PURPOSE: This study was conducted to provide basic data for quality improvement among oncology advanced practice nurses (oncology APNs) through increasing job satisfaction by determining their job satisfaction level and analyzing the influencing factors. METHODS: The subjects were 114 certified oncology APNs working at general hospitals in metropolitan areas. Data were collected using a structured questionnaire from August 4 to October 29, 2018. The instruments were the Role Conflict Scale, Self-Efficacy Scale, Professional Self-Concept Scale, and the Level of Job Satisfaction. The data were analyzed using descriptive statistics, t-tests, chi-square tests, ANOVA, Pearson’s correlation coefficients and multiple regression in SPSS version 23.0, IBM. RESULTS: Factors that significantly affected job satisfaction were number of years since being certified as an oncology APN (β=-.20, p=.031), oncology advanced practice (β=.38, p<.001), and professional self-concept (β=.44, p<.001). The explanatory power was 39.4%. CONCLUSION: These results showed that factors significantly affecting job satisfaction were number of years since being certified as an oncology APN, advanced practice in oncology, and professional self-concept. Job satisfaction was found to be higher when the number of years since being certified as an oncology APN was shorter and professional self-concept was higher.
Advanced Practice Nursing ; Hospitals, General ; Job Satisfaction ; Oncology Nursing ; Quality Improvement

Purpose: This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. Methods: A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews.Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha. Results: The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, main-taining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, andtest-retest reliability of intraclass correlation coefficient was .90. Conclusion Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.

The Korean Neonatal Network (KNN), which is celebrating its 10th anniversary, currently has more than 100 staff and researchers from >70 neonatal intensive care units nationwide in Korea. More than 85% to 90% of the population of very low birth weight infants in Korea are registered yearly, and more than half are followed up for up to 3 years at the KNN. A total of >19,000 cases have been accumulated through a strict data quality management process of the KNN. Based on this, >100 research projects have been proposed, >70 peer-reviewed papers have been published in leading international journals, and the cornerstone of the quality improvement project has been launched. In addition, we recently expanded the number of subjects for registration to very premature infants <32 weeks of age and continue to provide essential evidence data for establishing national health policies, such as linking with government policy projects of the Ministry of Health and Welfare for preterm infants. In such manner, the KNN is confident to be successfully and actively moving toward reaching the ultimate goal of standardizing neonatal intensive care and management of preterm infants in Korea by providing essential data for national health policy establishment along with quality improvement through evidence-based interactive data.

A case of recurrent rhinocerebral mucormycosis that has occurred during an induction chemotherapy for acute megakaryocytic leukemia in a 10 year-old boy is reported. He had suffered from high fever, proptosis, right eye ball pain and necrotic inflammation of hard palate during the chemotherapy of leukemia. CT scan of the paranasal sinus showed inflammatory change of right ethmoid and maxillary sinuses, and right orbital cystic mass which displaced medial rectus muscle. Pathologic examination of the inflammatory mass revealed mucormycosis with characteristic hyphae invading vessel walls. He was managed with 2 times of extensive debridement of necrotic tissue and currettage of cystic mass, and intravenous amphotericin-B for 80 days with apparent improvement. Seven months after discharge from the hospital, necrosis of posterior nasal septum and hard palate was noted for second time. It was managed again with 2 times of extensive debridement. Since this last operation he is on follow-up for 16 months uneventfully and is on therapy with low dose Ara-C in continuous remission.
Child ; Cytarabine ; Debridement ; Drug Therapy ; Exophthalmos ; Fever ; Follow-Up Studies ; Humans ; Hyphae ; Induction Chemotherapy ; Inflammation ; Leukemia ; Leukemia, Megakaryoblastic, Acute ; Male ; Maxillary Sinus ; Mucormycosis* ; Nasal Septum ; Necrosis ; Orbit ; Palate, Hard ; Tomography, X-Ray Computed

