PURPOSE: The purpose of this study was to identify factors that affect reality shock in new nurses. METHODS: Participants were 216 newly graduated nurses with less than 1 year experience in 5 university and 10 general hospitals in Busan, Ulsan and Gyeongnam, A self-report questionnaire was completed by the nurses between November 18 and December 25, 2013. Data were analyzed using t-test, ANOVA and hierarchial multiple regression analysis with the SPSS/WIN 21.0 Program. RESULTS: Average scores for work environment and environmental reality shock were 2.63+/-0.33 and 2.66+/-0.43 points respectively. Regression analysis showed that with the nurses' demographic and work characteristics controlled, work environment explained 4.2% of the reality shock. Factors significantly affecting reality shock included nurses' changing residence because of job (beta=.21, p=.001), whether they were able to work on the unit of their choice (beta=-.13, p=.031) and whether they had a choice in days off (beta=-.14, p=.038). CONCLUSION: When these factors are considered, reduction in nurses' reality shock requires improvement in work environment, placing new nurses in a department of their choice and allowing them a choice in off-duty days. These measures would also help achieve organizational goals and develop the new nurses as professional nurses.
Busan ; Hospitals, General ; Organizational Objectives ; Surveys and Questionnaires ; Shock* ; Ulsan

No abstract available.

PURPOSE: The purpose of this study was to investigate the impact of the unit-level nurse practice environment on nurse turnover intention in the small and medium sized hospitals. METHODS: A cross-sectional study was conducted using a questionnaire survey with 308 nurses in 38 nursing units of 6 small and medium sized hospitals, having over 200 beds and under 300 beds and located in B metropolitan city. Data were collected from July 20 to August 10, 2011. Data were analyzed using hierarchical multiple regression. RESULTS: The mean turnover intention in nurses of small and medium sized hospitals was 3.52+/-0.53. Factors affecting turnover intention in the nurses included age, work unit, monthly income, number of night-duties, work hours per day and unit-level nurse practice environment. The unit-level nurse practice environment accounted for 15% of turnover intention when other variables were controlled. CONCLUSION: The results of the study indicate that nurse turnover intention is associated with the nurse practice environment at the unit level. Small and medium sized hospitals can improve nurse retention and lower turnover intention by changing the nurse practice environment of unit, such as creating better support services and nurse participation in hospital affairs.
Cross-Sectional Studies ; Hospital Units ; Intention ; Professional Practice ; Surveys and Questionnaires ; Retention (Psychology)

No abstract available.

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

PURPOSE: The purpose of this study was to identify the work environment related to the handling and administration of antineoplastic drugs in the members of the Korean Oncology Nursing Society.METHODS: The study was carried out from October 2018 to November 2018. The self-reported surveys included questions on the work environment, experience and concerns from occupational exposure, safe activities of antineoplastic drugs and use of personal protective equipment (PPE), hand hygiene, and type of PPE (e.g., gown, gloves, and mask).RESULTS: A total of 125 participants from 41 organizations were surveyed. The nurses were mostly educated on safe management of antineoplastic drugs (95.2%) and concerned about health threats caused by occupational exposure (7.23±2.14 out of 10). In addition, harmful activities were found, with gown use being the lowest when handling antineoplastic drugs.CONCLUSION: This study supports that appropriate staffing, equipment, and facilities, mandatory education, and establishment of policies are very important in creating a safe work environment for handling antineoplastic drugs.
Antineoplastic Agents ; Education ; Hand Hygiene ; Occupational Exposure ; Oncology Nursing ; Personal Protective Equipment ; Safety Management

