PURPOSE: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. METHODS: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. RESULTS: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. CONCLUSION: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.
Aged ; Chronic Disease ; Databases, Factual ; Education, Nursing ; Humans ; Models, Theoretical ; Nurse's Role ; *Quality of Life ; *Transitional Care

PURPOSE: The purpose of this study was to examine the relationship between work-family conflict, social support, job satisfaction, and organizational commitment which are closely linked to staff turnover from the perspective of married hospital nurses. METHOD: A survey was conducted using self-report structured questionnaire from 220 married nurses. Data analysis included descriptive statistics, t-test, one-way ANOVA, correlation and multiple linear regression with SPSS Win 17.0 program. RESULTS: Job satisfaction, social support, work-family conflict and age were strong predictors of organizational commitment. These variables explained 46.5% of the variance of the organizational commitment. Higher levels of organizational commitment were associated with greater job satisfaction and social support. Nurse with lower levels of work-family conflict and older age reported a high level of organizational commitment. CONCLUSION: These results show that improving job satisfaction has the best effect on enhancing nurses' organizational commitment. Also supportive relationships, reduction of work-family conflict and older age were significantly correlated with organizational commitment. Organizations should design more family- friendly policies and provide opportunities for career development to health professionals to induce organizational commitment.
Health Occupations ; Job Satisfaction ; Linear Models ; Surveys and Questionnaires ; Statistics as Topic

OBJECTIVES: This study was for analyzing the research about international marriage immigrant women and a trial to find the right direction for future research. METHODS: Sixty articles published from June, 2004 to June, 2009 were reviewed and analyzed according to the general characteristics, major of author, and theme of health domains. RESULTS: Most of them were master's thesis(71.7%) and journals(21.7%) and doctoral dissertation(6.7%) have been published mostly after thesis. Among 83.3% for quantitative research, descriptive(33.3%) and descriptive correlation(41.7%) methods were the most used and there were some qualitative researches(16.7%). The most frequently used data gathering method was questionnaire(81.7%) and the next was interview(16.7%). The major rates of the author were 61.7% for social welfare and 2.1% for nursing. The investigated variables in social health domain were adaptation(28.3%), and communication(1.7%). In psychological health domain, marriage satisfaction(16.7%), life satisfaction(11.7%), and depression(10.0%) were most researched. Utilization of medical center(5.0%) and health promotion behavior(1.7%) were investigated in physical health domain. CONCLUSIONS: Above this, most articles were researched about the adaptation of international marriage immigrant women. But the life in foreign countries can cause physical and psychosocial unhealthy conditions, so many-sided health related researches are supposed to be conducted for adaptation and prevention health problems of international marriage immigrant women.
Emigrants and Immigrants ; Female ; Health Promotion ; Humans ; Marriage ; Social Welfare

PURPOSE: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. METHODS: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. RESULTS: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA > or =34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. CONCLUSION: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.
Apnea ; Bradycardia ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Early Intervention (Education) ; Growth and Development ; Head ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Neurologic Examination ; Physical Therapists ; Sepsis ; Ventilators, Mechanical ; Weight Gain

PURPOSE: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. METHODS: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. RESULTS: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA > or =34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. CONCLUSION: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.
Apnea ; Bradycardia ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Early Intervention (Education) ; Growth and Development ; Head ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Neurologic Examination ; Physical Therapists ; Sepsis ; Ventilators, Mechanical ; Weight Gain

BACKGROUND: Instead of hepatitis C virus (HCV) RNA test using RT-PCR, an enzyme immunoas-say for detection of HCV core protein as a simple, rapid method for the detection of HCV viremia has been developed recently. In this study, we investigated the usefulness of HCV core protein for the detection of HCV viremia by comparing the results of HCV RNA. METHODS: The study group included 71 patients; some of whom showed anti-HCV Ab. The HCV core protein assay was performed by enzyme immunoassay (Ortho Clinical Diagnostics, Raritan, NJ, USA). RESULTS: The concordance rate between HCV RNA and HCV core protein assay was 75%. Compared with the HCV RNA results, HCV core protein assay showed 50% sensitivity and 97% specificity. Among 17 patients whose results for HCV RNA were positive and those of HCV core protein were negative, all of them had anti-HCV Ab. CONCLUSIONS: Although the sensitivity of HCV core protein was not high in cases with anti-HCV Ab, the positive results for HCV core protein suggests the presence of HCV viremia. So, HCV core protein may be used as a simple and rapid method for detection of HCV viremia.
Hepacivirus ; Humans ; Immunoenzyme Techniques ; RNA ; Sensitivity and Specificity ; Staphylococcal Protein A ; Viremia*

BACKGROUND: The emergence of vancomycin-resistant enterococci(VRE) is increasingly serious problem throughout the world and is likely to increase in Korea. However, a few epidemiologic studies and risk factors of VRE infection have been reported in Korea. We investigated risk factors for VRE infection and colonization. METHODS: We analyzed 48 patients with VRE(24 infection, 24 fecal colonization) and 62 vancomycin-sensitive enterococci(VSE) in Ewha Womans university hospital from January 1997 to December 1998 and we performed case-control study to assess the risk factors for VRE. RESULTS: The incidence of VRE infection was 7.3% of all enterococcal isolates and the incidence of VRE colonization from surveillance cultures was increased 0.1% to 1.5% from 1997 to 1998. Compared with patients with VSE, patients with VRE had significantly longer hospital stays. They also had more frequent stays in intensive care unit(ICU) and oncology wards. They had more frequent invasive procedures such as central lines, urinary catheters, nasogastric tubes, ventilators and were more likely to have received vancomycin or teicoplanin or aztreonam or aminoglycosides or cephalosporins therapy(P<0.05). Compared with the patients infected with VRE, the patients colonized with VRE had significantly more frequent stays in the ICU(P <0.05). CONCLUSIONS: To prevent the VRE infection and colonization, appropriate antibiotic therapy according to the guidelines and cautious handling of medical devices may be necessary.
Aminoglycosides ; Aztreonam ; Case-Control Studies ; Cephalosporins ; Colon* ; Epidemiologic Studies ; Female ; Humans ; Incidence ; Critical Care ; Korea ; Length of Stay ; Risk Factors* ; Teicoplanin ; Urinary Catheters ; Vancomycin ; Ventilators, Mechanical

