; Nursing Methodology Research ; Nursing Care ; Nurses/*psychology ; Humans ; Female ; Attitude of Health Personnel ; Adult

This study examined effect of preceptorship on clinical education of senior nursing students of Y. University in Seoul. Quasi-experimental study design was used. Sixty students of pre-test and 80 of post-test participated in this study. Competency scores of the students before the clinical education(pre-competency scores) were compared with the competency scores after the clinical education(post-competency scores), and teacher evaluation scores between preceptors and clinical the data from students with preceptors(experimental group, N=22) and with clinical instructors(comparative group, N=58) were also examined. Study results indicated that the total post-competency scores were higher compared to the total pre-competency scores, and the difference was statistically significant. Among 7 sub-domains, differences were all statistically significant in 6 sub-domains except "self-esteem" domain. Competency scores of the students who had clinical education with had clinical education from clinical instructors. But the difference between those scores was not statistically significant. However, students gave higher evaluation scores to preceptors than clinical instructors. This study concluded that preceptorship did not influence much on clinical education at this time yet. However it is expected that when preceptors adjust their new roles and function them in expert education. This study recommended that for the preceptors to increase their motivation to teach students and to accept their roles, systemic rewards are needed.
Education* ; Humans ; Motivation ; Nursing* ; Preceptorship* ; Reward ; Seoul ; Students, Nursing*

Epiphora is a symptom in which tears overflow onto the face, with its most common cause being the obstruction of the nasolacrimal system. As a cause of nasolacrimal system obstruction, nasolacrimal duct tumors are very rare. Angioleiomyoma, which is a benign tumor, arises from vascular smooth muscle, occurs in the nasolacrimal duct, and is extremely rare. With the development of endoscopic intranasal approach for the treatment of nasolacrimal duct obstruction, there is increased importance for the consideration of otorhinolaryngological evaluation and treatment as well as dacryocystorhinostomy by conventional external approach. In this article, we introduce a case in which angioleiomyoma in the nasolacrimal duct was detected by nasal endoscopy and was successfully treated with endoscopic surgery.

Purpose: This study was conducted to examine the results of designing and implementing a teaching program for medical education as the elective course for 4th-year students of medical course. Methods: In order to design the teaching program for medical education as an elective course, we conducted literature review, five medical education experts were interviewed, and the literature required in the design process was reviewed. A developing teaching program was implemented as an elective course in a medical school of Korea, and 4th-year students of medical course participated in the program. Results: In the elective course, the medical education program process competencies were derived into three categories: theoretical educational knowledge, teaching competency, and research competency for education. Moreover, instructional materials were developed to help students achieve these competencies. And project-based learning strategy was selected and implemented for 4th-year students in medical course, and positive satisfaction was confirmed. Conclusion As a study designed and implemented in a medical education program in a medical school in Korea, it is expected to be helpful when introducing medical education to undergraduate students or developing a medical education program to strengthen the teaching capacity of residents.

PURPOSE: The purpose of this study were to identify the influential factors of bullying of intensive care nurses and to suggest a final structural model based on identified relationships between nursing organizational culture, authentic leadership, self-esteem, and bullying in the workplace. METHODS: Data were collected from 221 nurses at intensive care units in eight general hospitals using structured questionnaires and analyzed by structural equation modeling. RESULTS: In this study, the average of bullying in the workplace was 1.34±0.40, nursing organizational culture was 3.31±0.47, self-esteem was 2.79±0.44, and authentic leadership was 3.61±0.60. The factors affecting nursing organizational culture were authentic leadership (β=.54, p<.001) and self-esteem (β=.24, p=.002) that had direct positive effects on the nursing organizational culture. The nursing organizational culture had also a direct effect on reducing workplace bullying (β=−.45, p<.001). Authentic leadership (β=−.24, p=.004) and self-esteem (β=−.11, p=.004) had indirect effects on workplace bullying, which was mediated by the nursing organizational culture. CONCLUSION To understand and reduce workplace bullying, evaluating a nursing organizational culture should be preceded. Based on the finding of this study, an intervention for increasing authentic leadership and self-esteem of nurses can positively help to create the nursing organizational culture and then reduce workplace bullying.