Among patients scheduled for elective surgery at the Kyung Hee University Hospital, 15 patients undergoing open thoracotomy were selected. Two different ventilatory modes were employed and compared to the one-lung ventilation(control). First, 10 cmH2O of continuous positive airway pressure was applied to the unventilated lung while patients were under one lung ventilation with 50% oxygen(CPAP 10 cmH2O). Second, 10 cmH2O of positive end expiratory pressure to the ventilated lung and 10 cmH2O of continuous positive airway pressure to the unventilated lung were applied while patients were under one lung ventilation with 50% oxygen(CPAP/PEEP). Arterial oxygen tension, alveolar-arterial oxygen difference (A-aDO2) and intrapulmonary shunt fraction of two different ventilatory modes were observed and compared to control group, and CPAP/PEEP group to CPAP 10 cmHO group. The RESULTs were as followed: 1) Mean PaO2 in CPAP 10 cmH2O and CPAP/PEEP were 138+/-42 mmHg and 177+/-44 mmHg, respectively, and were significantly increased as compared to 100+/-29 mmHg of control group(P<0.05). Comparing the PaO2 of CPAP 10 cmH2O and CPAP/PEEP, there was statistically significant increase in CPAP/PEEP(P<0.05). 2) A-aDO2 in CPAP 10 cmH2O and CPAP/PEEP were 175+/-43 mmHg and 131+42 mmHg, respectively, and were significantly decreased as compared to 213+/-32 mmHg of control group(P<0.05). Shunt percentages(Qsp/QT) were measured as 23.7+/-5.8% in control group, 18.3+/-6.0% in CPAP 10 cmH2O, 13.0+/-4.3% in CPAP/PEEP. Shunt percentages of CPAP 10 cmH2O and CPAP/PEEP were decreased significantly as compared to the control group(P<0.05). Comparing the A-a DO2 and the shunt percentages of CPAP 10 cmH2O and CPAP/PEEP, there was statistically significant decrease in CPAP/PEEP(P<0.05). Based on the above RESULTs, the application of appropriate continuous positive airway pressure to the unventilated lung and 10 cmH2O of positive end expiratory pressure to the ventilated lung during one lung ventilation is thought to be more effective than only continuous positive airway pressure to the unventilated lung in preventing hypoxemia.
Anoxia ; Continuous Positive Airway Pressure ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Positive-Pressure Respiration ; Thoracotomy

PURPOSE: Although outcome of the children with ALL has been improved remarkably with the multidrug chemotherapy and supportive therapy, relapse is still important cause of treatment failure. One of the mechanism related to the relapse has been reported to be multidurg resistance (MDR). To investigate the relation between the expression of MDR related MDR1 gene and cell cycle and apoptosis related genes in children with ALL, this study was conducted. METHODS: The samples were collected from 9 children with ALL (5: at presentation, 4: at relapse) diagnosed at the pediatric department of Yeungnam University Hospital. From the mononuclear cells isolated from the peripheral blood or bone marrow, mRNA was extracted and analysed by RT-PCR. Using actin as a control, relative levels of mRNA of MDR1 gene, cell cycle control protein cyclin B and MAD2 and apoptosis related BAX gene were analysed. RESULTS: The expression of MDR1 gene at the presentation and the relapse were variable and showed high correlation (Pearson correlation: 0.826) with the expression of BAX gene but low correlation with the expression of cyclin B and MAD2 gene. CONCLUSION: These results suggest that mechanism involved in relapse of ALL include mechanisms other than MDR1 gene. High correlation between the expression of MDR1 gene and BAX gene suggests that high level of BAX expression increases probability of relapse but small sample size of this study precludes definite conclusion and further study is needed.
Actins ; Apoptosis ; Bone Marrow ; Cell Cycle ; Cell Cycle Checkpoints ; Child ; Cyclin B* ; Cyclins* ; Drug Therapy ; Gene Expression* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; RNA, Messenger ; Sample Size ; Treatment Failure

PURPOSE: The purpose of this study was to explore the effects of hand reflexology on the physiological?emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. METHOD: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. RESULT: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR and BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell and CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. CONCLUSION: We have found that the hand reflexology helps the chronic patients to improve physiological emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.
Chronic Disease* ; Surveys and Questionnaires ; Dialysis ; Drug Therapy ; Hand* ; Humans ; Kidney Failure, Chronic* ; Killer Cells, Natural ; Massage*

BACKGROUND: To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women. METHODS: Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D(TM)) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated. RESULTS: After 1 year of HRT, the drop-out rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6 %), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correhted with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage change of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT. CONCLUSIONS: After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Bone Density* ; Bone Resorption ; Female ; Forearm ; Hormone Replacement Therapy* ; Humans ; Immunoenzyme Techniques ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis