Purpose: This study aimed to identify the influence of moral sensitivity, knowledge of advanced directives, good death perception on nurses’ attitudes toward the withdrawal of life-sustaining treatment (WLST) in a general hospital. Methods: 189 nurses in a general hospital completed structured questionnaires including the Korean Moral Sensitivity Questionnaire, Knowledge of Advanced Directives Questionnaire, Concept of Good Death Measure, and Attitudes toward WLST Questionnaire. Data were analyzed with independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and hierarchical regression using SPSS/WIN 22.0 program. Results: Nurses’ attitudes toward WLST was significantly affected by experience of life-sustaining treatment, moral sensitivity and knowledge of advanced directives. In hierarchical multiple regression, nursing experience of life sustaining treatment (β=.27, p<.001), moral sensitivity (β=.23, p=.001), and knowledge of advanced directives (β=.39, p<.001) determined the attitudes toward WLST. These factors explained 48% of the total variability in WLST in this sample. Conclusion For patients’ dignified death, it is necessary to develop and apply nursing interventions considering the influencing factors on nurse's attitudes toward life-sustaining treatment, and suggest follow-up research on nurse's behavior related to WLST.

Purpose: The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults. Methods: A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger’s regression. Results: The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges’ g = - 0.35, 95% Confidence Interval [CI] = - 0.55~- 0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges’ g = 0.45, 95% CI = - 0.75~- 0.15) was higher than the auricular acupuncture (Hedges’ g = 0.27, 95% CI = - 0.53~0.00): the longer the intervention period, the greater the effect size. Conclusion In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.

Purpose: This study aimed to identify the factors influencing positive subjective health awareness of middle school-age multicultural adolescents in Korea. Methods: This study used data from the fourth to sixth waves of the Multicultural Adolescents Panel Study conducted by the National Youth Policy Institute. In this study, a panel logit model analysis was performed using the Eviews 8.0 program (p<.050). Results: Socioeconomic status (r=.02, t=2.13, p=.033), body satisfaction (r=.71, t=1.97, p=.048), and depression (r=-.74, t=2.35, p=.018) influenced positive subjective health awareness in multicultural adolescents. When multicultural characteristics were entered into a statistical model with environmental and personal characteristics, multicultural characteristics did not have a significant influence on positive subjective health awareness. Conclusion Environmental, personal, and multicultural characteristics were related to positive subjective health awareness in multicultural adolescents; thus, an integrated approach considering those variables is recommended. Nursing interventions and educational programs are needed to improve the psychological status of multicultural adolescents and reduce prejudice about them. In addition, nurses need to be sensitive to multicultural characteristics and the developmental characteristics of multicultural adolescents.

Purpose: This study was done to clarify and analyze the concept of emotional intelligence in Nursing. Methods: Using the framework of Walker and Avant’s concept analysis, 60 articles on emotional intelligence were selected for this study. Results: Emotional intelligence was defined as aspects of individual recognition of emotion and relational activities of emotion. The attributes of emotional intelligence are competency to be aware, regulate, express and use nurses’ own and patients’ emotions in a therapeutic manner. The antecedents of emotional intelligence include meeting with patients, cognitive ability, empathy, modulating emotion and interpersonal skills. Consequences of emotional intelligence are forming relationship between nurse and patients, personal growth, achievement in workplace, high job satisfaction, low burnout and high quality of nursing care. The concept was clarified by presentation of model, borderline, contrary and related cases. Conclusion This study is meaningful in that the concept and attributes of emotional intelligence are identified in the nursing area by reflecting the characteristic and the purpose of nursing. In addition, based on the results of this study, development of standardized tools to measure emotional intelligence and development of educational programs to enhance nurses’ emotional intelligence are recommended.