OBJECTIVE: This study is to measure the level of concentration of angiogenin, a cause of potent neovascularization and a marker of ischemia, and of interleukin-6 (IL-6), an indicator of acute inflammation, in the amniotic fluid of patients with elevated maternal serum free beta-hCG level during the second-trimester. MATERIALS AND METHODS: Twenty patients with elevated maternal serum free beta-hCG level (>2.5 MoM) at double screening test of Down syndrome were compared with the controlled group (<2.0 MoM). This study includes singleton gestation, gestational age of 14-18 weeks, and has no evidence of fetal structural and chromosomal anomalies. The levels of amniotic angiogenin and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) method. Data were analyzed by Mann-Whitney U test. p value <0.05 was considered significant. RESULTS: Amniotic angiogenin levels in the studied group were much lower than those in the controlled group (p<0.05), whereas the difference of IL-6 levels between the two groups was not significant. Nine studied patients delivered small for gestational age infants, but only one controlled patient (p<0.05) had the same infant. Other variables of perinatal outcome were not different between the two groups. CONCLUSION: That amniotic fluid angiogenin levels are significantly lower in patients with elevated maternal serum free beta-hCG suggests an inadequate angiogenesis. Elevated maternal serum free beta-hCG levels correlate with fetal growth restriction. IL-6 values in both groups have no significant difference.
Amniotic Fluid* ; Chorionic Gonadotropin* ; Down Syndrome ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Development ; Gestational Age ; Humans* ; Infant ; Inflammation ; Interleukin-6* ; Ischemia ; Mass Screening ; Pregnancy Trimester, Second* ; Pregnancy*

Surface immunoglobulin light-chain restriction is evidence of clonality in mature B-cell neoplasms. An aberrant pattern of surface light-chain expression can also be considered evidence of clonality. However, because this result could occur due to nonspecific staining or failure to stain, careful interpretation is required for accurate diagnosis. According to a previous study, flow cytometric analysis of the cytoplasmic pattern of light-chain expression in mature B-cell neoplasms is a viable approach to confirming clonality. Herein, we report a case, in which clonality could not be proven by surface light-chain analysis, but was demonstrated by cytoplasmic light-chain analysis. The case was in a patient with B-cell lymphoma showing non-specific surface expression of light-chains. This case support consideration of flow cytometric analysis of cytoplasmic light-chain expression patterns when aberrant surface light chain expression is observed, to confirm clonality of mature B-cell neoplasms.
B-Lymphocytes ; Cytoplasm ; Diagnosis ; Flow Cytometry ; Humans ; Immunoglobulin Light Chains ; Lymphoma, B-Cell

BACKGROUND: The herbicide paraquat can cause severe lung injury and fibrosis in experimental animals. In this study we have investigated the changes in lung endothelin-1 levels and immunohistochemical localization in relation to treatment with cyclophosphamide and methylprednisolone in paraquat induced pulmonary fibrosis in guinea pigs. MATERIAL AND METHODS: 29 male Hartley guinea pigs were divided into 4 groups. Group I was normal control. Paraquat was instilled into the lung of guinea pig of group II, III and IV unilaterally. Group II was treated with cyclophosphamide and methylprednisolone. Group III was treated with methlprednisolone. Group IV was not treated. The degree of fibrosis was evaluated by H-E stains and Masson's trichrome stains and cell activity was assessed by endothelin-1 immunohistochemical stains. Statistical evaluation was performed using the Kruskawallis oneway analysis. RESULTS: Paraquat induced an increase in numbers of fibroblasts and total amount of lung collagen in Group IV compared to the normal controls. There was no significant difference in total numbers of fibroblasts between any of paraquat instilled groups, but there was significant increase in total amount of collagen in Group IV compared to group II and III (p<0.05).The treatment of cyclophosphamide and methyprednisolone suppressed the growths of both fibroblasts and collagen, but this suppression was stastically significant only in the case of collagen. ET-1(endothelin 1) immunoreactivities of bronchial epithelium, type II pneumocytes, endothelial cells and fibroblast in group II and III were decreased compared to those in group IV. CONCLUSION: These results demonstrate that ET-1 is an important contributing factor in the pathogenesis of pulmonary fibrosis. ET-1 is synthesized and released by bronchial epithelium, Type II pneumocyte, endothelial cells, alveolar macrophages and fibroblasts.Especially they are associated with alveolar macrophage and fibroblasts. We conclude that combined therapy of cyclophosphamide and methylprednisolone are more effective in the control of ET-1 expression and collagen deposition.
Animals ; Collagen ; Coloring Agents ; Cyclophosphamide* ; Endothelial Cells ; Endothelin-1* ; Epithelium ; Fibroblasts ; Fibrosis ; Guinea Pigs* ; Guinea* ; Humans ; Lung ; Lung Injury ; Macrophages, Alveolar ; Male ; Methylprednisolone* ; Paraquat ; Pneumocytes ; Pulmonary Fibrosis*

OBJECTIVES: This study was conducted to investigate the association between the symptoms of boys with attentiondeficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. METHODS: Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). RESULTS: The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. CONCLUSIONS: The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parents ; Siblings ; Temperament