OBJECTIVE: The purpose of this research was to define the factors influencing turnover intention of customized home health care nurses. METHODS: Research participants were 237 nurses who worked in the customized home health care of 33 public health centers in Daegu city and Gyeong-Buk Province. The data were collected by self report questionnaires from July, 1 to August, 30, 2011. The data were analyzed by t-test, ANOVA, correlation coefficient, multiple stepwise regression using the SPSS program. RESULTS: The average score for turnover intention was 3.12 (5 score) and job satisfaction was 2.41 (4 score). The scores for sub-categories of job satisfaction were operational factors, 1.99, personnel factors, 2.03, work factors, 2.64 and relationship factors, 3.04. Marital status, religion, visiting nurses career, employment status, work area were the significant factors related to turnover intention in these subjects. There was a significant negative correlation between job satisfaction and turnover intention (r=-0.354, p<0.001). Significant factors were job satisfaction, marital status, employment status (Cum R2=0.198, F=17.179, p<0.001) that explained 19.8% of turnover intention. CONCLUSIONS: Customized home health care nurses management policy which includes job satisfaction and general characteristics of visiting nurses should be established to enhance of quality of customized home health care service.
Daegu ; Delivery of Health Care* ; Employment ; Intention* ; Job Satisfaction ; Marital Status ; Nurses, Community Health ; Personnel Turnover ; Public Health ; Self Report ; Surveys and Questionnaires

PURPOSE: With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. METHODS: A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. RESULTS: About 62.9% residents were found to be aggressive and 38.5% were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. CONCLUSION: Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.
Aged ; Aged, 80 and over ; *Aggression/psychology ; Attitude of Health Personnel ; Case-Control Studies ; Clinical Competence/standards ; Cognition Disorders/*complications/nursing ; Cross-Sectional Studies ; Education, Nursing, Continuing ; Female ; Geriatric Assessment ; Geriatric Nursing/education/organization & administration ; Health Services Needs and Demand ; Humans ; Inservice Training ; Korea/epidemiology ; Male ; Mental Competency ; *Nursing Homes ; Nursing Staff/education/psychology ; Prevalence ; Psychomotor Agitation/epidemiology/*etiology/prevention & control/psychology ; Questionnaires ; Risk Factors

OBJECTIVES: The aim of this study was to develop auditory-verbal and visual-spatial memory tasks using smart devices for children aged 8 to 10 years and examine their validity. METHODS: One-hundred and fourteen school-aged children were recruited through internet advertising. We developed memory tasks assessing auditory-verbal memory, visual-spatial memory, and working memory, and then examined their construct validity by examining the developmental trend of the children's mean scores with age. In order to examine the concurrent validity of the tasks, we conducted correlation analyses between the children's scores on the newly developed auditory-verbal, visual-spatial memory and working memory tasks and their scores on well-known standardized tests of memory and working memory, including the auditory-verbal memory subtests of the Korean Luria-Nebraska Neuropsychological Battery for Children, Korean Rey-Osterrieth Complex Figure Test, digit span and arithmetic subtest of Korean Educational Development Institute Wechsler Intelligence Scale for Children Revised, and Corsi block test. RESULTS: The memory and working memory scores measured by the newly developed tasks tended to increase with age. Further, there were significant correlations between the scores of the four cognitive tasks and the corresponding scores of the standardized assessment tools. CONCLUSION: This study revealed promising evidence for the validity of the memory tasks using smart devices, suggesting their utility for school-aged children in research and clinical settings.
Child* ; Humans ; Intelligence ; Internet ; Luria-Nebraska Neuropsychological Battery ; Memory* ; Memory, Short-Term

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

A 50-year-old woman was admitted for the evaluation of proteinuria and renal biopsy. On the basis of the serum monoclonal protein, marrow plasma cell dyscrasia and end organ damage (nephrotic range proteinuria), multiple myeloma was diagnosed. A renal biopsy showed a membranoproliferative glomerulonephritis pattern of injury and unusual organized deposits of striated structure in the subendothelial space, which were identified as non-amyloid non-immunoglobulin-derived deposits. These deposits contained regularly stacked straight electron-dense bands, which have not been described in the setting of paraproteinemia and/or plasma cell dyscrasia.
Biopsy ; Bone Marrow ; Female ; Glomerulonephritis, Membranoproliferative ; Humans ; Middle Aged ; Multiple Myeloma ; Paraproteinemias ; Proteinuria