PURPOSE: This study was done to analyze and clarify the concept of empathy in nursing. METHODS: Using the concept analysis framework of Walker & Avant 68 articles about empathy were selected for this study. RESULTS: Defining attributes of empathy included recognizing others' perspective and thought, understanding others' emotion, and communicating with them. The antecedents of empathy included contact with patients, respect and trust for patients, a certain level of cognitive ability, and communication skills. Consequences of empathy were increasing patient self-understanding, self-awareness as a therapeutic subject and improving quality of nursing. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: The results of this study are meaningful in that the concept and attributes of empathy are explored in the area of nursing. Also, based on results of this study, development of standardized tools to measure patient-perceived empathy and measure the three attributes of empathy is recommended as well as the development of educational programs to enhance empathy.
Empathy ; Humans ; Nursing ; Walkers

OBJECTIVE: This study assesses the hypothesis that preeclampsia is associated with the change of oxidative system balance by measuring the lipid peroxidation and antioxidant activity in preeclampsia. METHOD: Venous blood samples were collected from twenty women with preeclampsia and twenty women with uncomplicated pregnancies. Total lipid peroxidation, total antioxidant activity, antioxidant enzyme activity and antioxidant concentration were measured using flow injection-chemiluminescent method. RESULTS: 1. Total lipid peroxidation(PCOOH) was higher in preeclampsia(717.22+/-93.08 pmol/ml) than in normal pregnant(486.86+/-43.15 pmol/ml) (P<0.05). 2. Total antioxidant activity was significantly higher in preeclampsia(46.02+/-5.95 % inhibition) than in normal pregnant(38.59+/-7.57 % inhibition) (P<0.05).3. Antioxidant enzyme, catalase activity in RBC was lower in preeclampsia(346.59+/-82.84 unit/gHb) than in normal pregnant(440.62+/-72.8 unit/gHb) (P<0.05).4. Antioxidant, alpha-tocopherol concentration in RBC was slightly lower in preeclampsia(33.21+/-7.82 ng/gHb) than in normal pregnant(36.06+/-6.86 ng/gH), but there was no statistically significant difference (P<0.05). CONCLUSION: This data seems to show that preeclampsia is associated with an imbalance between the lipid peroxidation and the antioxidant system.
alpha-Tocopherol ; Catalase ; Female ; Free Radicals ; Humans ; Lipid Peroxidation ; Pre-Eclampsia* ; Pregnancy

Although cochlear implantation using posterior tympanotomy has been performed worldwide, other alternative approaches might be more beneficial and convenient in some selected cases. Of these, suprameatal approach was reported to be one of useful options in cases with narrow facial recess, anteriorly located facial nerve and an ossified cochlea. We describe a case of cochlear implantation using the modified suprameatal approach in a severely contracted mastoid cavity and suggest another indication of this approach.
Cochlea ; Cochlear Implantation* ; Cochlear Implants* ; Facial Nerve ; Mastoid*

BACKGROUND: Hyperhomocysteinemia increase the risk of vascular disease, dementia and cognitive impairment. The effect of homocysteine on cognitive function may be as a consequence of direct neurotoxicity or indirectly through cerebrovascular disease. Thus we examined the association between homocysteine levels and cognitive function, and assess whether this may be mediated by cerebral white matter lesions. METHODS: Non-dementic participants were recruited from March to December 2005, and underwent brain MRI. White matter hyperintensities(WMH) were rated visually by 4-class WMH grades. Informations of age, gender, education and vascular risk factor were obtained from interview. Cognitive function were assessed by using K-MMSE and HDS-R. The cross-sectional relationship between homocysteine level and cognitive test score was assessed by multiple regression analysis. RESULTS: Severe WMH groups more exposed to vascular risk factor such as age, hypertension and higher levels of homocyteine. More severe WMH grades also had lower K-MMSE and HDS-R score. Higher group of homocysteine concentration were significantly related to poorer performances on K-MMSE and HDS-R tests. In multiple linear regression analyses for the relationship between homocysteine and cognitive performances, higher homocysteine level was also related to lower cognitive performances. Adding cerebral WMH changes to the level of homocysteine did not significantly change the effect of homocysteine on cognitive ability, and cerebral WMH had a separate and additive effect with homocysteine. CONCLUSIONS: Elevated homocysteine level is associated decreased cognitive score and cerebral white matter lesion on MRI is independent association to the cognitive abilities.
Brain ; Dementia ; Education ; Homocysteine* ; Hyperhomocysteinemia ; Hypertension ; Linear Models ; Magnetic Resonance Imaging ; Risk Factors ; Vascular Diseases

