PURPOSE: The purpose of this study was to explore the relationships of critical thinking disposition (CT), nursing work environment (NWE), and clinical decision making ability among nurses. METHODS: A cross-sectional, descriptive study design was conducted on 192 nurses who had worked for more than six months in five general hospitals. A self-reported questionnaire was used to collect data, which included demographics, CT, NWE, and clinical decision making ability. RESULTS: The mean score of CT was 3.5. The highest score was on the objectivity of CT and the lowest on systematicity. The mean score of NWE was 2.3. The highest score was on the collegial nurse-physician relations of NWE and the lowest on the staffing and resource adequacy. The mean score of clinical decision making ability was 3.3. In hierarchical multiple regression, affecting factors on clinical decision making ability were CT and NWE. CONCLUSION: The findings showed that clinical decision making ability is associated with CT and NWE. To improve clinical decision making ability, it is important to improve CT. In addition, it should be considered to improve NWE where the nurses can make a decision with their job through critical thinking.
Clinical Decision-Making* ; Demography ; Hospitals, General ; Nursing* ; Physician-Nurse Relations ; Thinking*

PURPOSE: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. METHODS: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. RESULTS: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. CONCLUSION: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.
Activities of Daily Living ; Aged ; Delivery of Health Care ; Depression ; Humans ; Insurance ; Insurance, Long-Term Care* ; Long-Term Care ; Nursing Services* ; Propensity Score

PURPOSE: The aim of this study was to understand the hand-on breast massage techniques used by well-known experts in breastfeeding clinics. METHODS: A qualitative multiple-case design was applied that involved a feasibility test. Four experts sampling qualitative data collected by observing participants and in individual interviews were analyzed by content analysis, linking data to the propositions, and cross-case pattern matching. This study explored differences within and between cases, and the possibilities of replicating findings across cases. Thirty-nine postpartum women participated voluntarily in the feasibility test, which investigated the usability of four massage techniques. RESULTS: The four techniques showed considerable similarities in terms of the application of stimulation to the breast base and increased flexibility of the wired flexible body, which was the core mechanism underlying the techniques. The breast management strategies were consistent with existing practice guidelines with the exception of using cold cabbage to control engorgement pain. There was insufficient scientific evidence for supporting the massage techniques used by the experts. All of the techniques showed 100% education completeness, but application rates were higher for self-control-oriented techniques. CONCLUSION: The massage techniques applied by experts in breastfeeding were based on hypotheses and self-control techniques are feasible to apply in practice.
Brassica ; Breast Feeding* ; Breast* ; Education ; Massage* ; Pliability ; Postpartum Period ; Self-Control

PURPOSE: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. METHODS: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. RESULTS: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. CONCLUSION: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.
Child ; Child, Preschool ; Community Health Nursing ; Female ; Home Care Services* ; House Calls ; Humans ; Infant* ; Mothers* ; Patient Selection ; Pregnant Women* ; Self Care ; Vulnerable Populations

PURPOSE: The purpose of the study was to identify the factors, which predict care burden perceived by caregivers of elders with dementia. METHODS: The participants in this descriptive survey were 92 caregivers who used one of six daycare centers located in Incheon. The data were collected by questionnaires composed of items on general characteristics of the elders and caregivers, care burden, caregiver fatigue, and functional status of the elders. RESULTS: General characteristics of the elders associated with care burden were age, gender, religion, and the presence of a spouse. Features of caregivers related to care burden were education, relationship with elderly, amount of rest, intention to care, monthly family income, and perceived family economic status. There were significant correlations among care burden, fatigue of caregiver and functional status of the elders. In stepwised multiple regression analysis, significant influencing factors were identified as caregiver fatigue, functional status of the elders, intention to care, relationship with the elders, amount of rest and elder's gender. Those variables explained 46% of variance of care burden. CONCLUSION: Functional status of elders and amount of rest were significant predictors and are supported by other previous studies. Future interventions for caregivers need to be focused on the slowing down of functional status of elders and increasing of number and length of caregiver's rest periods.
Aged ; Caregivers ; Dementia ; Dependency (Psychology) ; Fatigue ; Humans ; Intention ; Surveys and Questionnaires ; Spouses

