PURPOSE: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. METHODS: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's alpha Descriptive statistics and multiple regressions were used to analyze data. RESULTS: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. CONCLUSION: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.
Adult ; Education, Continuing ; Humans ; Intensive Care Units ; Korea ; Tertiary Care Centers ; Surveys and Questionnaires

PURPOSE: This research was carried out to evaluate the validity and reliability of the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) for Korean older adults with type 2 diabetes. METHODS: Translation and back-translation were performed to develop the Korean version of the SDSCA. Then the Korean version SDSCA was applied to a sample of 112 older adults who had participated in diabetes self management education in Seoul. The internal consistency and the test-retest reliability were examined to test the reliability. Factor analysis was used to examine the construct validity. RESULTS: The internal consistency measured with Cronbach's alpha was .77 and the total test-retest reliability was .68 with items ranging from .21 to 1.00. As the result of the factor analysis, six factors -foot care, diet, exercise, blood sugar test, medication, and smoking- were revealed as the original instrument subcategories. These six factors explained 81.17% of total variance. CONCLUSION: The reliability and validity of the Korean version SDSCA Questionnaire was supported for use in older patients with type 2 diabetes in Korea.
Adult ; Blood Glucose ; Diet ; Humans ; Korea ; Reproducibility of Results ; Self Care ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. METHOD: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). RESULT: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. CONCLUSION: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
Risk Adjustment ; Middle Aged ; Male ; Korea ; Humans ; Home Care Services/*utilization ; Health Resources/*utilization ; Female ; Aged, 80 and over ; Aged ; Adult

PURPOSE: The purpose of this study was to test the turnover intention model for chief nurse officers in general hospitals. The variables for the study included job stress, social support, job satisfaction, and organization commitment. METHODS: A predictive, non-experimental design was used with a sample of 144 chief nurse officers from 144 general hospitals. Data were collected using self-administered questionnaires and analyzed using SPSS, AMOS program. RESULTS: The overall fitness of the hypothetical model to the data was good (chi2=16.80, p=.052, GFI=.96, AGFI=.90, NFI=.97, CFI=.99). Job stress, social support, job satisfaction, and organization commitment explained 59.0% of the variance in turnover intention by chief nurse officers. Both organization commitment and social support directly influenced turnover intention for chief nurse officers, and job stress and job satisfaction indirectly influenced turnover intention. CONCLUSION: The results imply that chief nurse officers in hospitals need social support and management of job stress to increase job satisfaction and organization commitment, and lower turnover intention.
Adult ; Female ; Humans ; Job Satisfaction ; Middle Aged ; *Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Personnel Turnover/*statistics & numerical data ; Questionnaires ; Social Support

PURPOSE: The purpose of this study was to examine if simulation training affects new graduate critical care nurses' knowledge, self-efficacy, and performance ability in emergency situations. METHODS: Forty new graduate critical care nurses were randomly assigned to either an experimental or a control group. The experimental group had didactic with simulation. The control group received only didactic without simulation about emergency situations. The data were collected before and after the training interventions. An independent t-test used for difference among variables. RESULTS: There were no significant demographic differences between the two groups or any differences on data collected knowledge, self-efficacy and performance ability. Following the training, there were significant performance ability scores (p<.001) among the nurses receiving didactic with simulation. There were no significant difference between the two groups relative to knowledge scores (p=.117), or the self-efficacy scores (p=.100). CONCLUSION: This study showed that simulation training for new graduate critical care nurses is useful to improve performance ability on emergency situations. Hence, providing simulation training to critical care nurses during an orientation period would improve quality of critical care nursing and help the new graduates nurse's adaptation.
Critical Care ; Emergencies ; Critical Care ; Intensive Care Units ; Orientation

PURPOSE: Thiazolidinediones (TZDs) are known to inhibit the proliferation of vascular smooth muscle cell (VSMC) by increasing the activity of p27(Kip1) and retinoblastoma protein (RB). However, the upstream signaling mechanisms associated with this pathway have not been elucidated. The Akt-mTOR-P70S6 kinase pathway is the central regulator of cell growth and proliferation, and increases cell proliferation by inhibiting the activities of p27(Kip1) and retinoblastoma protein (RB). Therefore, we hypothesized in this study that rosiglitazone inhibits VSMC proliferation through the inhibition of the Akt-TOR-P70S6K signaling pathway. MATERIALS and METHODS: Rat aortic smooth muscle cells (RAoSMCs) were treated with 10microM of rosiglitazone 24 hours before the addition of insulin as a mitogenic stimulus. Western blot analysis was performed to determine the inhibitory effect of rosiglitazone treatment on the Akt-mTOR-P70S6K signaling pathway. Carotid balloon injury was also performed in Otsuka Long-Evans Tokushima Fatty (OLETF) diabetic rats that were pretreated with 3 mg/kg of rosiglitazone. RESULTS: Western blot analysis demonstrated significant inhibition of activation of p-Akt, p-m-TOR, and p-p70S6K in cells treated with rosiglitazone. The inhibition of the activation of the p-mTOR-p-p70S6K pathway seemed to be mediated by both the upstream PI3K pathway and MEK-ERK complex. CONCLUSION: The inhibitory effect of rosiglitazone on RAoSMC proliferation in vitro and in vivo is mediated by the inhibition of the Akt-mTOR-P70S6K pathway.
Animals ; Cell Proliferation/drug effects ; Cells, Cultured ; Cytoprotection/drug effects ; Enzyme Activation/drug effects ; Insulin/*pharmacology ; Male ; Mitogen-Activated Protein Kinase Kinases/antagonists & inhibitors/metabolism ; Muscle, Smooth, Vascular/drug effects/*metabolism ; Myocytes, Smooth Muscle/drug effects/*metabolism ; Phosphorylation ; Protein Kinase Inhibitors/pharmacology ; Protein Kinases/*metabolism ; Proto-Oncogene Proteins c-akt/antagonists & inhibitors/*metabolism ; Rats ; Ribosomal Protein S6 Kinases, 70-kDa/*metabolism ; Signal Transduction/drug effects ; Thiazolidinediones/*pharmacology