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Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation.

EunOk KWON ; KyungSook CHOI

Asian Nursing Research.2017;11(1):74-78. doi:10.1016/j.anr.2017.03.004

PURPOSE: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. METHODS: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay. Based on the characteristics of the cohort of 230 patients who had unplanned extubation, 460 case control comparison groups with planned extubation were selected by matching age, gender and diagnosis. RESULTS: Risk factors of unplanned extubation were categorized as people, technologies, tasks, environmental factors and organizational factors, by five components of the patient safety model. The results showed the risk factors of unplanned extubation as admission route [odds ratio (OR) = 1.8], GlasgowComa Scaleemotor (OR = 1.3), Acute Physiology and Chronic Health Evaluation score (OR = 1.06), agitation (OR = 9.0), delirium(OR = 11.6), mode of mechanical ventilation (OR = 3.0–4.1) and night shifts (OR = 6.0). The significant differences were found between the unplanned and the planned extubation groups on the number of reintubation (4.3% vs. 79.6%, p < .001), ICU outcome at the time of discharge (χ² = 50.7, p < .001), and length of stay in the ICU (27.0 ± 33.0 vs. 43.8 ± 43.5) after unplanned extubation. CONCLUSIONS: ICU nurses should be able to recognize the risk factors of unplanned extubation related with the components of the safety model so as to improve patient safety by minimizing the risk for unplanned extubation.
Airway Extubation ; APACHE ; Case-Control Studies* ; Cohort Studies ; Critical Illness* ; Data Collection ; Diagnosis ; Dihydroergotamine ; Humans ; Intensive Care Units ; Length of Stay ; Patient Safety* ; Respiration, Artificial* ; Retrospective Studies ; Risk Factors* ; Ventilation

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Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

Jung Won AHN

Asian Nursing Research.2017;11(1):65-73. doi:10.1016/j.anr.2017.03.001

PURPOSE: This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. METHOD: Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. RESULTS: The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. CONCLUSION: Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved.
Anxiety ; Cultural Competency* ; Education, Nursing ; Emigrants and Immigrants ; Gyeonggi-do ; Hospitals, General ; Humans ; Immersion ; Korea ; Methods ; Models, Nursing ; Nursing Care ; Seoul ; Transcultural Nursing ; Uncertainty

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Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial.

Young Joo PARK ; Sook Ja LEE ; Nah Mee SHIN ; Hyunjeong SHIN ; Songi JEON ; Jungwoo LEE ; Inhae CHO

Asian Nursing Research.2017;11(1):56-64. doi:10.1016/j.anr.2017.03.005

PURPOSE: This randomized control trial was designed to examine the effect on the self-managing ability for promoting bone health of mobile typeebone health intervention (mobile typeeBHI). METHODS: The mobile typeeBHI consisted of amobile application called “Strong bone, Fit body” (SbFb) and group education. A total of 82 college women with low bone mass (Z score <−1) participated. They were assigned randomly to three groups, experimental group I, (n = 28), experimental group II (n = 32), and control group (n = 22). This study ran from June 2014 to January 2015. The outcome variables were bone mineral density, minerals related to bone metabolism (calcium, phosphorus, vitamin D), biochemical markers related to bone remodeling (osteocalcin, C-terminal telopeptide, sclerostin), food intake diary by 24 hours recall, and psychosocial variables related to bone health (knowledge, health belief and selfefficacy). Data were analyzed using SAS program and a computer aided nutritional analysis program. RESULTS: Both the experimental group I, who used mobile typeeBHI, and experimental group II, who only received group education, showed outcomes regarding knowledge of the benefits of exercise and calcium as compared with the control group. The two experimental groups also demonstrated results in the serum levels of calcium, vitamin D, and sclerostin compared to those of the control group. CONCLUSION: Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on selfmanagement ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.
Biomarkers ; Bone Density ; Bone Remodeling ; Calcium ; Eating ; Education ; Female ; Humans ; Metabolism ; Minerals ; Miners ; Mobile Applications ; Nutrition Assessment ; Phosphorus ; Vitamin D ; Vitamins ; Young Adult*

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Bladder Symptoms, Fatigue and Physical Activity in Postpartum Women.

Jeung Im KIM ; Kyung Jae LEE

Asian Nursing Research.2017;11(1):50-55. doi:10.1016/j.anr.2017.03.002

PURPOSE: Physical activity is important for postpartum women. The objective of this study was to evaluate bladder symptoms, fatigue, and physical activity according to time after birth and birth modes. METHODS: This was a cross-sectional study using web-based questionnaire or one-to-one contact. A total of 290 women after giving birth responded to self-administered questionnaires. Multivariate analysis of variance determined the differences in variables. RESULTS: Bladder symptoms were significantly different by time after birth and birth mode; they were the highest in the first week after birth and in Cesarean birth. Postpartum fatigue showed a significant tendency by birth mode, but not by time after birth. Physical activity was significantly different by birth mode. The lowest level of physical activity was found for women who gave Cesarean birth. Moderate physical activity was also significantly different by time after birth, but vigorous physical activity was not significantly different. CONCLUSION: In conclusion, bladder symptoms and physical activity are different by time after birth and birth mode in postpartum women. The first week after giving birth is an important period for postpartum women whose bladder symptoms and physical activity should be of concern.
Cross-Sectional Studies ; Fatigue* ; Female ; Humans ; Motor Activity* ; Multivariate Analysis ; Parturition ; Postpartum Period* ; Urinary Bladder*

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Antenatal Education on Pregnant Adolescents in Turkey: Prenatal Adaptation, Postpartum Adaptation, and Newborn Perceptions.

