PURPOSE: The purpose of this study was to identify the relationship between the practice environment of nursing and the critical thinking disposition of clinical nurses in local general hospitals. METHODS: A convenience sample of 468 registered nurses was obtained from three local general hospitals. Data were collected by a self-administered questionnaire during November, 2012. The survey tools were the K-PES-NWI verified by Cho et al (2011) and the critical thinking disposition instrument developed by Yoon (2004). Data were analyzed using descriptive statistics, one-way ANOVA with Scheffe test and multiple regression with SPSS/WIN 18.0. RESULTS: The mean score for practice environment of nursing was 3.3+/-0.4 and for critical thinking disposition, 2.3+/-0.4. There were statistically significant differences in critical thinking disposition according to age, education, length of career, current position, and marital status. In multivariate analysis, factors related to critical thinking disposition were collegial nurse-physician relations and education level. CONCLUSION: The results of the study indicate that collegial nurse-physician relations in the nursing practice environment are related to nurses' critical thinking disposition, and thus, it is important to improve the practice environment as well using individual approaches including on-the-job training to improve nurses' critical thinking disposition.
Education ; Hospitals, General* ; Inservice Training ; Marital Status ; Multivariate Analysis ; Nursing* ; Physician-Nurse Relations ; Surveys and Questionnaires ; Thinking*

PURPOSE: The purpose of this study was to identify the effect of nurses' psycho-social health and social support from colleagues on patient caring ability. METHODS: A cross-sectional survey design was used and the participants in this study were 422 nurses from 3 general hospitals. Data were collected using a self-administered questionnaire and collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression analysis with the SAS 9.4 program. RESULTS: Total mean score for psychosocial health was 3.15±0.57, for social support from colleagues, 3.43±0.55, and for caring ability, 4.04±0.53. Psychosocial health, social support from colleagues, and married status were identified as significant factors influencing patient caring ability. CONCLUSION: Findings from this study indicate that psychosocial health and social support from colleagues are related to patient caring ability, and thus, to improve nurses' caring ability for patient and for self, it is important to create a work environment that keeps nurses healthy and promotes collaboration with colleagues.
Cooperative Behavior ; Cross-Sectional Studies ; Empathy* ; Hospitals, General ; Humans

PURPOSE: The purpose of this study was to examine economic stress, depression, suicidal ideation, resilience and social support in college students and to examine the correlation between these variables. METHODS: The participants were 157 3th and 4th year college students. Data were collected in September and October, 2016. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression. RESULTS: Students' economic hardship and worry about future economic security, sub-categories of economic stress had positive correlations with depression and suicidal ideation. Economic hardship showed a significant negative correlation with resilience but no correlation with social support while worry about future economic security had negative correlations with resilience and social support. Factors significantly influencing suicidal ideation were depression (β=.37, p<.001) and social support (β=−.31, p<.001), with a total explanatory power of 36% (F=9.09, p<.001). CONCLUSION: These findings indicate that intervention strategies for managing economic stress in college students should include developing resilience and providing social support as well as decreasing depression and suicidal ideation.
Depression* ; Humans ; Suicidal Ideation*

PURPOSE: The purpose of this study was to investigate differences in the states of anger, depression, resilience and self-esteem according to type of school violence involving elementary school students. METHODS: The participants were 257 elementary school students in the 4th, 5th and 6th grades. Data was collected by structured questionnaires, and analyzed using descriptive statistics, chi2-test, t-test, ANOVA, and Pearson correlation coefficients with the SPSS/WIN 20.0 program. RESULTS: There were significant differences among the states of anger (Fs=16.66, p<.001), depression (Fs=18.04, p<.001), resilience (F=12.77, p<.001) and self-esteem (F=10.39, p<.001) according to the type of school violence. Of all the groups, bully-victim exhibited the highest score for anger and depression, and the lowest score for resilience and self-esteem. CONCLUSION: Based on the findings, developing intervention programs that consider the psychological characteristics of elementary school students is necessary. Also, the results of this study suggest that integrative programs for students that can enhance resilience and self-esteem, such as self-discovery programs, and reduce anger, such as anger control programs, need to be developed.
Anger* ; Depression* ; Humans ; Surveys and Questionnaires ; Resilience, Psychological ; Violence*

