PURPOSE: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. METHODS: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients' Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. RESULTS: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR=1.75; confidence interval, CI=1.09–2.82), nausea (OR=105.27; CI=61.03–181.58), total intravenous anesthesia (TIVA) of the thyroidectomy (OR=10.43; CI=5.01–21.70). CONCLUSION: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom associated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing interventions.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Intravenous ; Antiemetics ; Dizziness ; Electronic Health Records ; Female ; Headache ; Humans ; Logistic Models ; Nausea ; Nursing ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Thyroidectomy

The purpose of the current study was to examine the risk factors of young children’s smartphone addiction in a longitudinal study design. Data collected from 313 participants (mean age, 4.5 ± 0.82 years; male, 49.8%) over 4 years for Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood were analyzed in this study. Mixed effect models were used to evaluate the influence of various variables on the repeated measures of smartphone addiction tendency in young children over time. The multi-level analysis showed that parents’ lack of control over children’s smartphone use (t = −4.523; 95% confidence interval [CI], −7.32, −1.72), and parents’ higher smartphone addiction proneness (t = 6.340;95% CI, 0.23, 0.440) predicted higher smartphone addiction tendency in young children.The responsibility of the parents to prevent their children from becoming addicted to smartphones should start in a very early age when they start using the smartphones.

The purpose of the current study was to examine the risk factors of young children’s smartphone addiction in a longitudinal study design. Data collected from 313 participants (mean age, 4.5 ± 0.82 years; male, 49.8%) over 4 years for Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood were analyzed in this study. Mixed effect models were used to evaluate the influence of various variables on the repeated measures of smartphone addiction tendency in young children over time. The multi-level analysis showed that parents’ lack of control over children’s smartphone use (t = −4.523; 95% confidence interval [CI], −7.32, −1.72), and parents’ higher smartphone addiction proneness (t = 6.340;95% CI, 0.23, 0.440) predicted higher smartphone addiction tendency in young children.The responsibility of the parents to prevent their children from becoming addicted to smartphones should start in a very early age when they start using the smartphones.

The purpose of the current study was to examine the risk factors of young children’s smartphone addiction in a longitudinal study design. Data collected from 313 participants (mean age, 4.5 ± 0.82 years; male, 49.8%) over 4 years for Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood were analyzed in this study. Mixed effect models were used to evaluate the influence of various variables on the repeated measures of smartphone addiction tendency in young children over time. The multi-level analysis showed that parents’ lack of control over children’s smartphone use (t = −4.523; 95% confidence interval [CI], −7.32, −1.72), and parents’ higher smartphone addiction proneness (t = 6.340;95% CI, 0.23, 0.440) predicted higher smartphone addiction tendency in young children.The responsibility of the parents to prevent their children from becoming addicted to smartphones should start in a very early age when they start using the smartphones.

The purpose of the current study was to examine the risk factors of young children’s smartphone addiction in a longitudinal study design. Data collected from 313 participants (mean age, 4.5 ± 0.82 years; male, 49.8%) over 4 years for Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood were analyzed in this study. Mixed effect models were used to evaluate the influence of various variables on the repeated measures of smartphone addiction tendency in young children over time. The multi-level analysis showed that parents’ lack of control over children’s smartphone use (t = −4.523; 95% confidence interval [CI], −7.32, −1.72), and parents’ higher smartphone addiction proneness (t = 6.340;95% CI, 0.23, 0.440) predicted higher smartphone addiction tendency in young children.The responsibility of the parents to prevent their children from becoming addicted to smartphones should start in a very early age when they start using the smartphones.

PURPOSE: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. METHODS: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX(R) to calculate 10-year probability of major osteoporotic and hip fracture. RESULTS: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. CONCLUSION: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.
Chronic Disease ; Female ; Hip ; Humans ; Incidence ; Menopause ; Nursing Assessment ; Osteoporosis ; Prevalence ; Surveys and Questionnaires ; Risk Factors

PURPOSE: The purpose of this integrative review was to synthesize the available research on educational programs for the management of childhood atopic dermatitis. METHODS: Articles were retrieved from the following databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, and SCOPUS. Inclusion criteria were publication in the English or Korean language prior to March 2013, as a peer-reviewed empirical study focused on educational programs for childhood atopic dermatitis. RESULTS: Fifteen papers met the inclusion criteria. Four themes were derived from the data: (a) children of all ages and symptom severity, and their families as learners; (b) well-trained and family-preferred health professionals as educators; (c) long-term follow-up with diverse interventions as educational methods; and (d) quality of life for the child and family as educational goals. CONCLUSIONS: This review indicates the challenges that health professionals face in improving symptoms of atopic dermatitis. The identified strategies can be used in the development of more effective evidencebased programs. Future studies should focus on the development and evaluation of educational programs that include these themes.
Adolescent ; Caregivers ; Child ; Child, Preschool ; Dermatitis, Atopic/*therapy ; Empirical Research ; Humans ; Infant ; Infant, Newborn ; Parents ; *Patient Education as Topic

PURPOSE: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. METHODS: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. RESULTS: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. CONCLUSION: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.
Activities of Daily Living ; Dementia/physiopathology ; Humans ; Inpatients/*psychology ; Long-Term Care ; National Health Programs ; Nursing Staff, Hospital/psychology/*statistics & numerical data ; Personnel Turnover ; Pressure Ulcer/etiology ; *Quality Indicators, Health Care ; Risk Factors

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x 2 test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

PURPOSE: To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. MATERIALS AND METHODS: Nine patients with multiple (> or =4) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10-12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. RESULTS: The median biologically effective dose to metastatic tumors was 68.1 Gy10 and 67.2 Gy10 and the median brain volume irradiated more than 100 Gy3 were 1.9% (24 cm3) and 0.8% (13 cm3) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. CONCLUSION: RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.
Apraxias ; Brain ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Paresis ; Radiotherapy, Intensity-Modulated