PURPOSE: Web-based instructional programs have been criticized that it is not easy to grasp learners' learning behaviors. This study applied the web-based instructional program with log data analysis plans to a group of participants, and (1) explored variables of learners' learning behaviors, and (2) compared the level of learners' understanding about the topic before and after the program completion. METHODS: A total of 44 nursing students in their third year of one university participated in this descriptive study with one group pre-test and post-test design. RESULTS: The variables were actually produced, and reflected how participants completed the program. Participants' knowledge about the topic improved after the program completion. However, when the participants were divided into two groups depending on their learning behaviors, participants with honest learning behaviors performed better. CONCLUSION: This study confirmed that it was possible to grasp learners' learning activities by analyzing log data, and suggested that answering multiple choice items through internet may not be enough to determine the effects of an instructional program usage. More studies are in need to select appropriate indicators that could reflect learners' learning behaviors effectively and efficiently.
Blood Gas Analysis ; Education, Nursing ; Hand Strength ; Humans ; Internet ; Learning ; Statistics as Topic ; Students, Nursing

Purpose: : The aim of this study was to investigate sleep parameters and architecture in patients admitted to the intensive care unit (ICU) on the day of abdominal surgery. Methods: : A total of ten patients who underwent laparotomy under general anesthesia at the hepatopancreatobiliary surgery department of a general hospital in Busan, South Korea participated in this observational study. We measured total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), and sleep stages on their first night in the ICU using the WatchPAT300. Furthermore, we used nonparametric statistics to examine differences in postoperative sleep based on sedative administration. Results: : The Median (IQR) TST for the participants was 399.50(263.80) minutes; the SE was 75.1 (30.4)%; the WASO rate was 27.8(30.6)%; and the WASO frequency was 5.50(8.50) times. Patients’ rapid eye movement (REM) sleep time was 114.31(87.88) minutes, with 55.8(11.9)% of N1, 18.2(5.3)% of N2, and 24.8 (11.7)% of N3 sleep stages. The sedation group had a longer TST (Z=-2.619, p =.008), higher SE (Z=-2.611, p =.008), lower WASO rate (Z=-2.611, p =.008), smaller number of WASOs (Z=-2.627, p =.008), and longer REM sleep (Z=-2.617, p =.008) compared to the non-sedation group. Conclusion : We observed a high rate of light sleep and awakenings during sleep in patients admitted to the ICU after surgery. Moreover, non-sedated patients lacked either deep or REM sleep. Sleep-improving interventions are needed for non-sedated surgical patients who are admitted to the ICU.

PURPOSE: Bedside electrocardiograph (ECG) monitoring is continuously used for assessing patients' cardiac status in intensive care units. However, it has not been explored whether it is used with proper knowledge and nursing practices; if not, its usage will be limited and the risk for compromised patient safety might be significant. This study, therefore, explored knowledge and nursing practices regarding bedside ECG monitoring in nurses working at intensive care units. METHODS: Participants in this survey research were a convenience sample of 156 nurses from 25 intensive care units distributed in five hospitals with more than 1,000 beds each in Seoul, South Korea. RESULTS: Participants showed limited and incorrect knowledge and nursing practices. Only 4 (2.6%) participants correctly answered to all electrode placement sites of RA, LA, LL, and V1. Lead II was the most frequently monitored unit regardless of the main purpose of ECG monitoring, and nursing practices to manage noisy signals did not include skin care at the top priorities. CONCLUSION: Educators and clinicians alike need to make an effort to ensure that a safe level of knowledge and practices for the monitoring is maintained in order to make sure that patient outcomes are not compromised.
Electrocardiography* ; Electrodes ; Humans ; Intensive Care Units* ; Korea ; Nursing* ; Patient Safety ; Seoul ; Skin Care

PURPOSE: The purpose of this study was to determine whether the multiple mini-interview (MMI) predicts academic achievement for subjects in a medical school curriculum. METHODS: Of 49 students who were admitted in 2008, 46 students finished the entire medical education curriculum within 4 years. We calculated the Pearson correlation coefficients between the total MMI score of the 46 graduates and their academic achievements in all subjects of the curriculum. RESULTS: The correlation coefficients between total MMI score and academic achievement in Medical Interview and History Taking, Problem-Based Learning, Doctoring I, and Clinical Practice of Surgery ranged from 0.4 to 0.7, indicating that they were moderately related. The values between total MMI score and achievement in Research Overview, Technical and Procedural Skills, Clinical Performance Examinations 1 and 3, Clinical Practice of Laboratory Medicine and Psychiatry, Neurology, and Orthopedics ranged from 0.2 to 0.4, which meant that they were weakly related. CONCLUSION: MMI score can predict medical student' academic achievement in subjects in the medical humanities and clinical practice.
Clinical Competence ; Curriculum ; Education, Medical ; Humanities ; Humans ; Neurology ; Orthopedics ; Problem-Based Learning ; Schools, Medical*

