PURPOSE: Mechanistic case diagram (MCD) was recommended for increasing the depth of understanding of disease, but with few articles on its specific methods. We address the experience of making MCD in the fullest depth to identify the pros and cons of using MCDs in such ways. METHODS: During problem-based learning, we gave guidelines of MCD for its mechanistic exploration from subcellular processes to clinical features, being laid out in as much detail as possible. To understand the students' attitudes and depth of study using MCDs, we analyzed the results of a questionnaire in an open format about experiencing MCDs and examined the resulting products. RESULTS: Through the responses to questionnaire, we found several favorable outcomes, major of which was deeper insight and comprehensive understanding of disease facilitated by the process of making well-organized diagram. The main disadvantages of these guidelines were the feeling of too much workload and difficulty of finding mechanisms. Students gave suggestions to overcome these problems: cautious reading of comprehensive texts, additional guidance from staff about depth and focus of mechanisms, and cooperative group work. From the analysis of maps, we recognized there should be allowance of diversities in the appearance of maps and many hypothetical connections, which could be related to an insufficient understanding of mechanisms in nature. CONCLUSION: The more detailed an MCD task is, the better students can become acquainted with deep knowledges. However, this advantage should be balanced by the results that there are many ensuing difficulties for the work and deliberate help plans should be prepared.
Education, Medical ; Humans ; Problem-Based Learning*

PURPOSE: The aim of this study was to describe the experiences of student nurses during their clinical practice periods in an alcoholic ward. METHODS: A descriptive phenomenological study design was employed. Individual interviews were conducted and audio-taped. Colaizzi's method of data analysis was applied to inductively determine themes and formulated meanings. Data saturation was achieved and methodological rigor was established. RESULTS: Four themes were identified and these themes included anxiety of nursing practice in unfamiliar setting, sympathy with patients, learning about the inpatient alcoholics care, and self-reflection. CONCLUSION: Nursing students had positive and negative experiences in their clinical practice. The results of this study had important implications regarding clinical practice and research for nursing clinical education.
Alcoholics ; Alcoholism* ; Anxiety ; Education ; Humans ; Inpatients ; Learning ; Nursing ; Private Practice ; Qualitative Research ; Statistics as Topic ; Students, Nursing*

PURPOSE: This study aimed to investigate the correlation between death anxiety, terminal care stress, and job satisfaction of new nurses, as well as to identify factors affecting job satisfaction using descriptive correlations.METHODS: This study included 143 new nurses who had 3 to 12 months of experience in terminal care. Data were collected from January to February 2018, and were analyzed using descriptive statistics, t-test, ANOVA, Scheffé́ test, Pearson's correlation coefficient, and hierarchical regression analysis.RESULTS: There was a negative correlation between job satisfaction and terminal care stress (r=−.170, p=.043), while death anxiety and terminal care stress were positively correlated (r=.284, p=.001). The following findings demonstrated a significant effect on job satisfaction: lesser the clinical career experience, the lower the job load causing death anxiety and terminal care stress, and the higher the job satisfaction. Furthermore, the explanatory power of these factors was 15.1%.CONCLUSION: To assist new nurses within three months of joining in clinical adaptation, it is necessary to provide them with appropriate knowledge regarding terminal care through training, and with counseling opportunities for the psychological burdens they experience while caring for dying patients.
Anxiety ; Counseling ; Humans ; Job Satisfaction ; Terminal Care

Purpose: The purpose of this study was to examine the level of turnover intention and identify factors affecting turnover intention in nurses working at a tertiary hospital in Korea. Methods: A descriptive study was conducted. A total of 239 clinical nurses were recruited using a convenient sampling method. The standardized questionnaires was used to assess fatigue, nursing professionalism, and compassion satisfaction. Data were analyzed using SPSS software. Descriptive statistics were computed to describe the sample and study variables. Logistic regression analyses was performed to identify factors affecting turnover intention in clinical nurses working at a tertiary hospital. Results: Among the 239 clinical nurses, a mean age of participants was 28.80±5.08 years. Most of participants were female (n=228, 95.4%) and single (n=183, 76.6%) and achieved bachelor’s degree (n=186, 77.8%). Approximately 43.5% of them intended to turnover their current job. The findings showed that turnover intentions were significantly higher among clinical nurses who were younger (OR=0.93, 95% CI=0.86~0.99), worked in ICU or ER (OR=3.64, 95% CI=1.04~12.70), had higher fatigue (OR=1.02, 95% CI=1.01~1.04), and had lower professionalism (OR=0.98, 95% CI=0.96~0.99). It explained 23.7% of the variance in turnover intention. Conclusion The findings indicated that nurse administrators need to develop and provide customized intervention program to decrease fatigue and increase nursing professionalism to prevent turnover intention in clinical nurses working at a tertiary hospital.

Background/Aims: Advance directives (ADs) in Korean patients with heart failure (HF) and the associations of attitude towards ADs and HF prognosis with ADs were initially assessed using the model of the Korean-Advance Directive (K-AD). Methods: Twenty-four patients with HF (age, 67.1 years; men, 58.3%; ejection fraction, 35.9%) participated. A pilot test to evaluate the feasibility of ADs and the possible associations of attitudes towards ADs and prognosis with end-of-life treatment preferences among patients with HF was conducted. Results: Fifteen patients (62.5%) completed the K-ADs. The major reason for incomplete K-AD was knowledge deficit. Patients valued “comfortable death” the most (45.4%), followed by “giving no burden to the family” (13.6%). Among treatment preferences, hospice care was preferred by the majority (66.7%), while cardiopulmonary resuscitation (CPR) was preferred by the minority (31.8%). Children (50.0%) were mostly appointed as a proxy, followed by the spouse (33.3%). More patients with moderately positive attitudes completed the K-ADs than their counterparts (70.0% vs. 57.1%). The 5-year survival rate was 69.2%; the patients who preferred CPR had a higher survival rate (70.6% vs. 68.5%) whereas those who preferred hospice care had a lower survival rate than their counterparts (70.7% vs. 75.2%). Conclusions The findings support the feasibility of the K-AD model, with a high acceptance rate in two-thirds of the sample. Further studies are warranted to investigate whether treatment preferences are associated with attitude towards ADs and/or HF prognosis using larger sample size.

