1.Impacts of Ethical Dilemma, Job Stress, and Burnout on Turnover Intention of Long-term Care Hospital Nurses
Geun-Myun KIM ; Ok-Kyun LEE ; So-Hyeong SIM
Journal of Korean Academy of Psychiatric and Mental Health Nursing 2024;33(2):210-219
Purpose:
To identify factors affecting turnover intention of long-term care hospital nurses.
Methods:
After receiving permission from nursing managers at 10 nursing hospitals with 100 to 500 beds in three cities in South Korea, nurses who agreed to participate in this study were recruited and a survey was conducted. Final participants included 172 long-term care hospital nurses. Data collection was conducted from January 2, 2024 to April 30, 2024. Questionnaires included job stress, ethical dilemma, burnout, and turnover intention. Statistical analysis was performed using t-test, analysis of variance, Pearson’s correlation coefficient, and multiple regression analysis.
Results:
Ethical dilemma, job stress, burnout, and turnover intention of long-term care hospital nurses all had significant positive correlations. Age, position, job stress, and burnout were substantial in the turnover intention of long-term care hospital nurses.
Conclusion
Findings of this study can be used as primary data for improving the quality of nursing in long-term care hospitals, promoting efficient human resource management, and establishing policies.
2.Comparative Analysis of Clinical Outcomes Using Propensity Score Matching: Coronavirus Disease 2019vs. Seasonal Influenza in Korea
Jae Kyeom SIM ; Hye Sun LEE ; Juyeon YANG ; Jin GWACK ; Bryan Inho KIM ; Jeong-ok CHA ; Kyung Hoon MIN ; Young Seok LEE ; On behalf of the Severe Acute Respiratory Infection (SARI) Investigators
Journal of Korean Medical Science 2024;39(14):e128-
Background:
The advent of the omicron variant and the formulation of diverse therapeutic strategies marked a new epoch in the realm of coronavirus disease 2019 (COVID-19). Studies have compared the clinical outcomes between COVID-19 and seasonal influenza, but such studies were conducted during the early stages of the pandemic when effective treatment strategies had not yet been developed, which limits the generalizability of the findings.Therefore, an updated evaluation of the comparative analysis of clinical outcomes between COVID-19 and seasonal influenza is requisite.
Methods:
This study used data from the severe acute respiratory infection surveillance system of South Korea. We extracted data for influenza patients who were infected between 2018 and 2019 and COVID-19 patients who were infected in 2021 (pre-omicron period) and 2022 (omicron period). Comparisons of outcomes were conducted among the pre-omicron, omicron, and influenza cohorts utilizing propensity score matching. The adjusted covariates in the propensity score matching included age, sex, smoking, and comorbidities.
Results:
The study incorporated 1,227 patients in the pre-omicron cohort, 1,948 patients in the omicron cohort, and 920 patients in the influenza cohort. Following propensity score matching, 491 patients were included in each respective group. Clinical presentations exhibited similarities between the pre-omicron and omicron cohorts; however, COVID-19 patients demonstrated a higher prevalence of dyspnea and pulmonary infiltrates compared to their influenza counterparts. Both COVID-19 groups exhibited higher in-hospital mortality and longer hospital length of stay than the influenza group. The omicron group showed no significant improvement in clinical outcomes compared to the pre-omicron group.
Conclusion
The omicron group did not demonstrate better clinical outcomes than the pre-omicron group, and exhibited significant disease severity compared to the influenza group. Considering the likely persistence of COVID-19 infections, it is imperative to sustain comprehensive studies and ongoing policy support for the virus to enhance the prognosis for individuals affected by COVID-19.
3.Effect of lipid emulsion on vasoconstriction induced by epinephrine or norepinephrine in isolated rat aorta
Soo Hee LEE ; Kyeong-Eon PARK ; Kibaek EUM ; Yeran HWANG ; Seong-Ho OK ; Gyujin SIM ; Dumidu PERERA ; Henri K.M. RAVALD ; Youngho PARK ; Susanne K. WIEDMER ; Ju-Tae SOHN
Korean Journal of Anesthesiology 2024;77(5):555-564
Background:
Epinephrine (EPI) or norepinephrine (NOR) is widely used to treat cardiovascular collapse during lipid emulsion (LE) resuscitation for drug toxicity. However, the effect of LE on the vasoconstriction caused by EPI or NOR remains unknown. The purpose of this study was to examine the effect of an LE (Intralipid) on the vasoconstriction caused by EPI and NOR in isolated rat aorta.
