Purpose: : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods: : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane’s revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results: : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=–0.22, 95% CI : -0.51∼0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33∼1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

Purpose: : The purpose of this study is to develop an online global nursing competency promoting program for students in the college of nursing, and to identify the effectiveness by analyzing participation cases. Methods: : Before program development, essential elements were derived from existing programs through a meeting between graduates and experts who participated in the program. After recruiting students to participate, the program was developed after a pre-meeting with the students about the components of the program. The program was on August 9th -13th , 2021. After the program, satisfaction surveys, in-depth interviews, and participant diaries were analyzed. Results: : Satisfaction of the global nursing competency promoting program was an average of 4.10±0.96 for the program application process and 4.36±0.84 for program effectiveness and 4.43±1.07 for the global mind. As a result of qualitative data analysis, 8 subject areas and 26 categories were derived. It was divided into program elements and students’ changes, four in each element. In the students’ changes elements, curiosity and fear before the program, active attitude and open mind through friends’ encouragement, curiosity arising from the same experience and different perspectives, and developing friendship from responsibility were included. In the program elements, the subject areas were pre-requisite element, conversation facilitating element, difficult element, and online program evaluation. Conclusion : Online global nursing competency promoting program needs to be change according to the purpose of the students. In addition, it is necessary to deviate from the existing standardized operating method and to identify and participate in the needs of the students in the long term.

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p = .027), with fewer post-transplantation days (p = .027), absence of acute rejection (p = .004), or high self-efficacy (p < .001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β = 0.29, p < .001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

A short femoral stem (type 1 cementless stem) is being increasingly used to perform total hip arthroplasty; however, various types of intra- or postoperative periprosthetic fractures have been reported in recent times. A 66-year-old woman with a history of bilateral total hip arthroplasties using a type 1B femoral stem was admitted 2 months post-operation for a Vancouver type C periprosthetic fracture. She underwent open reduction and internal fixation; however, we observed recurrent non-union and plate breakage at the same site. In this case report, we discuss the factors associated with treatment failure in patients with a Vancouver type C periprosthetic fracture following type 1 femoral stem im-plantation.

Purpose: : The aim of this integrative review was to describe communication experiences and needs among the critically ill with an artificial airway and evaluate relevant intervention studies. Methods: : Using the method employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental ones) were identified and evaluated. Results: : Communication experiences while having an artificial airway, identified either by patients’ recall or direct observation, were predominantly negative. However, positive experiences were reported in patients with improvements in physical conditions and functions. Patients’ communication needs were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested included alternative and augmentative communication strategies, communication intervention packages, and voice restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using various methods including self-report surveys, interviews, and observations. Conclusions : The findings from this review represent the state of science regarding communication of the critically ill whose vocal abilities are inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures are warranted to better understand and support the complex needs of this highly vulnerable patient population.

Purpose: : The aim of this integrative review was to describe communication experiences and needs among the critically ill with an artificial airway and evaluate relevant intervention studies. Methods: : Using the method employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental ones) were identified and evaluated. Results: : Communication experiences while having an artificial airway, identified either by patients’ recall or direct observation, were predominantly negative. However, positive experiences were reported in patients with improvements in physical conditions and functions. Patients’ communication needs were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested included alternative and augmentative communication strategies, communication intervention packages, and voice restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using various methods including self-report surveys, interviews, and observations. Conclusions : The findings from this review represent the state of science regarding communication of the critically ill whose vocal abilities are inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures are warranted to better understand and support the complex needs of this highly vulnerable patient population.

Background: Treatment for lung cancer, which has high incidence and mortality rates, involves lung resection; however, the risk of postoperative pulmonary complications is high. Early walking exercise is a core strategy for preventing complications and promoting postoperative recovery, which is essential for returning to everyday life. This study aims to identify the factors associated with the postoperative recovery of patients who performed walking exercises in an intensive care unit after having a lung resection. Methods: This cross-sectional study collected data from 90 patients on the day before discharge at a tertiary hospital in Seoul between April and June 2019. Patients’ postoperative recovery was measured using the Postoperative Recovery Profile. Results: The mean score for postoperative recovery was 0.70±0.41 out of 3, 0 being none of the problems. Among the five subcategories, the psychological dimension had the highest recovery level at 0.57±0.58, while physical symptoms were rated lowest at 0.89±0.50. As a result of regression analysis, employment status (β=4.353, P=0.005), symptoms of nausea and vomiting during walking (β=0.596, P=0.043), and perceived exertion during walking (β=1.105, P=0.007) were associated with postoperative recovery. Conclusions The study indicated unemployed patients, those with more nausea and vomiting, and those who perceived severe exertion during walking showed lower perceived postoperative recovery levels. Not only multidisciplinary, patient-tailored interventions to facilitate return to work after surgery but also interventions to control physical symptoms actively should be developed and implemented to achieve higher postoperative recovery levels. Patients also need to exercise at an appropriate subjective level of perceived exertion.

PURPOSE: This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research. METHODS: Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors. RESULTS: In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking. CONCLUSION: Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.
Anxiety ; Caregivers* ; Depression ; Fatigue ; Humans ; Intensive Care Units* ; Intensive Care* ; Self Care ; Stress Disorders, Post-Traumatic ; Survivors

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery

OBJECTIVES: The purposes of the study were to assess wastes generated in school foodservice and to identify factors influencing the generation of plate waste. METHODS: A survey was administered from November 18–30 in 2015 to dietitians and nutrition teachers that were employed in schools located in Gyeonggi province. A questionnaire file and on-line survey site link were sent to the dietitians and nutrition teachers by e-mail. A total of 622 dietitians and nutrition teachers responded and 594 responses were used for data analysis after excluding 28 responses with significant missing data. RESULTS: Plate waste was the major part of food waste generated in school foodservice. Vegetable menus and soup/stews were discarded the most as plate waste. The dietitians and nutrition teachers perceived students' unbalanced diet and lack of appreciation of food as causes of the plate waste. Regarding waste management, they were concerned about environmental contamination by food waste and felt uncomfortable about discarding food. No plate waste day was the most frequently used plate waste reduction activity, followed by newsletters on plate waste reduction. Difficulty in getting teachers' support for dietary education during meal time was rated the greatest barrier to implementing the activities. To reduce plate waste, they perceived that students should understand the importance of environment conservation, teachers should supervise students' eating during meal time, students should be educated about proper portion, and foodservice staff should improve food quality. CONCLUSIONS: To improve students' intake and reduce plate waste in school foodservice, foodservice staff need to involve students in school foodservice and improve the palatability of meals, especially vegetable dishes. School nutrition teachers and dietitians should educate students about healthy eating and environment conservation and the school community needs to understand and support plate waste reduction and healthy eating in schools.
Diet ; Eating ; Education ; Electronic Mail ; Food Quality ; Food Services ; Gyeonggi-do ; Humans ; Meals ; Nutritionists ; Periodicals as Topic ; Statistics as Topic ; Vegetables ; Waste Management