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.

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.

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: 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*

PURPOSE: The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.METHODS: The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).RESULTS: The results showed that IPA extracted seven items with high importance but low satisfaction: “nursing fads and trends,” “teacher-learner communication and reflection,” “materials used in clinical settings such as monitoring results and test results,” “special presentations by experienced practitioners,” “instruction assures learners' comprehension,” “accurate and detailed evaluation standards” and “feedback on homework and exam.”CONCLUSION: The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.
Education ; Education, Nursing ; Flavin-Adenine Dinucleotide ; Humans ; Methods ; Nursing ; Schools, Nursing ; Students, Nursing

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.

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.