Arzu Aba YILDA ; Köomürcü NURAN

Asian Nursing Research.2017;11(1):42-49. doi:10.1016/j.anr.2017.03.003

PURPOSE: This clinical trial study was planned in order to evaluate the effect of antenatal education on antenatal and postpartum adaptation and newborn perceptions among adolescent pregnant women. METHODS: A research assistant met with pregnant adolesencents in a Family Health Center and at the participants' homes. The sample included 70 pregnant adolescents (35 in experimental group, 35 in control group) chosen through simple random sampling. The experimental group received antenatal eduation, whereas the control group merely had routine surveillance. As for data collection tools, the Prenatal Self Evaluation Questionnaire (PSEQ), the Postpartum Self Evaluation Questionnaire (PPSEQ) and the Newborn Perception Scale (NPI) was used. RESULTS: It was found that the experiment group who received antenatal education had a lower mean total PSEQ score (133.94 ± 15.62) compared to the control group (159.86 ± 17.83). In the comparison of two groups, it was determined that the experiment group had lower mean total PPSEQ scores on the 1st day, 1st week and 2nd week compared to the control group, indicating higher levels of postpartum adaptation (p = .017, p = .009, p = .029). CONCLUSION: It was determined that the level of prenatal adaptation was higher in the experiment group, which received antenatal education, than in the control group and that levels of postpartum adaptation was significantly higher in the experiment group on the 1st postpartum day and the 1st and 2nd postpartum weeks but not on the 4th postpartum week. There were no significant differences between the experiment and control groups in terms of NPI results.
Adolescent* ; Data Collection ; Diagnostic Self Evaluation ; Family Health ; Female ; Humans ; Infant, Newborn* ; Postpartum Period* ; Pregnancy ; Pregnancy in Adolescence ; Pregnant Women ; Prenatal Education* ; Turkey*

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Relationship Between Long Working Hours and Metabolic Syndrome Among Korean Workers.

Jungok YU

Asian Nursing Research.2017;11(1):36-41. doi:10.1016/j.anr.2017.02.003

PURPOSE: This study investigated gender differences in the relationship between long working hours and metabolic syndrome. METHODS: Data based on the Sixth National Health and Nutrition Examination Survey (2014) pertaining to a total of 1,145 paid workers were analyzed. Working hours were divided into three groups (40–51 hours/week, 52–59 hours/week, ≥ 60 hours/week). The relationship between working hours and metabolic syndrome was then analyzed after adjusting for general and occupational characteristics, using a multiple logistic regression model. RESULTS: Working 40–51 hours per week was associated with the lowest metabolic syndrome among female workers (11.2%), whereas it was associated with the highest metabolic syndrome among male workers (28.0%). After adjusting for general and occupational characteristics, female workers working ≥ 60 hours per week showed odds ratios of 2.21 [95% confidence interval (1.07, 4.57)], compared to those who worked 40–51 hours per week. However, no clear association between long working hours and metabolic syndrome was found among male workers. CONCLUSIONS: The results suggest that working long hours, especially≥ 60 hours per week, is related to metabolic syndrome among female Korean workers.
Employment ; Female ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X ; Nutrition Surveys ; Odds Ratio

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A New Comprehensive Short-form Health Literacy Survey Tool for Patients in General.

Tuyen Van DUONG ; Peter WuShou CHANG ; Shih Hsien YANG ; Ming Chu CHEN ; Wei Ting CHAO ; Tara CHEN ; Priscilla CHIAO ; Hsiao Ling HUANG

