The aim of this study was to identify the effects of speaking up climate, psychological safety, organizational learning culture, and supervisor support for patient safety on clinical nurses’ silence behavior. Methods: A cross-sectional online survey was conducted among 189 nurses working at a tertiary hospital. Data were analyzed using Pearson correlation coefficients and multiple linear regression. Results: The average score of nurses’ silence behavior was 2.23±0.62 out of 5 points. The strongest factor influencing nurses’ silence behavior was speaking up climate (β=-.33, p<.001), followed by psychological safety (β=-.20, p=.013), and organizational learning culture (β=-.15, p=.040). The regression model explained approximately 38% of the overall variance in the nurses’ silence behavior. Conclusion: This study found that the speaking up climate was the most important predictor of nurses’ silence behavior. Thus, we suggest that hospital administrators and nurse managers should encourage nurses to speak up by having regular meetings among healthcare professionals to enhance the psychological safety of nurses. In addition, to reduce nurses’ silence behavior, it is essential to create a culture wherein all members of the organization can constantly learn from mistakes or errors, which will, in turn, make it possible to improve patient safety at the system level.

Purpose: This study was done clarify the concept of illness acceptance in patients with chronic disease. Methods: This study was conducted using a hybrid model of concept analysis that consists of three phases. In the theoretical phase, a working definition was formulated through a systematic review. In the fieldwork phase, five participants who had diabetes or hypertension for at least one year were interviewed. In the third phase, the results were combined in the final analysis. Results: There are three phases of accepting an illness: experiencing the limits, disease management, and designing new life. At the experience of the limits and disease management stages, the attributes of physical, psychological and social domains were derived, but at the stage of designing their new life, integrated attributes of these three domains were derived. Conclusion Illness acceptance of chronic disease was defined as a continuous and dynamic process in three phases. First, patients experience limitations due to the disease, such as physical illness, psychological instability, and difficulty performing social roles. Second, patients manage the disease by engaging in self-management, psychological coping strategies, and establishing social support. Third, patients design their new life by seeking better health-related quality of life and integrating the illness into their everyday life. However, patients experienced negative changes when disease management was not performed properly. The fact that illness acceptance could be cyclic means the difference between illness and loss/death acceptance. Nurse should develop and provide an integrated nursing intervention that is appropriate for phases of illness acceptance.

Purpose: This study examined the effects of changes in the intensity of Functional Electrical Stimulation (FES) on CorticoMuscular Coherence (CMC) during action observation. This paper presents a neurophysiological basis for the effective intensity of FES. Methods: Twenty-seven healthy volunteers were asked to observed a video with FES. The FES was provided with a sensory stimulation level, nerve stimulation level, and motor stimulation level. Simultaneously, an electroencephalogram (EEG) of the sensorimotor cortex and electromyogram (EMG) from the wrist extensor muscle were recorded. The peak CMC and average CMC were analyzed to compare the differences caused by the FES intensity. Results: The peak CMC showed a significant increase in the alpha band during motor stimulation (p<0.05). The average CMC showed a significant increase in the beta band during motor stimulation (p<0.05). Conclusion The intensity of FES, which causes actual movement, increased the CMC during action observation. These results show that the intensity of the FES can affect the functional connection between the sensorimotor cortex and muscle.

Purpose: This study examined the effects of changes in the intensity of Functional Electrical Stimulation (FES) on CorticoMuscular Coherence (CMC) during action observation. This paper presents a neurophysiological basis for the effective intensity of FES. Methods: Twenty-seven healthy volunteers were asked to observed a video with FES. The FES was provided with a sensory stimulation level, nerve stimulation level, and motor stimulation level. Simultaneously, an electroencephalogram (EEG) of the sensorimotor cortex and electromyogram (EMG) from the wrist extensor muscle were recorded. The peak CMC and average CMC were analyzed to compare the differences caused by the FES intensity. Results: The peak CMC showed a significant increase in the alpha band during motor stimulation (p<0.05). The average CMC showed a significant increase in the beta band during motor stimulation (p<0.05). Conclusion The intensity of FES, which causes actual movement, increased the CMC during action observation. These results show that the intensity of the FES can affect the functional connection between the sensorimotor cortex and muscle.

Purpose: To examine the relationship between nurse-perceived patient safety culture and patient safety grade in healthcare organizations. Methods: A cross-sectional, correlational study design was used. An online survey was conducted with nurses in three tertiary hospitals in Korea who provided direct care to patients. Data were analyzed using Pearson correlation coefficients and ordinal logistic regression. Results: A total of 526 nurses completed the questionnaire. Among patient safety culture dimensions, staffing and work pace, reporting patient safety events, hospital management support for patient safety, handoffs and information exchange, organizational learningcontinuous improvement, and unit manager support for patient safety were significant predictors for patient safety grade. Conclusion Efforts should be made to create and enhance patient safety culture in healthcare organizations. This study showed that staffing and work pace were the strongest predictors of patient safety grade, indicating that adequate nurse staffing is important to handle workloads and improve patient safety. Our study also demonstrated the importance of hospital management and unit manager support for patient safety. Therefore, we suggest developing a leadership program for hospital administrators and unit managers, to help them develop the necessary leadership skills for creating a culture of safety in healthcare organizations.