PURPOSE: The purpose of this study was to identify the effect of Psychosocial health and Self-nurturance on the experience of new graduate nurses. METHODS: A cross-sectional survey design was used. The participants in this study were 149 nurses who had less than 12 months of nursing experience and were working at one of 4 general hospitals. The data were collected by a self-administered questionnaire from Nov. 2012 to Oct. 2014. RESULTS: The total mean score for Psychosocial health was 3.07+/-0.60, Self-nurturance, 3.38+/-0.44, and graduate nurse experience, 2.59+/-0.27. The effect of Psychosocial health and Self-nurturance predicted 23% of variance in graduate nurse experience. CONCLUSION: These results indicate that Psychosocial health and Self-nurturance have a positive relationship to graduate nurse experience. Therefore, further studies including approaches that support Psychosocial health and Self-nurturance are recommended to help in the adaptation of newly graduated nurses to clinical settings.
Cross-Sectional Studies ; Hospitals, General ; Nursing ; Self Care

BACKGROUND: Previous studies have shown that if performed without radiographic guidance, the loss of resistance (LOR) technique can result in inaccurate needle placement in up to 30% of lumbar epidural blocks. To date, no study has shown the efficacy of measuring the depth of the posterior complex (ligamentum flavum, epidural space, and posterior dura) ultrasonographically to distinguish true and false LOR. METHODS: 40 cervical epidural blocks were performed using the LOR technique and confirmed by epidurograms. Transverse ultrasound images of the C6/7 area were taken before each cervical epidural block, and the distances from the skin to the posterior complex, transverse process, and supraspinous ligament were measured on each ultrasound view. The number of LOR attempts was counted, and the depth of each LOR was measured with a standard ruler. Correlation of false and true positive LOR depth with ultrasonographically measured depth was also statistically analyzed. RESULTS: 76.5% of all cases (26 out of 34) showed false positive LOR. Concordance correlation coefficients between the measured distances on ultrasound (skin to ligamentum flavum) and actual needle depth were 0.8285 on true LOR. Depth of the true positive LOR correlated with height and weight, with a mean of 5.64 +/- 1.06 cm, while the mean depth of the false positive LOR was 4.08 +/- 1.00 cm. CONCLUSIONS: Ultrasonographic measurement of the ligamentum flavum depth (or posterior complex) preceding cervical epidural block is beneficial in excluding false LOR and increasing success rates of cervical epidural blocks.
Epidural Space ; Ligaments ; Ligamentum Flavum ; Needles ; Skin

This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit.
Humans ; *Liability, Legal ; Malpractice/*legislation & jurisprudence ; Reconstructive Surgical Procedures/adverse effects/legislation & jurisprudence ; Republic of Korea ; Surgery, Plastic/*adverse effects/*legislation & jurisprudence

The fetus is an unstable subject for an isolated physiological and biochemical study. To study the fetus in a controlled and stable environment, a trial was done using 12 goat fetuses. Extrauterine incubation system was devised using an extracorporeal membrane oxygenation system. The system consisted of a venous reservoir with a servo-controlled roller pump and a membrane oxygenator. The extra-corporeal circuit and membrane oxygenator were primed with the maternal whole blood of 200 mL. Fetal umbilical cords was exposed by Cesarean section. Fetal umbilical arterial blood was drained via the drainage cannula. The drained blood was perfused to the oxygenator by the roller pump. The highly oxygenated and decarboxylated blood was returned to an umbilical vein via the perfusion catheter. The blood flow rate was controlled manually using a roller pump. Fetal heart rate, blood pressure, and electrocardiogram were continuously recorded. Gas analysis of drained and perfused bood was performed hourly. With this system, the fetuses were able to survive under fairly stable physiological condition for periods of up to 34 hr. The extrauterine incubation system used in this study could therefore be a encouraging future experimental model in researching the artificial placenta for premature fetuses.
Animals ; Extracorporeal Membrane Oxygenation/adverse effects/*methods ; Female ; Fetal Blood/metabolism ; Fetus/*blood supply/*physiology ; Goats ; Humans ; Infant, Newborn ; Infant, Premature ; Models, Animal ; Pregnancy ; Time Factors ; Umbilical Arteries ; Umbilical Veins

