BACKGROUND: Reducing skin contamination rate and improving the positive rate in blood culture is essential for the correct diagnosis and management of sepsis. Chlorhexidine-alcohol was compared with povidone-iodine for the efficiency of disinfection. Positive rates were compared between the collection of 10 mL and 20 mL of blood per sample. METHODS: The study population included adult patients > or = 18 years old requested for blood culture in the Emergency Department. Povidone-iodine (10%) was used for antiseptic skin preparation from March to June 2011, and 0.5% chlorhexidine-alcohol from July to October 2011. The standard for blood collection was 10 mL in the first period and 20 mL in the second period. The dedicated phlebotomists had been educated on the optimal skin preparation and sample collection. RESULTS: After 10% povidone-iodine application, 31 of 2,755 samples (1.1%) were considered to be contaminated; whereas, a total of 60 of 3,064 samples (2.0%) were contaminated (P=0.011) after application of 0.5% chlorhexidine-alcohol. The positive rate of blood culture was 12.5% (345/2,755) in the first period versus 17.1% (524/3,064) in the second period (P<0.001). CONCLUSION: Both disinfectants appeared acceptable for skin preparation for blood culture collection, although chlorhexidine-alcohol had a higher contamination rate than povidone-iodine. The positive rate of blood culture was in accordance with the amount of sample collected. Continuous education and monitoring are needed for the proper collection and management of blood culture.
Adult ; Antisepsis ; Blood Volume ; Disinfectants ; Disinfection ; Emergencies ; Humans ; Povidone-Iodine ; Sepsis ; Skin

PURPOSE: The aim of this study was to examine the mediating effect of self-efficacy in the relationship of physical and psychological symptoms to exercise adherence in patients with heart failure. METHODS: The participants in this study were 186 patients with heart failure in two hospitals located in Busan. The measures included questions about general and disease characteristics, physical symptoms, psychological symptoms, self-efficacy for exercise, and exercise adherence. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, simple and multiple regression using Baron and Kenny steps for mediation. RESULTS: There were significant differences in age, gender and comorbidity on exercise adherence. There were also significant correlations among physical and psychological symptoms, self-efficacy for exercise, and exercise adherence. Self-efficacy for exercise showed partial mediating effects in the relationship between physical symptoms and exercise adherence. CONCLUSION: Based on the findings of this study, the enhancement of self-efficacy for exercise may positively affect the exercise compliance of the patients with health failure, even while they are experiencing physical symptoms. Therefore, it is necessary to develop effective strategies to enhance self-efficacy for exercise.
Busan ; Comorbidity ; Compliance ; Heart Failure ; Heart ; Humans ; Negotiating

PURPOSE: The purpose of this study was to identify the relationships between Moral Sensitivity, Empathy and Perceived Ethical Climate for nurses working in national mental hospitals and to provide basic data for the development of interventions that enhance Moral Sensitivity and help psychiatric hospital nurses in Ethical Decision-making. METHODS: This descriptive cross-sectional study was conducted with 182 psychiatric nurses working in the national mental hospitals. Data were collected through self-report questionnaires which included the Moral Sensitivity Questionnaire (MSQ), Interpersonal Reactivity Index (IRI), and Hospital Ethical Climate Survey (HECS). RESULTS: The mean score for MSQ was 5.19, for IRI, 2.49, and for HECS, 3.73. There was a significant positive correlation between moral sensitivity and empathy (r=.24, p=.001), between moral sensitivity and perceived ethical climate (r=.17, p= .025) and between empathy and perceived ethical climate (r=.17, p=.025). CONCLUSION: Findings indicate that moral sensitivity can be enhanced by improving empathy, a personal factor, and ethical climate, an organization factor. Further identification of the relationship between moral sensitivity and personal and organizational factors will be useful in the development of interventions to enhance moral sensitivity of nurses working in psychiatric wards.
Climate* ; Cross-Sectional Studies ; Empathy* ; Hospitals, Psychiatric* ; Humans

BACKGROUND: Previous antibiotic exposure may inhibit the growth of microorganisms in blood culture bottles. The authors investigated the frequency of previous antibiotic usage and analyzed the relationships among antibiotic usage, microbiological culture results and mortality of sepsis patients. METHODS: From April to May 2011, all blood cultures requested from inpatients were analyzed according to the admitted ward and antibiotic prescription records. The BacT/Alert 3D system (bioMerieux Inc.) was used with a standard bottle (SA, SN) for blood culture. RESULTS: Of 900 inpatients, 48% had been receiving antimicrobial agents when blood cultures were ordered. This group had a significantly higher mortality rate (36.2%) compared to the patients who had not received antibiotics (11.1%). Gram-negative rod bacteremia (37.1%) and candidemia (100%) resulted in a significantly higher mortality rate compared to Gram-positive cocci bacteremia (16.4%). In the analysis of 21 cases resulting in death, 15 (71.4%) patients died before or on the date when blood culture results were reported. CONCLUSION: Patients who receive antibiotics prior to blood collection may be at a higher risk for mortality. In the present study, Gram-negative rod bacteremia and candidemia cases showed a rapid progression of sepsis as indicated by Gram staining and thus should be regarded seriously.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteremia ; Candidemia ; Gram-Positive Cocci ; Humans ; Inpatients ; Prescriptions ; Sepsis ; Sydnones

