BACKGROUND: Clonidine, an alpha 2adrenergic agonist, has nonopiate antinociceptive properties which might be an alternative for postoperative analgesia free of undesirable effects from opioid. The aim of this study was to evaluate the postoperative analgesic effects of intravenous (IV) infusion of clonidine. METHODS: Seventy two healthy patients who undergoing cesarean section or gynecological surgery under general anesthesia were randomly divided into three groups as follows; the patients of group l received fentanyl (100 g bolus + 0.5ug/kg/hr) alone, the patients of group II received clonidine (100ug bolus + 10ug/kg/hr) and same dose of fentanyl, and the patients of group III received clonidine (200 g bolus + 20ug/kg/hr) and same dose of fentanyl. Pain score using a visual analogue scale (VAS), sedation score and any side effects were evaluated at 1, 6, 24 and 48 hours after starting the infusion. RESULT: Patients in group II and group III were more pain relieved during 48 hours and more sedated compared to group I at 1 hr, but there were no significant difference of side effects. CONCLUSION: Continuous IV infusion of clonidine potentiates postoperative analgesia induced by fentanyl.
Analgesia* ; Anesthesia, General ; Cesarean Section ; Clonidine* ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Infusions, Intravenous* ; Pain, Postoperative ; Pregnancy

The early postpartum period is crucial toward in recovery form childbirth and attainment of the maternal role. Maternal role attainment is a complex social and cognitive process of stimulus-response accomplished by learning. Helping for maternal role attainment is one of nursing goals in the early postpartum period. Based on King's conceptual framework for nursing, this study was planned as descriptive correlation study to determine the significant differences of the degree of nursery room nurses' role performance according to several variables of personal, interpersonal, and working system of nurses in nursery room, The purpose of this study was to contribute to the planning of nursing care to help maternal role attainment of the early postpartum period of mothers and to the development of relevant nursing theory, The data were collected from R3b. 3 to 28 by questionnaires with 273 nurses in nursery room. The instruments for this study were consisted of four parts: 21 questions for roll performance of nurse ; 37 questions for personal system of nurse including 31 questions for role perception of nurse ; 65 questions for interpersonal system including 63 questions for job stress of nurse ; 18 questions for working system of nurse. The toes to measure role performance and role perception, and job stress of nurse were tested for internal reliability. Cronbach's Alphas were 0.9612, 0.9058, and 0.9649. The data were analysed by using in S.A.S. computerized program and included percentage, t-test, ANOVA, Pearson Correlation Coefficient, and Duncan multiple range test. The conclusions obtained from this study are summarized as follows : 1. The mean score of the items of role performance was 2.12(SD=0.55) in Likert's 4 points scale. 2. The degree of role performance was significantly different according to role perception(p=0.0001), age(p=0.006), educational background(p=0.002), and certificate of midwife(p=0.03) among variables of personal system of subjects. 3. The degree of role performance was significantly different according to job stress(p=0.0001) and numbers of children(p=0.006) among variables of interpersonal system of subjects. 4. The degree of role performance was significantly different according to having opportunities for baby(p=0.03), the degree of flexibility to bring baby to mother's room(p=0.046), the scope of visitor for baby(p=0.016), the degree of flexibility of visiting for baby(p=0.049), the degree of participation of nurse in establishing visiting rules(p=0.017), existence and/or nonexistence of rules for breast feeding(p=0.010), existence and/or nonexistence of education for breast feeding(p=0.009), existence and/or nonexistence of breast feeding room(p=0.013), concret methods for breast feeding(p=0.003), working place(p=0.0001), and career(p=0.019) among variables of personal system of subjects.
Breast ; Breast Feeding ; Education ; Humans ; Learning ; Mothers* ; Nurseries* ; Nursing ; Nursing Care ; Nursing Theory ; Parturition ; Pliability ; Postpartum Period* ; Statistics as Topic ; Toes ; Child Health ; Surveys and Questionnaires