The purpose of this experiment is to know the relation of the detection and characterization of liver's diseases as comparison of finding at MR imaging using a Ferucarbotran (SPIO) and Gd-EOB-DTPA (Primovist) agents in diffuse liver disease. A total of 50 patients (25 men and 25 women, mean age: 50 years) with liver diseases were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) "with 8 Ch body coil for comparison of diseases and contrast's uptake relation, which used the LAVA, MGRE." All images were performed on the same location with before and after Ferucarbotran and Gd-EOB-DTPA administrations (p<0.05). Contrast to noise ratio of Ferucarbotran and Gd-EOB-DTPA in the HCC were 3.08+/-0.12 and 7.00+/-0.27 with MGRE and LAVA pulse sequence, 3.62+/-0.13 and 2.60+/-0.23 in the hyper-plastic nodule, 1.70+/-0.09 and 2.60+/-0.23 in the meta, 2.12+/-0.28 and 5.86+/-0.28 in the FNH, 4.45+/-0.28 and 1.73+/-0.02 in the abscess and ANOVA test was used to evaluate the diagnostic performance of each disease (p<0.05). In conclusions, two techniques were well demonstrated with the relation of the detection and characterization of liver's diseases.
Abscess ; Contrast Media ; Dextrans ; Female ; Gadolinium DTPA ; Humans ; Liver ; Liver Diseases ; Magnetite Nanoparticles ; Male ; Noise

PURPOSE: Genetic factor is an important predisposing element influencing the susceptibility to osteoporosis and related complications. The purpose of the present study is to investigate whether genetic polymorphisms of farnesyl diphosphate synthase (FDPS) or geranylgeranyl diphosphate synthase (GGPS) genes were associated with the response to bisphosphonate therapy. MATERIALS AND METHODS: In the present study, 144 Korean women with osteoporosis were included. Among 13 genetic polymorphisms found within the FDPS and GGPS1 gene, 4 genetic polymorphisms with frequencies > 5% were selected for further study. Bone mineral density (BMD) response after 1 year treatment of bisphosphonate therapy was analyzed according to the genotypes. RESULTS: Women with 2 deletion allele of GGPS1 -8188A ins/del (rs3840452) had significantly higher femoral neck BMD at baseline compared with those with one or no deletion allele (0.768 +/- 0.127 vs. 0.695 +/- 0.090 respectively; p = 0.041). The response rate of women with 2 deletion allele of GGPS1 -8188A ins/del (28.6%) was significantly lower than the rate of women with one (81.4%) or no deletion allele (75.0%) (p = 0.011). Women with 2 deletion allele of GGPS1 -8188A ins/del had 7-fold higher risk of non-response to bisphosphonate therapy compared with women with other genotypes in GGPS1 -8188 after adjusting for baseline BMD (OR = 7.48; 95% CI = 1.32-42.30; p = 0.023). Other polymorphisms in FDPS or GGPS1 were not associated with lumbar spine BMD or femoral neck BMD. CONCLUSION: Our study suggested that GGPS1 - 8188A ins/del polymorphism may confer susceptibility to femoral neck BMD response to bisphosphonate therapy in Korean women. However, further study should be done to confirm the results in a larger population.
Aged ; Asian Continental Ancestry Group ; Bone Density/*drug effects/*genetics ; Bone Density Conservation Agents/*pharmacology ; Dimethylallyltranstransferase/*genetics ; Diphosphonates/*pharmacology ; Farnesyltranstransferase/*genetics ; Female ; Geranyltranstransferase/*genetics ; Humans ; Middle Aged ; Polymorphism, Genetic/*genetics