OBJECTIVES: The purpose of this study is to establish animal model of extracorporeal membrane oxygenation (ECMO) system that uses membreane type oxygenator and circulation circuit of umbilical artery and vein. Blood gas and hemodynamic changes in the fetal goat undergoing ECMO were also evaluated. METHODS: Total 15 pregnant goat had been used to perform extrauterine fetal incubation using ECMO through umbilical artery and vein. Cesarean-section was performed to pregnant goat (35 kg) of 120-130 days of gestation to insert catheters (8 Fr) into the umbilical artery and vein. The tip of inserted catheter's the other end was connected with the circuit system including membrane type oxygenator (Polystan) and roller pump. A total of 300 ml of blood was drawn from donor nonpregnant goat and primed into circuit on the day of surgery. The goat fetus was immersed in a chamber filled with artificial amniotic fluid to monitor blood flow dynamics and blood gas was analyzed. RESULTS: The ECMO system using umbilical cord in the extrauterine incubation of fetal goat was developed and maximum survival of goat fetus was 34.5 hrs (mean survival was 856.6+/-688 min). Oxygen tension (PO2) in umbilical artery and vein were 20.53+/-2.54 mmHg, 31.03+/-13.03 mmHg and oxygen saturation (SO2) in umbilical artery and vein were 46.61+/-18.14 mmHg, 71.56+/-15.39 mmHg. Mean blood flow was 176+/-62 ml/min/kg. CONCLUSION: We suggest that our experimental model as an extrauterine fetal research could be a reasonable method in future advanced studies. However, longterm survival of extrauterine fetus needs more suitable hemodynamic and blood gas condition supported by further researches.
Amniotic Fluid ; Catheters ; Extracorporeal Membrane Oxygenation* ; Female ; Fetal Research ; Fetus ; Goats* ; Hemodynamics* ; Humans ; Membranes ; Models, Animal ; Models, Theoretical ; Oxygen ; Oxygenators ; Pregnancy ; Tissue Donors ; Umbilical Arteries* ; Umbilical Cord ; Veins*

BACKGROUND: To analyze how lidocaine 40 mg mixed prevents injection pain of propofol affects the onset time of rocuronium, tracheal intubating conditions and intubation related hemodynamic changes. METHODS: This study consisted of 70 patients with an American Society of Anesthesiologists (ASA) physical status class 1 or 2 for general anesthesia. All the patients were randomly allocated into two groups: propofol 2 mg/kg plus normal saline 2 ml (Group C) and propofol 2 mg/kg plus 2% lidocaine 40 mg (Group L). Each group was administrated intravenously during induction and the patient was intubated 1 minute after an injection of 0.6 mg/kg of rocuronium. The time at disappearance of the first twitch and intubation scores were recorded. Also, blood pressure and heart rate were measured at the baseline, after intravenous injection of propofol, before intubation, and at 0, 1, 2, 3 and 5 minutes after intubation. RESULTS: There were no significant differences between group C and L (P > 0.05). CONCLUSIONS: 40 mg of lidocaine mixed with propofol to prevent injection pain did not affect the onset time of rocuronium, intubating conditions and intubation related hemodynamic changes.
Androstanols ; Anesthesia, General ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation ; Lidocaine ; Neuromuscular Blockade ; Propofol