BACKGROUND: Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. METHODS: This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. RESULTS: Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. CONCLUSIONS: This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.
Aged ; Atherosclerosis ; Depression ; Female ; Humans ; Hypothyroidism ; Mass Screening ; Memory Disorders ; Search Engine

Background: This systematic review and meta-analysis aimed at investigating the current status and prevalence of sleep disturbance in Korean university students and provide evidence to develop appropriate strategies for improving sleep disturbance. Methods: Pooled prevalence of sleep disturbance in Korean university students was assessed using PubMed, CINAHL, Research Information Sharing Service, National Assembly Library, Korean studies Information Service System, and Korea Citation Index databases. A total of 1,843 studies were retrieved from the literature search, and 14 studies were included in the analysis. Statistical analysis was performed using comprehensive meta-analysis software. Results: The overall pooled prevalence was 48.9% (95% confidence interval [CI], 41.6-56.3%). Subgroup analyses revealed that the pooled prevalence rates were 59.2% (95% CI, 38.8-50.7%) in the Pittsburgh Sleep Quality Index (PSQI)-based and 26.0% (95% CI, 19.5-33.9%) in non-PSQI-based studies, 23.2% (95% CI, 15.6-33.1%) in low-quality and 56.9% (95% CI, 49.3-64.2%) in moderate-quality studies, 35.6% (95% CI, 33.4-37.8%) in studies published before 2010 and 51.4% (95% CI, 42.9-59.8%) in studies published since 2011. Conclusions The prevalence of sleep disturbance is higher in university students. Therefore, further studies are needed to identify sleep problems of university students and gain future-oriented insights to develop mediation strategies.

BACKGROUND: Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. METHODS: This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. RESULTS: Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. CONCLUSIONS This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.

Purpose: The study aimed to examine the concept and attributes of the quality of clinical nursing education for new graduate nurses. Methods: This study adopted a hybrid model introduced by Schwartz-Barcott and Kim. In the theoretical stage, the meaning and attributes of the quality of clinical nursing education for new graduate nurses were determined by analyzing eight articles. In the fieldwork stage, data were collected using semi-structured interviews with five new graduate nurses and seven experienced nurses. The data were analyzed by qualitative content analysis methods developed by Elo and Kyngӓs. In the final analysis, a final result was arrived at comparing, contrasting, and integrating the attributes of the concepts derived in the theoretical and field-work stages. Results: The quality of clinical nursing education for new graduate nurses was identified as excellence or the standard of education for new graduate nurses that would support them in adapting to clinical settings and transitioning to professional nurses. The attributes of the quality of clinical nursing education were founded to possess three dimensions, six categories, and 18 attributes. The multidimensional attributes of the quality of clinical nursing education for new graduate nurses were confirmed as education resources, design, method, content, evaluation, interaction, and outcome under the three dimensions of input, process, and output. Conclusion The concept and nature of the quality of clinical nursing education observed in this study can be utilized as a basis for the future development, evaluation, and improvement of clinical nursing education for new graduate nurses in healthcare organizations.

PURPOSE: This integrative review study was done to analyze methods used for validation studies in Korean nursing research. METHODS: In this study, the literature on instrument development in nursing research from Research Information Sharing Service (RISS) and major nursing journal databases in Korea were examined. The MeSH search terms included 'nursing', 'instrument', 'instrument development', 'validation' and 189 articles were included in the review. RESULTS: The most frequently reported validity type was content validity, followed by construct validity, and criterion validity. One third reported a single type of validity, and 15% of the studies demonstrated three kinds of validity at the same time. In about 40% of the studies, both content and construct validity were examined. CONCLUSION: The results of the study indicate that it is necessary to provide a wider variety of evidence to establish whether instruments are valid enough to use in nursing research.
Databases, Factual ; Humans ; *Nursing Research ; Republic of Korea ; Social Validity, Research