No abstract available.
Animals ; Rats*

PURPOSE: The purpose of this study was to investigate gender related factors that influence regular exercise adherence in patients with coronary artery disease. METHODS: This secondary analysis study used data from the 2013~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Three hundred and eighty patients over 20 years of age and having coronary artery disease were selected for this study. Measures included questions about regular exercise, general characteristics, health behaviors, and health status. Data were analyzed using descriptive analysis, Rao-Scott χ² statistic, and multiple logistic regression analysis with the SPSS 21.0 program. RESULTS: The results were as follows. Men did more regular exercise than women (58.8% vs 40.1%). The multivariate-adjusted Odds Ratios (OR) for regular exercise adherence in men were 2.93 (95% CI: 1.39~6.17) for non smokers and 3.06 (95% CI: 1.53~6.13) for men with 0 to 1 comorbidities. Women had a high odds ratios of 0.38 (95% CI: 0.18~0.82) for not using alcohol and 2.10 (95% CI: 1.03~4.29) for no back pain. CONCLUSION: To improve regular exercise adherence in patients with coronary artery disease, it is necessary to develop different approaches considering gender.
Back Pain ; Comorbidity ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Health Behavior ; Humans ; Korea* ; Logistic Models ; Male ; Nutrition Surveys* ; Odds Ratio

PURPOSE: The purpose of this study was to investigate the level of traumatic experiences, posttraumatic stress symptoms and mental health-related characteristics in young adults and identify relationships among the variables. METHODS: In this descriptive cross-sectional study, data were collected through a Web-based survey (N=568). Structured instruments included valid measures of traumatic experiences, posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Collected data were analyzed using descriptive statistics, t-tests, χ2 tests, ANOVA, and Pearson correlation coefficient with SPSS statistics 23. RESULTS: Among study participants, 76.8% reported traumatic experiences. The severity of trauma was associated with high levels of posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Women showed more severe posttraumatic stress and depressive symptoms than men. There were positive correlations for trauma experiences with posttraumatic stress symptoms, depression, somatization symptoms, and insomnia. CONCLUSION: Findings indicate the need to develop nursing intervention programs to relieve posttraumatic stress symptoms and improve mental health related characteristics targeting young adults, and to establish a national policy that addresses characteristics of trauma experienced in Korea.
Cross-Sectional Studies ; Depression ; Female ; Humans ; Korea ; Male ; Mental Health ; Nursing ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Young Adult

The definition of faculty development has been refined and expanded over the past few decades, and various definitions have been used in higher education. Initially, faculty development was defined as activities that help teachers improve teaching skills, design better curricula, and improve the organizational environment for education. Since then, as the focus of faculty development has shifted from individual professors to institutional needs, faculty development is now defined as the personal and professional development of professors, clinicians, researchers, and managers to meet institutional goals, visions, and missions in social terms and moral responsibility to the community. Faculty development in medical education is universally needed to recognize and cope with widespread changes in education, including the traditional role of professors, advances in pedagogical theory, changes in learning styles, innovative curriculum models, and evaluation philosophy. However, critics have pointed out that most universities could not actively implement faculty development or accept professors’ various demands. In this paper, various reports related to faculty development are reviewed to summarize how faculty development has progressed and present future directions for accepting various opinions to improve educational excellence and the quality of health care.

OBJECTIVES: The aim of this study was to investigate continuously on how a short-term family psychoeducation program for schizophrenia would change the emotional stress and the knowledge of the family members. METHODS: Subjects were the family members who participated in the short-term family psychoeducation program for schizophrenia. The participants were asked to fill out self-reporting forms for 3 times-before commencing the 6-week family education, immediately after completing the program, and 3 months after completing the program respectively. RESULTS: A total of 46 subjects participated, and 20 of them responded to all questionnaires. Three months after the completion of psychoeducation, depression and anxiety subscale score among the General Health Questionnaire-28 decreased by 2.60 (p=0.04) and 2.20 (p=0.04) respectively. In caregiver burden criterion, the score decreased by 9.45 (p=0.04) in 3 months after completing the education. In knowledge about schizophrenia test, the score increased by 2.60 score (p<0.001), and this result was maintained after 3 months. CONCLUSION: It was found that a short-term family education program for schizophrenia was effective not only in improving the knowledge on the disease but also in reducing anxiety and depression, and this effect was maintained immediately after the psychoeducation and so was it as time passed as well.
Anxiety ; Caregivers ; Depression ; Education ; Humans ; Surveys and Questionnaires ; Schizophrenia* ; Stress, Psychological

Background: Protection from yellow dust and particulate matter is ensured by the use of respirators among the Korean citizens and workers. However, the manikins used to test the performance of the same were manufactured considering western facial specifications owing to which they do not represent Korean facial characteristics. Methods: Analysis of the data from the 6th 3D anthropometric survey of Koreans (Size Korea; 2010–2013) of 4,583 people aged 7 to 69 years was performed to obtain their facial dimensions. We subsequently clustered 44 facial measurements using Design X software, followed by the creation of the cluster centroid. Results: Three 3D head forms were developed—small, medium, and large, and their images were stored in “.stl” format for 3D printing. The facial widths and lengths of the three head forms were 127.1 mm × 90.6 mm, 143.2 mm × 104.0 mm, and 149.1 mm × 120.2 mm, respectively. Conclusion We developed manikin head forms according to the facial dimensions of the Korean population, which was essential in evaluating respiratory protective equipment. These head forms can be used to test the performance of respirators considering the facial dimensions of the Korean population.