BACKGROUNDS: The emergence of resistant strains to glycopeptide in enterococci(GRE) is increasingly serious problem in the worldwide. Automated methods and disk diffusion test have difficulties in detecting vancomycin resistance of some strains of vancomycin-resistant enterococci(VRE), especially having vanC genotypes. And a few studies have been done assessing the ability of antimicrobial susceptibility testing methods to detect teicoplanin resistance in enterococci. METHODS: We evaluated the abilities of two commercial kits including Vitek GPS-IZ(BioMerieux, Vitek, Inc., USA) and E-test(AB Biodisk, USA), and disk diffusion test to detect glycopeptide resistance using 34 strains of vanA and 15 strains of vanC1/C2 VRE. We compared the results with those of standard agar dilution test. RESULTS: In detecting vancomycin resistance, no very major or major errors were seen, and minor error rates were observed with disk diffusion(25%), Vitek GPS-IZ(20%) and E-test(8%). Overall sensitivities of all three methods in detecting vancomycin resistance of vanA VRE were 97-100%, but sensitivities in detecting vancomycin resistance of vanC VRE were 20% in disk diffusion, 87% in E-test and 87% in Vitek GPS-IZ. In detecting teicoplanin resistance, very major error rate was high in Vitek GPS-IZ(47%), but no very major or major errors were seen in disk diffusion and E-test; minor error rates of 2% and 6% were seen in Vitek GPS-IZ and E-test, respectively. CONCLUSION: All three methods detect vancomycin resistance of vanA VRE, but they continue to demonstrate problems in detecting low-level vancomycin resistance and the Vitek GPS-IZ is difficult to detect teicoplanin resistance in enterococci.
Agar* ; Diffusion* ; Genotype ; Teicoplanin ; Vancomycin Resistance

The group A streptococcus is capable of producing exotoxins that have been linked to a toxic shock-like syndrome. Streptococcal toxic shock syndrome is a rapidly progressive associated with injury to multiple organ systems and a 30-60% mortality rate. These cases are very rare in Korea. We present a case of 32-year-old prenant woman who developed streptococcal toxic shock syndrome following intrauterine fetal death. She manifestated hypotension, shock, increased level of creatinine, disseminated intravascular coagulopathy, liver impairment, renal failure, pulmonary edema and adult respiratory distress syndrome. Blood cultures yielded Streptococcus pyogenes. After 17 hours on admission, she died in spite of massive transfusion, antibiotics therapy and ventilatory support. Clinicians should be alert to the importance of early diagnosis and treatment of this lethal infection.
Adult ; Anti-Bacterial Agents ; Creatinine ; Early Diagnosis ; Exotoxins ; Female ; Fetal Death* ; Humans ; Hypotension ; Korea ; Liver ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Shock ; Shock, Septic* ; Streptococcus ; Streptococcus pyogenes

OBJECTIVE: To develop and evaluate the psychometric properties of a modified Naturalistic Action Test (m-NAT) for Korean patients with impaired cognition. The NAT was originally designed to assess everyday action impairment associated with higher cortical dysfunction. METHODS: We developed the m-NAT by adapting the NAT for the Korean cultural background. The m-NAT was modeled as closely as possible on the original version in terms of rules and scoring. Thirty patients receiving neurorehabilitation (twenty-three stroke patients, five traumatic brain injury patients, and two dementia patients) and twenty healthy matched controls were included. Inter-rater reliability was assessed between two raters. Validity was evaluated by comparing the m-NAT score with various measures of attention, executive functions, and daily life. RESULTS: Performance on the m-NAT in terms of the total score was significantly different between patients and controls (p<0.01). Patients made significantly more total errors than controls (p<0.01). Omissions error was the most frequent type of error in patient group. Intraclass correlation coefficients for total m-NAT score was 0.95 (95% confidence interval [CI], 0.92 to 0.97; p<0.001); total error was 0.91 (95% CI, 0.89 to 0.92; p<0.001). Total m-NAT score showed moderate to strong correlations with Stroop test interference score & index, Trail Making Test parts A and B, Sustained Attention to Response Task commission error, Functional Independence Measure, Korean instrumental activities of daily living, Korean version of the Cognitive Failures Questionnaire, and Executive Behavior Scale (p<0.05). CONCLUSION: The m-NAT showed very good inter-rater reliability and adequate validity. The m-NAT adjusted to Korean cultural background can be useful in performance-based assessment of naturalistic action for clinical and research purposes.
Activities of Daily Living ; Brain Injuries ; Cognition ; Dementia ; Executive Function ; Humans ; Psychometrics ; Stroke ; Stroop Test ; Trail Making Test ; Uronic Acids ; Surveys and Questionnaires