PURPOSE: This study was done to identify the effects of Type D personality on compassion fatigue, burnout, compassion satisfaction, and job stress in clinical nurses. METHODS: A descriptive cross-sectional design was used. Data were collected from a convenience sample of 172 clinical nurses working in two tertiary hospitals. The structured questionnaires included Type D personality scale, compassion fatigue, burnout, compassion satisfaction, and job stress scales. RESULTS: About 79.7% of participants were classified as Type D personality group. The Type D personality was not related to general characteristics of clinical nurses. The Type D personality group showed statistically significant higher compassion fatigue, burnout, and job stress and lower compassion satisfaction compared to the non-Type D personality group. In addition, compassion fatigue and burnout were positively correlated with job stress and compassion fatigue was positively correlated with burnout. However, compassion satisfaction was negatively correlated with burnout. CONCLUSION: As the prevalence of Type D personality is high in clinical nurses, it is necessary to assess stress-related personality. In addition, management for the nurse with Type D personality is required to alleviate compassion fatigue, burnout, and job stress and to improve compassion satisfaction.
Empathy* ; Fatigue* ; Prevalence ; Surveys and Questionnaires ; Tertiary Care Centers ; Type D Personality* ; Weights and Measures

PURPOSE: This study was performed to identify the levels of paclitaxel-containing chemotherapy-induced peripheral neuropathy (CIPN) in relation to quality of life (QOL) in patients with breast cancer. METHODS: A total of 82 breast cancer patients with CIPN participated in this study. Data were collected through self-reported questionnaires containing three instruments by the European Organization for Research and Treatment of Cancer (EORTC), such as QLQ-C30 for health-related QOL, QLQ-BR23 for breast cancer-related QOL, and QLQ-CIPN20 for CIPN. Scores from all three instruments were transformed into 0 to 100 scale. Data were analyzed using SPSS/WIN20 with descriptive statistics and Pearson's correlations. RESULTS: The mean score for each subscale of health-related QOL was 46.14 for global health status, 62.43 for functional scale, and 31.29 for symptom scale. The mean score for each subscale of breast cancer-related QOL was 56.55 for the functional scale and 42.06 for the symptom scale. Also, the CIPN's mean score on the sensory scale was 30.42, 24.03 on the motor scale, and 22.70 on the autonomic scale. There were significant moderate correlations between QOLs and CIPN (r ranged from -.37 to .65). CONCLUSION: There is a need to develop interventions for breast cancer patients to enhance their quality of life and to alleviate chemotherapy-induced peripheral neuropathy.
Breast Neoplasms* ; Breast* ; Humans ; Peripheral Nervous System Diseases* ; Quality of Life* ; Surveys and Questionnaires

PURPOSE: South Korean adolescents have been identified as a chronic partial sleep-deprived population in several previous studies. This study was to identify the current nocturnal sleep duration by age in South Korean adolescents and to analyze the association of emotional status factors such as subjective happiness, depression and suicidal attempts, and health-risk behaviors with the nocturnal sleep duration. METHODS: The findings in this study are based on the data obtained from the 7th Korea Youth Risk Behavior Web-Based Survey (KYRBWS-VII), a cross-sectional, annual survey of the health-risk behaviors in a representative sample of South Korean middle- and high-school students aged 13-18 years, which was conducted in 2011. Out of 75,643 students from 800 schools across the nation, 75,205 students were selected by using the complex sampling design of the survey. We analyzed the relationships between the duration of nocturnal sleep and emotional status (subjective happiness, stress level, depression, and suicidal thoughts), health-risk behaviors (smoking, drinking), and sleep satisfaction. RESULTS: There was a significant relationship between the duration of sleep and the emotional status. In general, happy students had the longest nocturnal sleep duration, regardless of their grades. Self-rated stress levels and depression in adolescents were inversely proportional to nocturnal sleep duration. Health-risk behaviors such as smoking and alcohol consumptions were more common in sleep-deprived students (P<0.001). CONCLUSION: Appropriate nocturnal sleep duration is critical for emotional health as well as prevention of suicide in the adolescent population.
Adolescent* ; Depression ; Happiness ; Humans ; Korea ; Risk-Taking ; Sleep Deprivation ; Smoke ; Smoking ; Suicidal Ideation ; Suicide

PURPOSE: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. METHODS: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. RESULTS: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. CONCLUSION: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.
Adult ; Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Asian Continental Ancestry Group ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Neoplasms/drug therapy ; Peripheral Nervous System Diseases/*etiology ; Pilot Projects ; *Quality of Life ; Questionnaires ; Republic of Korea ; Research Design ; *Translating

PURPOSE: Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC). METHODS: Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5–10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification. RESULTS: No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53% of the patients had a mild dPNI (<5); only 15% had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95% confidence interval [CI], 1.577–4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95%CI, 1.225–4.978). CONCLUSION: The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.
Classification ; Colorectal Neoplasms ; Gastrointestinal Neoplasms ; Humans ; Multivariate Analysis ; Nutrition Assessment ; Postoperative Complications ; Prospective Studies ; Rectal Neoplasms*