BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

PURPOSE: Excess intake of sodium is a major diet-related risk factor for human diseases including hypertension and cancer as well as obesity and inflammation. However, findings are still controversial, and evidence is lacking in Koreans. Therefore, for better understanding of the role of dietary sodium intake in disease etiology, this study investigated the effects of dietary sodium intake on adiposity, inflammation, and hormones in Koreans. METHODS: A total of 80 males and females joined the study. The general characteristics and dietary intake data were investigated by trained interviewers using a questionnaire and 24-h dietary recall, respectively. For the markers of adiposity, body weight, body mass index, percent of body fat, visceral fat area, and waist and hip circumference were measured. For the inflammation and hormone markers, leptin, adiponectin, insulin, tumor necrosis factor-α, and interleukin-6 were also analyzed. RESULTS: Multivariate linear regression analyses suggested that dietary sodium intake was not associated with adiposity. However, dietary sodium showed a significant association with insulin level: Plasma insulin concentration increased with sodium intake independent of other dietary intake or percent of body fat (β = 0.296, adjusted r² = 0.276, p < 0.01). Other markers for inflammation and hormonal responses were not associated with dietary sodium intake. CONCLUSION: Findings suggested that dietary sodium intake may be a critical modifying factor in the level of plasma insulin. However, it showed a limited effect on obesity and other inflammation markers and hormone levels. These findings should be confirmed in larger, well-designed investigations.
Adiponectin ; Adipose Tissue ; Adiposity* ; Body Mass Index ; Body Weight ; Female ; Hip ; Humans ; Hypertension ; Inflammation* ; Insulin ; Interleukin-6 ; Intra-Abdominal Fat ; Leptin ; Linear Models ; Male ; Necrosis ; Obesity ; Plasma ; Risk Factors ; Sodium ; Sodium, Dietary*

PURPOSE: To develop an e-learning blood-borne infection control program and to evaluate the effects of the program on risk perception, knowledge, preventive health behaviors related to blood-borne infections, and satisfaction with the program by nursing student. METHODS: The program was developed through the processes of analysis, design, development, implementation, and evaluation. The pre-experimental research design involved a one group pretest-posttest design. The setting was two universities located in Daejeon, Korea. RESULTS: Using the program that was designed and developed, results for the total score of risk perception, knowledge, and preventive health behaviors in the post-test application were significantly higher than in the pre-test application (p<.05). Relevance and usefulness of the information received the highest ratings, while the system's design were demonstrated to have the lowest ratings. Those areas requiring correction were modified accordingly. CONCLUSION: Application of an e-learning blood-borne infection control program is effective, and can be expanded to other student nurses who also have a high risk of blood-borne infections.
Blood-Borne Pathogens ; Health Behavior ; Humans ; Infection Control ; Korea ; Research Design ; Students, Nursing

PURPOSE: Sodium intake is known to be a critical dietary factor in several diseases including cataract. Earlier studies have reported that excess intake of sodium may elevate the risk of cataract. However, little is known about this in Koreans. Thus, the purpose of this study was to examine whether dietary intake of sodium and potassium might modify the risk of cataract. METHODS: A total of 1,319 males (219 cases) and 1,966 females (369 cases) from Korean National Health and Nutrition Examination Survey 2012 were analyzed. Energy adjusted dietary intakes of sodium and potassium and their ratios were evaluated to ascertain their associations with the risk of cataract. Dietary intake levels were stratified into quartiles and their risk modifying effects were estimated with logistic regression models with or without subjects' socio-economic characteristics and life styles for each sex. RESULTS: Findings suggested that various descriptive factors were associated with the risk of cataract either in males or females. Males' intake levels of sodium and potassium and their ratios did not differ between phenotypes. Higher intakes or higher ratio was not associated with the risk of cataract. In contrast, female controls had higher intakes of sodium and potassium. Higher intake of potassium reduced the risk of cataract in females. However, such association was not retained when subjects' socioeconomic status and life styles were factored into the analysis. CONCLUSION: Dietary sodium and potassium intakes minimally affected the risk of cataract in Korean males and females. More studies are needed to ascertain the true pathological effect of sodium intake on cataract aetiology.
Cataract ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Nutrition Surveys ; Phenotype ; Potassium ; Social Class ; Sodium ; Sodium, Dietary

Objectives: This study aimed to investigate the current status of nutrition education via a free learning semester program (NE). The understanding of the program, the potential difficulties, and future initiatives for NE improvement were also investigated. Methods: A total number of 161 nutrition teachers from Gwangju and Jeonnam filled in a questionnaire and participated in this survey, which was performed from July to August 2019. Results: Our results showed that 8.1% of the nutrition teachers had taught nutrition education in free learning semester programs. The most frequently implemented model was subject selection, followed by club activities. Most of the nutrition teachers comprehended the purpose of NE. The attitude of nutrition teachers to NE differed by the understanding of its purpose. Positive attitude was evident due to a better understanding of the purpose by nutrition teachers. Nutrition teachers reported the most common difficulties of NE were the lack of preparation due to the heavy workload and the lack of a standard running program.The most effective method of NE was the activity classes. The experience of practicing NE influenced the choice of contents for each operating model. Nutrition teachers that were experienced in NE conducted via free learning semester programs preferred the selected topics model, but those without experience chose the career search model. Conclusions Although some obstacles exist, nutrition teachers had a positive attitude and perceived well the importance of NE. Therefore, the awareness for the significance of NE of nutrition teachers needs to be improved. For better NE practice, it is necessary to reduce/ manage the workload of general food service. Furthermore, the development of standard running and promotion programs, and teacher training programs should be ensured.