BACKGROUND/OBJECTIVES: The branched-chain amino acids (BCAA), including isoleucine, leucine, and valine, promote muscle protein synthesis. However, obesity may interfere with protein synthesis by dysregulating mitochondrial function in the muscles.This study aimed to examine the association between dietary intake levels of BCAA and skeletal muscle mass index (SMI) in middle-aged participants, and the effect of obesity/ abdominal obesity on this association. SUBJECTS/METHODS: The data of 3,966 men and women aged 50–64 years who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were analyzed.Intake levels of energy-adjusted dietary amino acids were obtained using a 24-hour dietary recall. SMI was calculated by dividing the appendicular skeletal muscle mass by body weight (kg) and multiplying the result by 100%. Multivariable general linear models were used to analyze the association of dietary BCAA intake levels with SMI. RESULTS: The beneficial effects of energy-adjusted dietary BCAA intakes on SMI were greater in the non-obesityon-abdominal obesity groups; however, no significant associations were observed in the obesity/abdominal obesity groups (P > 0.05). CONCLUSIONS Healthy weight and sufficient intake of dietary BCAA are recommended to maintain muscle mass.

BACKGROUND/OBJECTIVES: This study aimed to analyze the association between dietary omega-3 fatty acid intake and depression in postmenopausal women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI. SUBJECTS/METHODS: The KNHANES is a cross-sectional nationwide health and nutrition survey. Dietary data, including omega-3 fatty acids, were assessed using the 24-h recall method. Depression was evaluated using a survey questionnaire. The association between dietary omega-3 fatty acids and depression was evaluated using multivariate logistic regression analysis. Depression, according to the dietary omega-3 fatty acid intake, was expressed as the odds ratio (OR) with a 95% confidence interval (CI). A total of 4,150 postmenopausal women were included in the analysis. RESULTS: In the fully-adjusted model, the group with the highest dietary omega-3 fatty acid intake significantly showed lower prevalence of depression than the group with the lowest intake (OR, 0.52; 95% CI, 0.33–0.83); a significant linear trend was detected (P for trend = 0.04). According to the dose-response analysis using cubic restricted spline regression, this association was linear and monotonic (P for non-linearity = 0.32). CONCLUSIONS In this study, the dietary omega-3 fatty acid intake in postmenopausal women was inversely proportional to depression in a dose-response manner. Large cohort studies are needed to verify the causality between omega-3 fatty acids and depression in Korean postmenopausal women.

In young patients with type 1 diabetes, insulin pump therapy lowers the risk of severe hypoglycemia and diabetic ketoacidosis compared to insulin injection therapy. It also increases lifestyle flexibility and improves glucose control. However, appropriate use of insulin pumps requires structured education programs to improve patient self-care. In addition, feedback and ongoing attention from diabetes educators are needed. For this purpose, a systematic education program for medical staff related to insulin pump treatment should be pursued in Korea.

Purpose: : The purpose of this study is to examine the relationship between burnout, nursing work environment, patient-centered communication, and person-centered care nursing among intensive care unit (ICU) nurses and to identify factors related to person-centered care nursing. Methods: : This is a descriptive study involving 156 ICU nurses. A structured questionnaire was used to assess burnout, nursing work environment, patient-centered communication, and person-centered critical care nursing performance. Data were collected from February to March 2020, and descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis were conducted using SPSS/WIN 25.0 program. Results: : The mean scores for person-centered care nursing, burnout, nursing work environment, and patient-centered communication of ICU nurses were 3.52±0.42, 3.00±0.76, 2.62±0.34, 4.06±0.64, respectively. Person-centered nursing showed a statistically significant negative correlation with burnout (r=-.20, p=.013) and a statistically significant positive correlation with patient-centered communication (r=.49, p<.001). In addition, patient-centered communication (β=.47, p<.001) was significantly correlated with person-centered nursing. Conclusion : The results of this study showed that the factors affecting the person-centered care nursing of ICU nurses were patient-centered communication. Therefore, it is necessary to develop and apply patient-centered communication programs for improving the person-centered nursing performance of ICU nurses.

PURPOSE: This study aimed to investigate the correlation between death anxiety, terminal care stress, and job satisfaction of new nurses, as well as to identify factors affecting job satisfaction using descriptive correlations. METHODS: This study included 143 new nurses who had 3 to 12 months of experience in terminal care. Data were collected from January to February 2018, and were analyzed using descriptive statistics, t-test, ANOVA, Scheffé́ test, Pearson's correlation coefficient, and hierarchical regression analysis. RESULTS: There was a negative correlation between job satisfaction and terminal care stress (r=−.170, p=.043), while death anxiety and terminal care stress were positively correlated (r=.284, p=.001). The following findings demonstrated a significant effect on job satisfaction: lesser the clinical career experience, the lower the job load causing death anxiety and terminal care stress, and the higher the job satisfaction. Furthermore, the explanatory power of these factors was 15.1%. CONCLUSION To assist new nurses within three months of joining in clinical adaptation, it is necessary to provide them with appropriate knowledge regarding terminal care through training, and with counseling opportunities for the psychological burdens they experience while caring for dying patients.