Purpose: This study aimed to explore nursing students’ experience with community-linked nursing education programs. Methods: This study utilized a qualitative content analysis. Participants were 55 sophomore nursing students. The community-linked nursing education program was conducted for eight weeks using the Analysis, Design, Development, Implementation, Evolution (ADDIE) model. Data were collected from 55 reflection records and five individual interviews and then analyzed through the three steps of qualitative content analysis, coding, condensing, and categorizing. Results: Twelve categories, 26 subcategories, and six topics emerged. The themes of impression and lesson from the community-linked nursing education programs were “recognizing the importance of professional competence in performing the role of nurse,” “recognizing the need for leadership and cooperation in nursing practice,” and “increased awareness of the role as a nursing professional for community residents.” The themes of the strategies used were “looking at the goal and moving forward,” and “aligning differences and working together with team/community members.” The theme of strategies for the advancement of community-linked nursing education programs was “establishing a sustainable student-participating community-linked education program.” Conclusion The community-linked nursing education programs made students aware of the necessary competencies as professionals. In particular, they gave them hope for their role as professional nurses in the community. It could also be seen that they developed the ability to engage in team activities for community activities. Community-linked nursing education programs will need to be developed into continuous programs with community residents.

Purpose: This study aimed to evaluate the effectiveness of an infection control education (ICE) program based on digital story-telling for new graduate nurses. Methods: From June 2 to July 30, 2022, a total of 58 new graduate nurses (30 and 28 nurses in the experimental and control group, respectively) at a tertiary general hospital in D city were enrolled. The effects were evaluated using a nonequivalent control group, non-synchronized design. The effects of the program were evaluated in terms of awareness of standard precautions, performance of standard precautions, and grit. Results: Statistically significant differences between the two groups were found in the awareness of standard precautions (t=-2.18, p=.034) and the performance of standard precautions (t=-3.27, p=.002). Grit was also significantly higher in the experimental group (t=-4.17, p<.001). Conclusion The development and application of the ICE program effectively improved the awareness of standard precautions, the performance of standard precautions, and grit among new nurses.

OBJECTIVE: To obtain sharable and reusable knowledge among various hospital information systems, it is essential to represent each term with standard terminology. To support knowledge representation for interoperable clinical decision support system for hypertension management, the feasibility of SNOMED CT was evaluated. METHODS: Concept matching was conducted using the method of direct matching, post-coordinated matching and general matching. For semantic matching, the SNOMED CT hierarchy was considered, and for raising the mapping rate, preferred terms and synonyms were used. RESULTS: Excluding the recommendation concepts that were not used in clinical data, finally 182 concepts were evaluated in terms of concept matching. Seventy two percent of the concepts was directly matched to pre-coordinated concepts in SNOMED CT. For the post-coordinated matching and the general matching to broader meaning, 9.3% and 18.7% were covered respectively. CONCLUSION: The direct coverage of SNOMED CT was moderate to high level for representing guideline knowledge concepts without loss of semantics. To supplement the coverage, it is inevitable to consider defining local concepts for implementing hypertension management systems.
Hospital Information Systems ; Hypertension ; Logic ; Semantics ; Systematized Nomenclature of Medicine

PURPOSE: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. METHODS: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital's Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. RESULTS: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. CONCLUSION: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.
Accidental Falls ; Case-Control Studies ; Cohort Studies ; Gait ; Hospitalization ; Humans ; Length of Stay ; Logistic Models ; Organothiophosphorus Compounds ; Predictive Value of Tests ; Quality Improvement ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity

Background: The Ask Suicide-Screening Questions (ASQ) tool is a simple suicide screening tool developed to screen patient suicide risk (SR). The purpose of this study was to verify the reliability and validity of the ASQ tool in hospitalized patients. Methods: The internal consistency and test-retest reliability of the South Korean version of the ASQ tool were verified in 99 hospitalized patients admitted to a tertiary medical institution in Seoul. To verify the correlations and validity of each convergence with other scales, the Mini-International Neuropsychiatric Interview (MINI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Satisfaction with Life Scale (SWLS) were also conducted to determine convergent and discriminant validity. Then, the receiver operating characteristic (ROC) curve diagnosis values for suicide and depression levels with the highest correlations were analyzed. Results: As a result, Cronbach’s alpha was 0.826, and when each item was removed sequentially, Cronbach’s alpha ranged from 0.736–0.840, showing stable internal consistency. Most of the corrected item-total correlation were over 0.500; however, a relatively low correlation was shown for the fourth and fifth questions, which had values of 0.429 and 0.410, respectively. The test-retest reliability was 0.830, and the MINI and PHQ-9 showed high values of 0.872 and 0.672, respectively. The area under the curve (AUC) according to the ASQ diagnosis value was also the highest for the MINI (0.936). Conclusion The validity and reliability of the South Korean version of the ASQ tool were demonstrated. Through this validation, the ASQ tool can be used for simple suicide risk screening (SRS) in hospitalized patients.