The aim of this study was to investigate the relationship between survival and incidence of bronchopulmonary dysplasia (BPD) in extremely premature infants, and identify clinical factors responsible for this association. Medical records of 350 infants at 23-26 weeks gestation from 2000 to 2005 (period I, n = 137) and 2006 to 2010 (period II, n = 213) were retrospectively reviewed. The infants were stratified into 23-24 and 25-26 weeks gestation, and the survival, BPD incidence, and clinical characteristics were analyzed. BPD was defined as oxygen dependency at 36 weeks postmenstrual age. The overall survival rate was significantly improved in period II compared to period I (80.3% vs. 70.0%, respectively; P = 0.028), especially in infants at 23-24 weeks gestation (73.9% vs. 47.4%, respectively; P = 0.001). The BPD incidence in survivors during period II (55.0%) was significantly decreased compared to period I (67.7%; P = 0.042), especially at 25-26 weeks gestation (41.7% vs. 62.3%, respectively; P = 0.008). Significantly improved survival at 23-24 weeks gestation was associated with a higher antenatal steroid use and an improved 5-minute Apgar score. A significant decrease in BPD incidence at 25-26 weeks gestation was associated with early extubation, prolonged use of less invasive continuous positive airway pressure, and reduced supplemental oxygen. Improved perinatal and neonatal care can simultaneously lead to improved survival and decreased BPD incidence in extremely premature infants.
Adult ; Bronchopulmonary Dysplasia/epidemiology/*mortality ; Demography ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Extremely Premature ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Multivariate Analysis ; Odds Ratio ; Pregnancy ; Retrospective Studies ; Severity of Illness Index ; Survival Rate/*trends

Bronchopulmonary dysplasia (BPD), a chronic lung disease affecting very premature infants, is a major cause of mortality and long-term morbidities despite of current progress in neonatal intensive care medicine. Though there has not been any effective treatment or preventive strategy for BPD, recent stem cell research seems to support the assumption that stem cell therapy could be a promising and novel therapeutic modality for attenuating BPD severity. This review summarizes the recent advances in stem cell research for treating BPD. In particular, we focused on the preclinical data about stem cell transplantation to improve the lung injury using animal models of neonatal BPD. These translational research provided the data related with the safety issue, optimal type of stem cells, optimal timing, route, and dose of cell transplantation, and potency marker of cells as a therapeutic agent. Those are essential subjects for the approval and clinical translation. In addition, the successful phase I clinical trial results of stem cell therapies for BPD are also discussed.
Bronchopulmonary Dysplasia/*therapy ; Cell- and Tissue-Based Therapy ; Clinical Trials as Topic ; Fetal Blood/cytology/transplantation ; Humans ; Infant, Newborn ; Infant, Premature ; *Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells/cytology

Despite recent advances in neonatal medicine, neonatal disorders, such as bronchopulmonary dysplasia and intraventricular hemorrhage in preterm neonates and hypoxic ischemic encephalopathy in term neonates, remain major causes of mortality and morbidities. Promising preclinical research results suggest that stem cell therapies represent the next breakthrough in the treatment of currently intractable and devastating neonatal disorders with complex multifactorial etiologies. This review focuses primarily on the potential role of stem cell therapy in the above mentioned neonatal disorders, highlighting the results of human clinical trials and the challenges that remain to be addressed for their safe and successful translation into clinical care of newborn infants.
Bronchopulmonary Dysplasia ; Hemorrhage ; Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Mesenchymal Stromal Cells ; Mortality ; Stem Cells*

Although, recently in Korea, it has been apparent that declining total birth rate in face of rapidly aging population and rapid increasing birth rate for high-risk infants such as preterm infants, mortality rate of premature infants is still higher than that of other developed countries and the significant morbidities including cerebral palsy or development delay is high among survived patients. Thus, the substantial socio-economic burden caused by high risk infants became a substantial problem to us. To improve the survival rate and to decrease major morbidities of high risk infants, Korean Neonatal Network (KNN) was established by Korean Society of Neonatology with the support from Korea Centers for Disease Control and Prevention and begins an official operation with a declaration for launching on April 15th, 2013. With base project of national prospective registry of very low birth weight infants, KNN would be an infrastructure for active and productive multi-center research for quality improvement of neonatal intensive care units (NICU) and development of Korean-style guideline or strategy for NICU management. In this review, we describe the background, purpose, progress, expected outcomes and future plans of the KNN.
Aging ; Birth Rate ; Centers for Disease Control and Prevention (U.S.) ; Cerebral Palsy ; Delivery of Health Care ; Developed Countries ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Critical Care ; Intensive Care Units, Neonatal ; Korea ; Neonatology ; Quality Improvement ; Survival Rate