INTRODUCTION: Patient-controlled analgesia (PCA) has become an important means for postoperative analgesia with parenteral opioid, but postoperative nausea and vomiting (PONV) remains a major problem using a PCA system. The present study was designed to assess the antiemetic effectiveness of droperidol in patients using an intravenous PCA during the first 24 hours after surgery. METHODS: For the postoperative analgesia, 80 patients underwent orthopedic surgery were randomly allocated to receive PCA with either a mixture of 3.75 mg droperidol and fentanyl 2500 microgram after initial bolus of 1.25 mg droperidol as the FD group, or a mixture of saline and fentanyl 2500 microgram as the FS group at the end of surgery. RESULTS: The incidence of PONV showed 52.5% in FS group and 15% in FD group respectively (P<0.05). The incidence of PONV was 2~3 times more in women (76% in FS group & 25% in FD group) than men (35% in FS group & 9% in FD group). CONCLUSION: The addition of droperidol to fentanyl in a PCA system reduces the PONV during the first 24 hours after surgery.
Analgesia ; Analgesia, Patient-Controlled* ; Antiemetics ; Droperidol* ; Female ; Fentanyl* ; Humans ; Incidence ; Male ; Orthopedics ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting*

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

PURPOSE: The aim of this study was to analyze relationships between perfectionism, burnout, and emotional intelligence in APN and to identify the mediating effect of emotional intelligence on the relationship between perfectionism and burnout. METHODS: A structured self-report questionnaire was used to measure perfectionism, burnout, and emotional intelligence. Data were collected from 121 APN working in five advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, Independent t-test, One-way ANOVA, Mann-Whitney U test, Pearson correlation and Hierarchical multiple regression with the SPSS/WIN 22.0 program. RESULTS: Mean scores for each variable were: perfectionism 3.57 (on a 5-point scale), burnout 3.32 (on a 7-point scale), and emotional intelligence 5.00 (on a 7-point scale). Self-oriented perfectionism had a positive correlation with burnout, as did socially prescribed perfectionism. Emotional intelligence was a significant variable reducing burnout, as it also had a reverse buffering effect on the relationship between self-oriented perfectionism and burnout. Explanatory power of the final model based on variables was 34%. CONCLUSION: The results of this study suggest a mediating direction regarding burnout by demonstrating that emotional intelligence plays a direct and reverse buffering role to self-oriented perfectionism, which can be used to reduce burnout in APN.
Emotional Intelligence* ; Hospitals, General ; Negotiating*

PURPOSE: This descriptive research was conducted to identify educational needs in pediatric nursing handoff training to improve students' handoff skills. METHODS: Data were collected using a survey with 188 senior nursing students and 48 pediatric nursing professors and clinical nurses. The survey included items on general information as well as experiences in handoff training, necessity, training content, and items for a handoff training program in pediatric nursing. RESULTS: Of the nursing students, 30.5% reported receiving handoff training during their clinical hours. After their handoff training, the students' confidence index was only 3.78 out of 10. Significantly, 98.3% of the respondents said that pediatric handoff training is necessary. In addition, participants reported that simulation practice (26.5%) is an appropriate educational method, and the time required for handoff training should be 8.16 hrs. Admission process was placed first as the most critical circumstance for handoff (56.8%). High demands were observed for the necessity of training content for patients with respiratory problems. CONCLUSION: The results of this study show the various educational needs for developing a patient safety pediatric handoff training program to promote nursing students' skills in handoff.
Surveys and Questionnaires ; Education ; Humans ; Needs Assessment* ; Nursing* ; Patient Handoff ; Patient Safety ; Pediatric Nursing* ; Students, Nursing*

An immunohistochemical study on the tissue localization of human chorionic gonadotropin (HCG), human placental lactogen (HPL), and human pregnancy specific bata-1 glycoprotein (SP-1) in the non-neoplastic (5 incomplete abortion, 5 ectopic pregnancy) and neoplastic (hydatidiform mole 3 cases, 5 ectopic pregnancy) and neoplastic (hydatidiform mole 3 cases, choriocarcinoma 2 cases) gestational status, and germ cell tumors of the ovary (dysgerminoma 2 cases, immature teratoma 1 case) and the testis (seminoma 2 cases, endodermal sinus tumor 1 case) by means of sensitive peroxidase-antiperoxidase method. The results were as follows. 1) Cytoplasmic HCG, HPL, and SP-1 were readily identified in syncytiotrophoblasts of chorionic villi of the incomplete abortion and ectopic pregnancy, as moderate to strong positive reactions. In the cytoplasm of the neoplastic syncytiotrophblasts of hydatidiform mole and choriocarcinoma, positive reactions were stronger than in non-neoplastic syncytiotrophblasts. but the cytotrophoblasts and villous stromal cells showed negative reactions to these hormones. 2) All of the tumor cells of dysgerminoma and immature teratoma of the ovary, and seminoma and endodermal sinus tumor of the testis showed negative reactions to HCG, HPL, and SP-1. According to these results, HCG, HPL, and SP-1 are specifically synthesized and secreted by normal or neoplastic syncytiotrophoblasts Malignant tumors originated from other cells or tissues than trophoblastic cells show elevated serum concentration of these hormones are only evident in the presence of syncytiotrophoblastic giant cells among the tumor cells.
Pregnancy ; Female ; Humans

No abstract available.
Hand* ; Humans

PURPOSE: The purpose of this study was to develop a model for handoff education for nursing students based on simulation using video and to identify educational effects of a simulated situation in pediatric care units. METHODS: Data were collected from May 1 to 30, 2016. Participants were 84 senior nursing students in Seoul(video group: 43, simulation group: 41). Both groups were given a lecture and pre-briefing on handoff education. The simulation group had nursing practice on resolving health issues for respiratory distress using a high-fidelity baby simulator. The video group watched a video recording of a scenario based simulation, and used a summarized handoff situation to practice patient handoff to another student. RESULTS: There was no significant difference between the two groups for handoff self-confidence, problem solving ability, handoff competence(self-assessment of students), or learning satisfaction. Self-confidence increased significantly in both groups. Handoff competency evaluated by the instructor was higher in the video group compared to the simulation group(t=2.33, p=.022). CONCLUSION: Nursing student education for handoff practice utilizing a video in the pediatric unit was more cost effective. Therefore, it could be a useful educational method for students in learning patient handoff practices and helpful for related research.
Clinical Competence ; Education ; Humans ; Learning ; Methods ; Nursing ; Patient Handoff ; Patient Simulation ; Pediatric Nursing ; Problem Solving ; Students, Nursing ; Video Recording

Neutrophils are important effector cells against protozoan extracellular parasite Entamoeba histolytica, which causes amoebic colitis and liver abscess in human beings. Apoptotic cell death of neutrophils is an important event in the resolution of inflammation and parasite's survival in vivo. This study was undertaken to investigate the ultrastructural aspects of apoptotic cells during neutrophil death triggered by Entamoeba histolytica. Isolated human neutrophils from the peripheral blood were incubated with or without live trophozoites of E. histolytica and examined by transmission electron microscopy (TEM). Neutrophils incubated with E. histolytica were observed to show apoptotic characteristics, such as compaction of the nuclear chromatin and swelling of the nuclear envelop. In contrast, neutrophils incubated in the absence of the amoeba had many protrusions of irregular cell surfaces and heterogenous nuclear chromatin. Therefore, it is suggested that Entamoeba-induced neutrophil apoptosis contribute to prevent unwanted tissue inflammation and damage in the amoeba-invaded lesions in vivo.
Animals ; Apoptosis/*physiology ; Entamoeba histolytica/*physiology ; Host-Parasite Relations/physiology ; Humans ; In Vitro ; Neutrophils/physiology/*ultrastructure ; Research Support, Non-U.S. Gov't