Purpose: This study aims to systematically review the literature and conduct a meta-analysis to thoroughly analyze the outcomes of studies on simulation programs in psychiatric nursing. Methods: We conducted an initial search from January 1, 2000, to September 30, 2023, using databases such as PubMed, EMBASE, CINAHL, the Cochrane Library, and Web of Science. A total of 2,571 articles were reviewed based on inclusion and exclusion criteria. We selected 35 articles for systematic literature review and subjected 20 of them to meta-analysis. Data analysis was conducted using descriptive statistics and the Comprehensive Meta-Analysis program. Results: The number of psychiatric nursing simulation programs has increased since 2015. The most common programs used Standard Patients (SP), but studies using Virtual Reality (VR), audio, video, and other methods have recently been reported. The programs addressed various mental health issues, including depression, suicide, violence, alcohol problems, and mood disorders. Overall, considering all the studies, a significant effect was observed with a pooled Hedges’s g value of 0.56 (95% CI: 0.35~0.78; p<.001). Conclusion These findings highlight the importance of incorporating simulation-based education into nursing curricula to equip professionals with the skills to provide high-quality care to individuals with mental health problems. Further research is needed to explore the long-term benefits of these educational interventions on patient care.

Purpose: The aim of the study was to conduct a systematic review and meta-analysis of nurses’ turnover intention in existing studies. Methods: A literature search was conducted in two rounds. The first round was performed on December 16, 2018. The search period was from January 1, 2008, to December 16, 2018, and involved seven databases: MEDLINE and EMBASE, which are international academic databases, and KoreaMed, KERIS, KISS, KISTI, and KMbase, which are domestic academic databases. The second search round was performed on July 2, 2022. The search period was from 2019 to 2022. Results: Fifty-three variables associated with turnover intention were identified in articles in the first round, with significantly associated work- and organization-related parameters, including burnout, emotional labor, job stress, role conflict, job satisfaction, and organizational commitment. Thirty-eight variables were identified in the second round, with mental and psychological parameters, including mental health and psychological capital, having a more significant influence. Conclusion The findings of this study can be used to prevent the turnover of hospital nurses and develop strategies for retaining excellent and professional hospital nurses.

Purpose: This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness. Methods: A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program. Results: XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001). Conclusion Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Purpose: To develop a fall risk assessment tool to predict fall risk in pediatric inpatients. Methods: Three tools widely used in clinical practice (Humpty Dumpty Fall Scale, General Risk Assessment for Pediatric Inpatient Falls, and Seoul National University Hospital Pediatric Fall Risk Scale) were examined, and assessment items were extracted. Employing a case-control design, 29 children who experienced falls during hospital stays were selected as the "fall" group, and a control group (93 children) was selected based on age and sex matching. The sensitivity, specificity, and positive and negative predictive values of the newly developed tool ("Newfs-PI") were analyzed. Results: The Newfs-PI consisted of seven items: age, activity, history of falls, length of hospital stay, and medication. The total score ranged from 0 to 15. Its sensitivity and specificity were 62.07% and 74.19%, respectively. Conclusion The Newfs-PI has high specificity and sensitivity, which are essential for a fall risk assessment tool that complements existing tools. These values are high relative to those of existing assessment tools and satisfy both sensitivity and specificity criteria. As the EMR enables monitoring of the components of the Newfs-PI, the tool can be used as a fall risk assessment and prevention scale for pediatric inpatients.

Purpose: The purpose of this study was to develop and psychometrically test the nursing start-up attitude scale for student nurses. Methods: The initial items were based on the second analysis of systematic review of previous studies and in-depth interview data with 9 nurse entrepreneurs. In total, 25 items were derived based on the pilot survey.Psychometric testing was conducted with 324 student nurses. Data were analyzed using validity and reliability test methods. Results: Six factors, including 12 items explaining 74.4% of the total variance, were verified. The factors were opportunity of self actualization, network building, enhacing start-up competencies, outcomes of start-up, preparation for start-ups, and risk taking. Cronbach's ⍺ was .75. Conclusion As validity and reliability have been verified through various methods, the developed scale in this study can contribute to assessing student nurses’ attitudes to nursing start-ups.

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.
Accidental Falls ; Diagnosis ; Diagnostic Tests, Routine* ; Electronic Health Records ; Forests ; Humans ; Inpatients* ; Judgment ; Pediatrics ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures*

PURPOSE: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. METHODS: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. RESULTS: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. CONCLUSION: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.
Bioethics* ; Consent Forms ; Data Collection ; Education ; Ethics ; Ethics, Medical ; Humans ; Life Support Care ; Mortality ; Nursing* ; Students, Nursing