PURPOSE: This study was designed to assess the effects of cyclic parenteral nutrition(CP) on parenteral nutrition induced liver diseases. METHODS: Before and after CP, data were collected on diagnosis, age, duration of parenteral nutrition, macronutrients and biochemical parameters. Initially parenteral nutrition was cycled off for 1-2 hours and the off-time was advanced by 0.5-1 hour daily over 1 week. Blood and urine glucose were monitored during procedure. RESULTS: Data on 6 sets of CP in 4 patients, among whom 2 patients had undertaken CP 2 times, respectively, were analyzed. The mean age was approximately 4 months, ranging from 2 to 11 months. Underlying diseases were as follows : 2 cases of microvillous inclusion disease, 1 case of protracted diarrhea of infancy and 1 case of feeding intolerance. The mean duration of parenteral nutrition before CP were 38.6 days, and that of CP was 41.6 days. During CP, the mean total caloric intake of each patient was 107kcal/kg/day, and the mean weight gain was 6.0g/kg/day. After CP, the biochemical parameters changed as follows : bilirubin was decreased in 4 cases, not changed in 1 case but increased in 1 case who had sepsis during CP period; the level of ALT was decreased in 2 cases but increased in 2 cases and not changed in 2 cases. Overall, CP was tolerated well although 3 cases had hypoglycemia(serum glucose concentration less than 40mg/dL) at the initial CP period. CONCLUSION: CP has potential beneficial metabolic effects on total parenteral nutrition induced cholestasis with minimal complications.
Bilirubin ; Cholestasis* ; Cytomegalovirus Infections ; Diagnosis ; Diarrhea ; Energy Intake ; Glucose ; Humans ; Infant* ; Liver Diseases ; Parenteral Nutrition* ; Parenteral Nutrition, Total* ; Sepsis ; Weight Gain

PURPOSE: This study was designed to assess the effects of cyclic parenteral nutrition(CP) on parenteral nutrition induced liver diseases. METHODS: Before and after CP, data were collected on diagnosis, age, duration of parenteral nutrition, macronutrients and biochemical parameters. Initially parenteral nutrition was cycled off for 1-2 hours and the off-time was advanced by 0.5-1 hour daily over 1 week. Blood and urine glucose were monitored during procedure. RESULTS: Data on 6 sets of CP in 4 patients, among whom 2 patients had undertaken CP 2 times, respectively, were analyzed. The mean age was approximately 4 months, ranging from 2 to 11 months. Underlying diseases were as follows : 2 cases of microvillous inclusion disease, 1 case of protracted diarrhea of infancy and 1 case of feeding intolerance. The mean duration of parenteral nutrition before CP were 38.6 days, and that of CP was 41.6 days. During CP, the mean total caloric intake of each patient was 107kcal/kg/day, and the mean weight gain was 6.0g/kg/day. After CP, the biochemical parameters changed as follows : bilirubin was decreased in 4 cases, not changed in 1 case but increased in 1 case who had sepsis during CP period; the level of ALT was decreased in 2 cases but increased in 2 cases and not changed in 2 cases. Overall, CP was tolerated well although 3 cases had hypoglycemia(serum glucose concentration less than 40mg/dL) at the initial CP period. CONCLUSION: CP has potential beneficial metabolic effects on total parenteral nutrition induced cholestasis with minimal complications.
Bilirubin ; Cholestasis* ; Cytomegalovirus Infections ; Diagnosis ; Diarrhea ; Energy Intake ; Glucose ; Humans ; Infant* ; Liver Diseases ; Parenteral Nutrition* ; Parenteral Nutrition, Total* ; Sepsis ; Weight Gain