Methods:
The effect of LE on the vasoconstriction caused by EPI or NOR in isolated rat aorta was examined. Additionally, the effect of LE on the calcium increase caused by EPI or NOR was investigated. The distribution constant (KD: lipid to aqueous phase) of EPI or NOR between a LE (1%) and an aqueous phase was determined.
Results:
LE (1 and 2%) did not significantly alter vasoconstriction caused by EPI or NOR in isolated endothelium-intact aorta. Moreover, the LE did not significantly alter the increased calcium level caused by EPI or NOR. The log KD of EPI in the LE (1%) was −0.71, −0.99, and −1.00 at 20, 50, and 100 mM ionic strength, respectively. The log KD of NOR in the LE (1%) was −1.22, −1.25, and −0.96 at 20, 50, and 100 mM ionic strength, respectively.
Conclusions
Taken together, the Intralipid emulsion did not alter vasoconstriction induced by EPI or NOR that seems to be due to the hydrophilicity of EPI or NOR, leading to sustained hemodynamic support produced by EPI or NOR used during LE resuscitation.
4.Factors Affecting the Well-dying Awareness of Lung Cancer Survivors
Asian Oncology Nursing 2023;23(4):225-233
Purpose:
The purpose of this study was to identify the factors that affect lung cancer survivors’ awareness of well-dying.
Methods:
Data were collected from November 8, 2022 to December 23, 2022. Participants were 105 lung cancer survivors university hospital located in Chungcheongnam-do. Data was analyzed using independent t-test, one-way ANOVA, Scheffétest, Pearson correlation coefficient and stepwise multiple regression with the SPSS/WIN 25.0 program. Symptom experience, resilience, awareness of well-dying, general cancer-related variables were measured.
Results:
Multiple regression analysis, the factors influencing awareness of well-dying were identified as symptomexperience (intensity), presence or absence of a spouse, andgender. The explanatory power of well-dying awareness through the three variables was 30.9%. The factor that has the greatest influence on the awareness of well-dying was symptom experience (intensity) (β=-.44), followed by spouse (β=.29) and gender (β=-22) in order.
Conclusion
Lung cancer survivors’ symptom experienceis a key factor influencing awareness of well-dying. Therefore, in order to increase awareness of well-dying among lung cancer survivors, symptom management should be actively provided to male patients and those who have received radiation therapy.
5.Lipid emulsion inhibits the cardiac toxicity caused by chloroquine via inhibition of reactive oxygen species production
Soo Hee LEE ; Seong-Ho OK ; Seung Hyun AHN ; Gyujin SIM ; Hyun-Jin KIM ; Mingu KIM ; Sangcheol YOON ; Ju-Tae SOHN
Korean Journal of Anesthesiology 2023;76(4):368-382
Background:
Lipid emulsion (LE) is effective in treating intractable cardiac depression induced by the toxicity of highly lipid-soluble drugs including local anesthetics. However, the effect of LE on chloroquine (CQ)-evoked cardiac toxicity remains unclear. This study aimed to examine the effect of Lipofundin MCT/LCT, an LE, on the cardiotoxicity caused by CQ in H9c2 rat cardiomyoblasts and elucidate the underlying cellular mechanism.
Methods:
The effects of CQ (1 × 10-4 M), LE, and the reactive oxygen species (ROS) scavengers mitotempo and N-acetyl-L-cysteine (NAC), alone or combined, on cell viability and migration, apoptosis, ROS production, calcium levels, mitochondrial membrane potential, and adenosine triphosphate (ATP) were examined. Additionally, the effects of LE on the activities of catalase (CAT), malondialdehyde (MDA), and superoxide dismutase (SOD) induced by CQ were assessed.