PURPOSE: The purpose of this study was to develop a revised version of the clinical critical thinking skills test (CCTS) and to subsequently validate its performance. METHODS: This study is a secondary analysis of the CCTS. Data were obtained from a convenience sample of 284 college students in June 2011. Thirty items were analyzed using item response theory and test reliability was assessed. Test-retest reliability was measured using the results of 20 nursing college and graduate school students in July 2013. The content validity of the revised items was analyzed by calculating the degree of agreement between instrument developer intention in item development and the judgments of six experts. To analyze response process validity, qualitative data related to the response processes of nine nursing college students obtained through cognitive interviews were analyzed. RESULTS: Out of initial 30 items, 11 items were excluded after the analysis of difficulty and discrimination parameter. When the 19 items of the revised version of the CCTS were analyzed, levels of item difficulty were found to be relatively low and levels of discrimination were found to be appropriate or high. The degree of agreement between item developer intention and expert judgments equaled or exceeded 50%. CONCLUSION: From above results, evidence of the response process validity was demonstrated, indicating that subjects respondeds as intended by the test developer. The revised 19-item CCTS was found to have sufficient reliability and validity and will therefore represents a more convenient measurement of critical thinking ability.
Discrimination (Psychology) ; Humans ; Intention ; Judgment ; Nursing* ; Reproducibility of Results ; Students, Nursing ; Thinking*

The high degree of academic burnout experienced during academic life indicates that job skill levels during the first year following graduation are low, and the correlation with turnover intention is high. We investigated the effects of clinical practice stress and resilience on nursing students’ burnout, and searched for factors that can prevent or control burnout. We recruited a convenience sample of 202 nursing students. Academic burnout, general characteristics, clinical practice stress, and resilience were assessed via self-reported questionnaires. The mean total score of academic burnout was 44.0 points; exhaustion was the highest at 18.5 points, inefficacy was 15.9 points, and cynicism was 9.6 points. High levels of clinical practice stress affected academic burnout (β=0.194, p=0.003), while high resilience was a factor that lowered the degree of academic burnout (β=-0.449, p<0.001). Based on our results, factors affecting students’ experiences of academic burnout were clinical practice stress and resilience. We therefore propose the implementation of a new curriculum aimed at increasing satisfaction with the major, reducing clinical practice stress, and increasing resilience, including an efficient peer mentoring program for clinical practice.

This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.
Cooperative Behavior ; Education ; Education, Nursing ; Humans ; Inservice Training ; Learning ; Negotiating ; Nursing ; Pharmacists ; Physical Therapists

The purpose of this study was to investigate the effects of academic resilience and interpersonal competence on the happiness of nursing students. A descriptive design was used to study 158 nursing students in nursing school through convenience sampling. IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) was used to analyze data for descriptive statistics, t-test, analysis of variance, Tukey post hoc test, Pearson's correlations, and multiple regressions. The results showed that the level of nursing students' happiness was lower than that of college students in other majors, but academic resilience and interpersonal competence among nursing students were relatively high. Nursing students' happiness was positively correlated with academic resilience and interpersonal competence. The factors affecting happiness were academic resilience (β=0.459, p < 0.001), satisfaction with major (β=0.272, p=0.006), perceived subjective health status (β=0.223, p=0.013), and interpersonal competence (β=0.185, p=0.003). Explained variance for happiness was 56.4%, and academic resilience was the most influential factor in the happiness of nursing students. Nursing students are caring human beings and should be able to pursue a happy life; therefore, it is necessary to improve satisfaction levels with the nursing major, guide students to excel in their academic achievement, prepare health education programs, and design curriculum that inspires confidence in interpersonal relationships.
Curriculum ; Diagnostic Self Evaluation ; Happiness ; Health Education ; Humans ; Mental Competency ; Nursing ; Schools, Nursing ; Students, Nursing

PURPOSE: The purpose of this study was to identify the relationship between attitudes toward the withdrawal of life-sustaining treatment, death anxiety and death acceptance among hospitalized cancer patients who were at least 65 years old. METHODS: This study adopted a descriptive study design. Data were collected from 128 patients diagnosed with cancer. The instruments used were the Attitudes toward Life-sustaining Treatment Scale, Death Anxiety Scale and modified versions of the Death Attitude Profile-Revised (DAP-R) questionnaire. RESULTS: The mean score for the subjects' attitudes toward the withdrawal of life-sustaining treatment was 3.48±0.50 out of 5. Death anxiety was reported at 2.53±0.54 out of 4. Death acceptance was reported at 4.10±1.20 out of 7. There was a significant negative correlation between the subjects' attitudes toward the withdrawal of life-sustaining treatment and death anxiety (r=−.21, p=.018), however there was no statistically significant correlation between the subjects' attitude towards the withdrawal of life-sustaining treatment and death acceptance (r=−.07, p=.462) CONCLUSION: The more positive elderly cancer patients are about the withdrawal of life-sustaining treatment, the lower their death anxiety is. This finding can help nurses with patient care towards the end of life by considering the relationship between death anxiety and their attitudes toward the withdrawal of life-sustaining treatment.
Aged ; Anxiety ; Attitude to Death ; Humans ; Patient Care