The development of a serological marker for early diagnosis of isocyanate-induced occupational asthma (isocyanate-OA) may improve clinical outcome. Our previous proteomic study found that expression of vitamin D-binding protein (VDBP) was upregulated in the patients with isocyanate-OA. In the present study, we evaluated the clinical relevance of VDBP as a serological marker in screening for isocyanate-OA among exposed workers and its role in the pathogenesis of isocyanate-OA. Three study groups including 61 patients with isocyanate-OA (group I), 180 asymptomatic exposed controls (AECs, group II), 58 unexposed healthy controls (NCs, group III) were enrolled in this study. The baseline serum VDBP level was significantly higher in group I compared with groups II and III. The sensitivity and specificity for predicting the phenotype of isocyanate-OA with VDBP were 69% and 81%, respectively. The group I subjects with high VDBP (> or = 311 microg/ml) had significantly lower PC20 methacholine levels than did subjects with low VDBP. The in vitro studies showed that TDI suppressed the uptake of VDBP into RLE-6TN cells, which was mediated by the downregulation of megalin, an endocytic receptor of the 25-hydroxycholecalciferol-VDBP complex. Furthermore, toluene diisocyanate (TDI) increased VEGF production and secretion from this epithelial cells by suppression of 1,25-dihydroxycholecalciferol [1,25(OH)2D3] production. The findings of this study suggest that the serum VDBP level may be used as a serological marker for the detection of isocyanate-OA among workers exposed to isocyanate. The TDI-induced VEGF production/secretion was reversed by 1,25(OH)2D3 treatment, which may provide a potential therapeutic strategy for patients with isocyanate-OA.
Adult ; Animals ; *Asthma/blood/chemically induced/pathology ; Cell Line ; Epithelial Cells ; Female ; Gene Expression/drug effects ; Humans ; Isocyanates/toxicity ; Male ; Middle Aged ; *Occupational Diseases/blood/chemically induced/pathology ; Rats ; Toluene 2,4-Diisocyanate/toxicity ; Vitamin D-Binding Protein/*blood

To evaluate availability of the BMP-7 adenovirus (AdBMP-7) as a gene therapy for osteoinduction, we investigated in morphological aspect at 1, 2, 4, 6 weeks after cells injection. Primary cultured human dermal fibroblasts, transduced with AdBMP-7, were injected into gastrocnemius muscle of the nude mice. One week after fibroblasts transplantation new tissue was observed in the muscle. Majority of new tissue was evaluated as cartilage and calcification in the matrix was confirmed by Von Kossa stain as well as electron microscopy. Two weeks after transplantation, spongy bone was built up and adipocytes were observed in intertrabecular spaces. Osteoblasts and osteoclasts were observed in the bony tissue surface. In the result of Von Kossa-Van Gieson stain, osteolysis was dominant in bony trabeculae. Bone marrow was established in 4th weeks with intertrabecular space filled up by hematopoietic cells. At the 6th weeks, the number of trabeculae decreased and thickness of the cortical bone was increased. A great part of bone matrix has laminar structure which run paralleled to surface and which included osteocytes and canaliculi. These data demonstrate that cell mediated AdBMP-7 for gene therapy initiate development of cartilage and calcification of matrix within 1 week and complete bone and bone marrow formation within 4 weeks, so then, could be made practical application for promotion of osteoinduction.
Adenoviridae* ; Adipocytes ; Animals ; Bone Marrow ; Bone Matrix ; Bone Morphogenetic Protein 7 ; Cartilage ; Fibroblasts* ; Genes, vif ; Genetic Therapy ; Humans* ; Mice ; Mice, Nude ; Microscopy, Electron ; Muscle, Skeletal ; Osteoblasts ; Osteoclasts ; Osteocytes ; Osteolysis

As a preceding study to apply recombinant BMP-7 gene to the human, we investigated bone formation in immunodeficient mice by using tissue engineering and gene transplatation. Human dermal fibroblasts were transduced with AdBMP-7 and cultured with type I collagen solution to form collagen sponge. The collagen sponge containing AdBMP-7 transduced fibroblasts was transplanted into hypodermis of the mice and osteogenesis in the spongy was investigated by histochemical, electronmicroscopic, and radiologic methods at 1, 2, 4, 6, and 8 weeks. At one week after transplantation, there were fluent cells infiltration around the collagen sponge and capsular structure was formed with fibers arranged in concentric circles. New vessel formation was observed in the capsule and subcapsular area of the sponge, but there were nucleus condensation and obscure cell boundary in the cells of the central region. Lacuna containing eosinophilic structures were observed in the capsular structure at two weeks. This structures were enlarged with time and were confirmed to be bone tissue by showing positive reaction for Von Kossa stain. Cartilaginous structure was not observed in light microscopic level, but a few chondroblasts were observed in pericapsular area in electron microscopic observation. After 6 weeks, radiopaque shadows were observed at the region of transplantation. Cortical bone was formed in periphery of the sponge while marrow like structure was observed in central region; some trabecula bone, adipocytes, and well developed vessels. The percentage of bone formation in transplanted sponge at 1, 2, 4, 6, and 8 weeks were 0, 63, 88, 100, and 100% (n = 8), respectively. From these results, bone formation by BMP-7 transduced human dermal fibroblasts using collagen sponge scaffolds in immunodeficient mouse shows another potential way of human gene transplantation using recombinant BMP-7 adenovirus.
Adenoviridae ; Adipocytes ; Animals ; Bone and Bones ; Bone Marrow ; Bone Morphogenetic Protein 7* ; Chondrocytes ; Collagen Type I ; Collagen* ; Eosinophils ; Fibroblasts* ; Humans* ; Mice ; Osteogenesis* ; Porifera* ; Subcutaneous Tissue ; Tissue Engineering