Purpose: The purpose of this study was to find stress mediation strategies for pandemic task forces in the future by identifying role stress experienced by local officials in public health centers working as COVID-19 response task force. Whether they suffered from trauma and post-traumatic stress disorder (PTSD) due to COVID-19 was also determined. Methods: Subjects for this research were 185 public health center workers in 7 northern Gyeonggi cities with at least three months of COVID-19 response task force experience. The investigation lasted for two months, from February to March of 2021. Data were collected using a self-administered questionnaire. Results: The average role stress of research subjects was 2.79 ± 0.60. There were 64 subjects (34.6%) who answered ‘yes’ for trauma experience due to COVID-19. Subjects’ role stress by sociodemographic and role characteristics displayed statistically significant differences in gender (t = -2.74, p = .007), age (F = 6.41, p = .002), profession (F = 0.01, p = .014), and COVID-19 response task (F = 3.01, p = .019). Specifically, role stress was higher for females than for males, those who were in their 20’s (than 40’s), a nursing profession (rather than others). Role stress was also higher in COVID-19 confirmed response work or in a self-quarantine work. There was a significant difference in trauma according to COVID-19 response roles (χ² = 26.59, p = < .001) and other tasks given or not (χ² = 9.48, p = .002). Conclusion It is necessary to take measures to reduce COVID-19 response task force’s role stress and trauma.

Purpose: The purpose of this study was to provide evidence for future research by analyzing the contents, delivery methods, and educational effects of educational programs for hemodialysis patients. Methods: A literature review was conducted in the following order: problem identification, literature search and data collection, data evaluation, data analysis, and data presentation. In total, 936 documents were retrieved from the search, and 24 documents were finally included in this study. Results: The contents of the educational programs were comprehensive hemodialysis-related knowledge education in seven studies, exercise-related education in 10 studies, diet-related education in four studies, drug-related education in one study, and complex education in two studies. The delivery methods were pamphlets in six studies, audio-visual materials in four studies, direct guidance by researchers in six studies, and multiple methods in seven studies. The effects of the educational program were divided into physical indicators, emotional indicators, and knowledge and performance related to hemodialysis. Sixteen out of 20 articles using physical indicators showed significant outcomes, and 10 out of 12 articles using emotional indicators derived positive results. Hemodialysis-related knowledge and performance were measured in eight and 10 studies, respectively, and meaningful results were found in six studies for knowledge and seven studies for performance. Conclusion Future research will require the development of a systematic and standardized educational program with comprehensive content that can be provided to all hemodialysis patients, as well as a highly accessible education delivery method to enhance the effectiveness of education.

PURPOSE: The purpose of this study is to examine the association between each phase of the Life Transition Process (LTP) and depressive symptoms among parents of children with Autism Spectrum Disorder (ASD). METHODS: Using a cross-sectional study design, data pertaining to LTP and depressive symptoms were collected from 285 parents of children with ASD (101 fathers and 184 mothers). Participants were recruited through the Autism Society of Korea and a counseling center for families of children with ASD. RESULTS: Using a cut-off point of 5 or higher on the Beck Depression Inventory-Short Form, more than half of the parents (53.4%) were deemed depressed; these parents experienced moderate (27.4%) to severe (11.6%) levels of depressive symptoms. A hierarchical multiple regression using the socio-demographic characteristics of children and parents and each phase of the LTP as predictors, found that lower income (β=-.14, p=.007) and greater scores for the wandering phase (β=.59, p < .001) were significant predictors of greater levels of depressive symptoms. CONCLUSION: These findings confirm the association between LTP and depressive symptoms for parents of children with ASD, who were found to have a greater risk of depressive symptoms during wandering phase.
Autism Spectrum Disorder* ; Autistic Disorder* ; Child* ; Counseling ; Cross-Sectional Studies ; Depression* ; Fathers ; Humans ; Korea ; Parents*

Oxidative stress in eye lens is one of the main causes of the cataract. Dietary antioxidants including vitamin A and C are therefore known to be associated with the risk of the disease. However, evidences are still lacking in Koreans. This study aimed to examine whether dietary vitamin A and C levels are associated with the cataract, using data of Korea National Health and Nutrition Examination Survey 2012. A total of 3,344 individuals (599 cases and 2,745 controls) were analyzed in the study. Dietary data was classified into 3 groups following Dietary Reference Intakes for Koreans 2015: 1) ≤ estimated average requirements (EAR), 2) EAR-recommended nutrient intake (RNI), and 3) ≥ RNI. Findings suggested normal subjects (controls) had better vitamin A and C nutritional status. Vitamin A and C intakes of normal subjects were significantly higher than those of cataract cases (p < 0.001, respectively). Ratio of subjects who consumed vitamin A and C lower than EAR was higher in cataract cases compared to normal subjects (p < 0.001, respectively). These antioxidant intake levels predicted that having lower level of vitamins lower than EAR increased the odd ratios (ORs) for cataract [for vitamin A: OR, 1.89; 95% confidence interval (CI), 1.55–2.31 and for vitamin C: OR, 2.06; 95% CI, 1.69–2.51]. However, such associations were not retained, when the subjects’ demographic and lifestyle factor were adjusted. In conclusion, vitamin A and C showed a protective effect against cataract. However, subjects' life style and demographic factors nullified the association. More studies are required to verify the true association between dietary antioxidants and risk of cataract in Koreans.