Results:
Pretreatment with LE, mitotempo, or NAC reversed the reduction in cell migration and viability, mitochondrial membrane potential, and ATP levels evoked by CQ, and inhibited the increase in cleaved caspase-3, ROS, and calcium concentration induced by CQ. LE inhibited the increase in Bax expression, terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells, MDA activity, and late apoptosis, and reversed the reduction in SOD and CAT activity induced by CQ. CQ did not significantly affect cleaved caspase-8 expression, and LE did not significantly affect CQ concentration.
Conclusions
Collectively, these results suggest that LE (Lipofundin MCT/LCT) inhibits the cardiotoxicity and late apoptosis induced by CQ toxicity via the intrinsic mitochondrial apoptotic pathway that is associated with direct inhibition of ROS production.
6.Prescription Patterns for Bipolar Disorder in Asian Countries:Findings from Research on Asian Prescription Pattern-Bipolar Disorder
Shih-Ku LIN ; Shu-Yu YANG ; Seon-Cheol PARK ; Ok-Jin JANG ; Xiaomin ZHU ; Yu-Tao XIANG ; Wen-Chen OUYANG ; Afzal JAVED ; M. Nasar SAYEED KHAN ; Sandeep GROVER ; Ajit AVASTHI ; Roy Abraham KALLIVAYALIL ; Kok Yoon CHEE ; Norliza CHEMI ; Takahiro A. KATO ; Kohei HAYAKAWA ; Pornjira PARIWATCHARAKUL ; Margarita MARAMIS ; Lakmi SENEVIRATNE ; Sim KANG ; Wai Kwong TANG ; Tin OO ; Norman SARTORIUS ; Chay-Hoon TAN ; Mian-Yoon CHONG ; Yong Chon PARK ; Naotaka SHINFUKU
Clinical Psychopharmacology and Neuroscience 2022;20(1):61-69
Objective:
Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest lasting international collaborative research in psychiatry in Asia. The objective of REAP BD was to investigate the prescription patterns of psychotropic medications across Asian countries. The rates of polypharmacy and psychotropic drug load were also analyzed.
Methods:
The data collection was web-based. Prescription patterns were categorized as (1) mood stabilizer monotherapy: one mood stabilizer; (2) antipsychotic monotherapy: one antipsychotic; (3) simple polypharmacy: one mood stabilizer and one antipsychotic; and (4) complex polypharmacy: ≥ 2 mood stabilizers or/and antipsychotics. The psychotropic drug load in each patient was calculated using the defined daily dose method.
Results:
Among 2003 patients with BD (52.1% female, 42.4 years) from 12 countries, 1,619 (80.8%) patients received mood stabilizers, 1,644 (82.14%) received antipsychotics, and 424 (21.2%) received antidepressants, with 14.7% mood stabilizer monotherapy, 13.4% antipsychotic monotherapy, 48.9% simple polypharmacy, 20.3% complex polypharmacy, and 2.6% other therapy. The average psychotropic drug load was 2.05 ± 1.40. Results varied widely between countries.
Conclusion
Over 70% of psychotropic regimens involved polypharmacy, which accords with the high prevalence of polypharmacy in BD under a permissive criterion (2 or more core psychotropic drugs) worldwide. Notably, ≥ 80% of our sample received antipsychotics, which may indicate an increasing trend in antipsychotic use for BD treatment.
7.Ten-Year Trends of Hepatitis A Seroprevalence in People Living with HIV in Korea
Shinwon LEE ; Jeong Eun LEE ; Soon Ok LEE ; Yong Ki SIM ; Sun Hee LEE
Infection and Chemotherapy 2022;54(3):529-533
Epidemiological information on hepatitis A among people living with HIV (PLHIV) in Korea is scarce. This retrospective study was performed at a tertiary care hospital and included 756 PLHIV with anti- hepatitis A virus (HAV) IgG tests. Between 2012 and 2021, the age at antiHAV IgG seroconversion is gradually delayed, and the proportion of individuals susceptible to HAV infection increased among adult PLHIV in Korea. The independent risk factors for HAV seropositivity were female sex and HBs antigen (Ag) positivity. Therefore, HAV vaccination is highly recommended for young PLHIV, especially for women or HBsAg-positive individuals.
8.The effect of interleukin-8 in the early stage after anterior cruciate ligament reconstruction with remnant preservation
Kyung-Ok KIM ; Jae Ang SIM ; Ji Uk CHOI ; Beom Koo LEE ; Hong Gi PARK
The Journal of Korean Knee Society 2020;32(1):e5-
Purpose:
We studied the effect of interleukin-8 (IL-8) as the factor for angiogenesis in the joint fluid of remnantpreserved anterior cruciate ligament reconstruction (RP-ACLR).
Materials and methods:
We measured 12 cytokines in joint fluid by multiplex assay and assessed the relationship between IL-8 and vascular endothelial growth factor (VEGF) concentrations. The signal intensity and mean sagittal diameter via postoperative magnetic resonance imaging (MRI) scans were evaluated and the stress X-ray image was analyzed at 3, 6, and 12 months after operation.
Results:
The IL-8 concentration was highest 3 months postoperatively in those patients who underwent RP-ACLR.Clinical data also showed that the signal intensity and stress radiography of the knee graft were significantly better at the early postoperative stage.Discussion: Our results show that IL-8 plays an important role in angiogenesis within 3 months after RP-ACLR. This effect yields better recovery after operation. RP-ACLR patients with high knee stability in clinical data were identical to those with high expression of IL-8 in experimental data. Therefore, IL-8 has been shown to help revascularization and ligamentization of the grafted tendon. These results indicate that IL-8 in RP-ACLR is an important factor for angiogenesis after operation. Unfortunately, the relationship of IL-8 and VEGF in vivo has not been studied.
Conclusion
Our results showed that the IL-8 concentration was very high within 3 months after RP-ACLR operation. The increase in concentration of IL-8 over time was consistent with the increase in VEGF concentration.In the IL-8 clinical setting, MRI analysis showed that ACL synovialization and tension were better in patients who underwent the remnant preservation method. In addition, it was shown that RP-ACLR may be advantageous for early anterior stability within 1 year post operation and beneficial for tendon graft in the early stage post operation.Taken together, our findings suggest that IL-8 may contribute to angiogenesis which is helpful for revascularization and ligamentization of the graft tendon in the early stages of RP-ACLR.
9.A Study of Respiratory Syncytial Virus Outbreak at Postpartum Care Center in Busan, Korea
Su-Jeong HWANG ; Ho-Cheol YUN ; Pyeong-Tae KU ; Ju-Hee SIM ; Mi-Ok LEE
Journal of Bacteriology and Virology 2020;50(2):124-131
Respiratory syncytial virus (RSV) is common cause of acute respiratory infection in infants and young children. Group life in postpartum care centers is easily exposed to infectious diseases in neonates and puerperds immediately after giving birth, and the harm caused by exposure to them is much greater. In particular, respiratory diseases are highly infectious and infections occur in a short period of time. among them, RSV infections are very serious in children under 5 years of age, leading to death. This paper studied an infection of RSV in outbreaks at postpartum care center in Busan. In 4 postpartum care centers, a total of 877 people (390 neonates, 386 puerperds, 106 others) were exposed to RSV outbreak. Of these, there were 73 RSV-positive patients; most of them had cough and runny nose and no fever. We were collected from neonates and puerperds with acute respiratory tract a total of 146 samples (throat swabs). In 51 samples, RSV (43 cases), human rhinovirus (6 cases), human coronavirus NL63 (1 case), and human coronavirus 229E (1 case) were found to be positive and the rest were negative. All 43 RSV positive samples were identified as RSV B. Sequence analysis of the detected strains was performed to confirm the molecular genetic information of RSV. Out of 43 RSV positive samples, 38 samples were successfully sequenced using the G gene, resulting in all of the same genotype BA9. This study provides a better understanding of RSV prevalence patterns and genetic characteristics. It also contributes to the accumulation of epidemiological data and the development of public health and hygiene.

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