Asian Nursing Research.2017;11(1):30-35. doi:10.1016/j.anr.2017.02.001

PURPOSE: To validate a conceptual short-form health literacy 12 items questionnaire (HL-SF12) in patient populations. METHODS: A cross-sectional study was conducted via a convenient sample of 403 patients from three departments of a community general hospital in the northern Taiwan. Patients' health literacy was assessed with a validated HL-SF12, derived from the full scale, the European Health Literacy Survey Questionnaire (HLS-EU-Q), as well as a single-item from Chew's Set of Brief Health Literacy Question. A reference population in Northern Taiwan (n = 928) via the HLS-EU-Q in 2013–2014 was used as a reference to compare the health literacy between that of the general public and the patients. Data was analyzed by confirmatory factor analysis (CFA), internal consistency analysis, correlation analysis, and linear regression models. RESULTS: Patients' health literacy assessed with the HL-SF12 was shown with high internal consistency (Cronbach α = .87), and moderately correlated with the single-item from Chew's Set of Brief Health Literacy Question, with satisfactory item-scale convergent validity (item-scale correlation ≥ .40), without floor/ceiling effect, and with satisfactory goodness of fit indices of the three-factor construct model for most of the patients. Their health literacy was significantly positively associated with female gender, higher income, and more often watching health-related TV programs. On the other hands, patients were reported with significantly higher healthcare health literacy than the general public, but not in general health literacy, disease prevention health literacy, or health promotion health literacy. CONCLUSION: The comprehensive HL-SF12 was a valid and easy to use tool for assessing patients' health literacy in the hospitals to facilitate healthcare providers in enhancing patients' health literacy and healthcare qualities.
Cross-Sectional Studies ; Delivery of Health Care ; Female ; Hand ; Health Literacy* ; Health Personnel ; Health Promotion ; Hospitals, General ; Humans ; Linear Models ; Taiwan

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Psychosocial Work Stressors, Work Fatigue, and Musculoskeletal Disorders: Comparison between Emergency and Critical Care Nurses in Brunei Public Hospitals.

Abdul Rahman HANIF ; Abdul Mumin KHADIZAH ; Naing LIN

Asian Nursing Research.2017;11(1):13-18. doi:10.1016/j.anr.2017.01.003

PURPOSE: Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. METHODS: This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. RESULTS: In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. CONCLUSION: This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment.
Asian Continental Ancestry Group ; Brunei* ; Bullying ; Critical Care Nursing ; Critical Care* ; Cross-Sectional Studies ; Emergencies* ; Emergency Nursing ; Fatigue* ; Foot ; Hospitals, Public* ; Humans ; Musculoskeletal Pain ; Neck ; Nursing ; Occupational Health ; Prevalence ; Shoulder ; Social Support ; Violence

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Mediating Role of Psychological Capital in Relationship between Occupational Stress and Turnover Intention among Nurses at Veterans Administration Hospitals in Korea.

Hee Yun YIM ; Hyun Ju SEO ; Yoonhyung CHO ; JinHee KIM

Asian Nursing Research.2017;11(1):6-12. doi:10.1016/j.anr.2017.01.002

PURPOSE: The aim of this study was to evaluate the mediating role of psychological capital (PCP) in the relationship between occupational stress and turnover intention in nurses. METHODS: Data were collected from a sample of 447 nurses working at four Veterans Administration Hospitals throughout South Korea from July 1 to July 31, 2014. We collected data from the nurses using the following surveys: the Short Form Korean-Occupational Stress Scale, the Korean version of the Turnover Intention Scale, and the Korean version of the Psychological Capital Questionnaire. Multiple linear regression analysis was performed to examine the mediating role of PCP. RESULTS: The level of occupational stress was 1.81 ± 0.23, the level of turnover intention was 3.29 ± 0.86, and the PCP level was 3.95 ± 0.52. There were significant correlations among the three variables (occupational stress, turnover intention, and PCP). PCP played a partial mediating role (β=−0.22, p = .008) in the relationship between occupational stress and turnover intention (p < .001) among nurses working at the Veterans Administration Hospitals. CONCLUSION: Based on the findings of this study, we recommend that South Korean hospitals offer occupational stress management programs that incorporate relevant programs in efforts to strengthen the overall components of PCP among nurses to reduce turnover intentions. Further studies are required to determine the most effective intervention programs for hospital settings.
Humans ; Intention* ; Korea* ; Linear Models ; Negotiating* ; Nursing Care ; Personnel Turnover ; United States Department of Veterans Affairs* ; Veterans*

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Perceived Cognitive Function and Related Factors in Korean Women With Breast Cancer.

Seongmi MOON ; Sun Hee KIM ; Mi Ja KIM

Asian Nursing Research.2011;5(2):141-150.

PURPOSE: The aim of this study was to explore perceived cognitive function and its related factors in breast cancer patients that had received or were receiving adjuvant chemotherapy after surgery. METHODS: A cross-sectional and correlational design was used in this study. A total of 118 women who had undergone or were undergoing adjuvant chemotherapy after breast cancer surgery recruited from a convenience sample from a university hospital in Korea were included in the study. The attentional function index was used to measure perceived cognitive function while the linear analogue self-assessment scale was used to measure mood disturbance. Hierarchical multiple regression analyses were done to determine possible predictors of perceived cognitive function in patients with breast cancer. RESULTS: Perceived cognitive function and mood disturbance had a mean score of 66.22 (SD = 13.43) and 159.78 (SD = 81.40), respectively. Mood disturbance was a statistically significant predictor of cognitive function in patients with breast cancer. CONCLUSIONS: Breast cancer patients with mood disturbance may experience decrements in perceived cognitive function. Nurses should be aware of mood changes and its influence on perceived cognitive function in breast cancer patients.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cognition ; Female ; Humans ; Korea ; Self-Assessment

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