PURPOSE: The purpose of this study was to analyze the ultrasonographic (USG) findings of Kikuchi cervical lymphadenopathy in pediatric patients. METHODS: Between April 2007 and September 2016, 84 children (42 male and 42 female; mean±standard deviation age, 12.9±3.2 years; range, 5 to 18 years) confirmed with Kikuchi disease were enrolled. Clinical findings and USG findings of Kikuchi cervical lymphadenopathy were retrospectively reviewed. Localized symptoms, systemic symptoms, and laboratory findings including the white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed. An analysis of the USG findings included evaluation of the location, size, and presence of intranodal abscess; intranodal calcification; perinodal fat swelling; localized fluid collection; and loss of nodal echogenic hilum. RESULTS: Among the patients, 49 (58%) showed localized tenderness at the cervical lymphadenopathy. Fever was present in 55 (66%), while 27 (32%) had prolonged fever. Of 74 with lab results, 54 (73%) had leukopenia but none had leukocytosis. Among the same 74, there was a high ESR (>50 mm/hr) in 10 (14%) and a high CRP level (>5 mg/dL) in seven (9%). The USG findings of most of the patients (n=72, 86%) showed unilateral neck involvement, especially in the left side neck (45 of 72, 63%). The most common site of Kikuchi lymphadenopathy involvement was the area at cervical lymph node level V, at the posterior triangle (n=77, 92%). Conglomerated nodal distribution (n=57, 68%), preserved central nodal echogenic hilum (n=84, 98%), and perinodal fat swelling (n=55, 65%) were common USG findings in the children with Kikuchi. In addition, multiple cervical lymph nodes showed a relatively even size distribution (n=73, 87%). CONCLUSION: The common USG findings of Kikuchi disease in the pediatric population of our study were multiple conglomerated unilateral cervical lymphadenopathy showing perinodal fat swelling and even size distribution.
Abscess ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Leukocyte Count ; Leukocytosis ; Leukopenia ; Lymph Nodes ; Lymphatic Diseases* ; Male ; Neck ; Pediatrics ; Retrospective Studies ; Ultrasonography

PURPOSE: This study was done to analyze the trend of theory application in articles published in the Journal of Korean Academy of Nursing Administration (JKANA) over the last 10 years. METHODS: Four hundred and eighty-five articles were reviewed to determine the scope of theory-applied research. General characteristics, study design and keywords classification by nursing meta-paradigm were analyzed using established analysis framework. RESULTS: Twenty-four articles (4.9%) were identified as theory-applied research publications. More than half of the articles (54.2%) stated that a theoretical framework was used; the number of theories used in the 24 articles was 27 including nine nursing theories. The majority of the studies were conducted in hospital settings. In the keyword classification by nursing meta-paradigm, 28 environment-related keywords were identified but only 7 keywords were related to health. CONCLUSION: The results show that theory application in Korean nursing administration research is very limited. It is necessary to create a positive educational environment for graduate students to learn about nursing theories as well as theories from other disciplines. In addition, different levels of nursing theories should be continuously developed in the field of nursing administration.
Classification ; Humans ; Nursing Administration Research ; Nursing Research ; Nursing Theory ; Nursing

Histone deacetylase 4 (HDAC4), a class IIa HDAC, has gained attention as a potential therapeutic target in treating inflammatory and metabolic processes based on its essential role in various biological pathways by deacetylating non-histone proteins, including transcription factors. The activity of HDAC4 is regulated at the transcriptional, post-transcriptional, and post-translational levels. The functions of HDAC4 are tissue-dependent in response to endogenous and exogenous factors and their substrates. In particular, the association of HDAC4 with non-histone targets, including transcription factors, such as myocyte enhancer factor 2, hypoxia-inducible factor, signal transducer and activator of transcription 1, and forkhead box proteins, play a crucial role in regulating inflammatory and metabolic processes. This review summarizes the regulatory modes of HDAC4 activity and its functions in inflammation, insulin signaling and glucose metabolism, and cardiac muscle development.

Histone deacetylase 4 (HDAC4), a class IIa HDAC, has gained attention as a potential therapeutic target in treating inflammatory and metabolic processes based on its essential role in various biological pathways by deacetylating non-histone proteins, including transcription factors. The activity of HDAC4 is regulated at the transcriptional, post-transcriptional, and post-translational levels. The functions of HDAC4 are tissue-dependent in response to endogenous and exogenous factors and their substrates. In particular, the association of HDAC4 with non-histone targets, including transcription factors, such as myocyte enhancer factor 2, hypoxia-inducible factor, signal transducer and activator of transcription 1, and forkhead box proteins, play a crucial role in regulating inflammatory and metabolic processes. This review summarizes the regulatory modes of HDAC4 activity and its functions in inflammation, insulin signaling and glucose metabolism, and cardiac muscle development.

Histone deacetylase 4 (HDAC4), a class IIa HDAC, has gained attention as a potential therapeutic target in treating inflammatory and metabolic processes based on its essential role in various biological pathways by deacetylating non-histone proteins, including transcription factors. The activity of HDAC4 is regulated at the transcriptional, post-transcriptional, and post-translational levels. The functions of HDAC4 are tissue-dependent in response to endogenous and exogenous factors and their substrates. In particular, the association of HDAC4 with non-histone targets, including transcription factors, such as myocyte enhancer factor 2, hypoxia-inducible factor, signal transducer and activator of transcription 1, and forkhead box proteins, play a crucial role in regulating inflammatory and metabolic processes. This review summarizes the regulatory modes of HDAC4 activity and its functions in inflammation, insulin signaling and glucose metabolism, and cardiac muscle development.