Purpose: This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. Methods: The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. Results: The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse’s perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient’s perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). Conclusion Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.

PURPOSE: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. METHODS: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and χ² analysis were performed using SPSS 25.0 program. RESULTS: The mean age of participants was 36.6±8.5 years and the mean working experience was 12.92±9.23 years. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals (χ²=28.54, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals (χ²=6.30, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. CONCLUSION: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.
Checklist ; Decision Making ; Humans ; Korea ; Needs Assessment ; Nursing Services ; Nursing ; Patient Discharge ; Patient Handoff ; Patient Participation ; Patient Satisfaction ; Research Personnel ; Tertiary Care Centers

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been an established treatment for indicated early gastric cancer (EGC) without deterioration of quality of life (QOL) compared with surgical resection. The aim of this study was to evaluate long-term QOL in patients undergoing ESD for EGC. METHODS: Patients scheduled to undergo curative ESD for EGC were prospectively enrolled from 12 institutions between May 2010 and December 2011. Assessments of QOL with Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire-core (QLQ-C30) and a gastric cancer-specific questionnaire (STO22) were performed at baseline and at 7 days, 3 months, and 6 months after ESD. RESULTS: A total of 666 subjects were assessed for QLQ-C30 and QLQ-STO22. The mean QLQ-C30 score was 69.5 at baseline, 68.8 at 7 days, 73.1 at 3 months, and 73.2 at 6 months. The global health status on the EORTC QLQ-C30 was significantly improved after 3 and 6 months (p=0.0003 and p<0.0001, respectively). The QLQ-C30 and STO22 scores were not significantly different, or they only slightly deteriorated between before and immediately after ESD, but they were significantly improved after 3 and 6 months (p<0.05). CONCLUSIONS: QOL did not deteriorate immediately after ESD, and it improved more significantly at up to 6 months in patients who underwent curative ESD for EGC without significant complications.
Cohort Studies* ; Global Health ; Humans ; Prospective Studies* ; Quality of Life* ; Stomach Neoplasms*

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer (EGC) that has demonstrated a minimal risk of lymph node metastasis in retrospective studies. We sought to prospectively evaluate the short-term outcomes of ESD treatment in EGCs. METHODS: A prospective multicenter cohort study of neoplasms 3 cm or less in diameter at endoscopic size evaluation was performed in 12 Korean ESD study group-related university hospitals and the National Cancer Center. Resected specimens were evaluated by the central pathologic review board. RESULTS: A patient cohort (n=712) with a total of 737 EGCs was analyzed. The margin-freeen bloc resection rate was 97.3%, and curative resection of 640 lesions (86.8%) was achieved. Lower curative resection rates were associated with lesions 2 to 3 cm in size prior to ESD compared with lesions 2 cm or less in size (78.6% vs 88.1%, respectively, p=0.009). Significant factors associated with noncurative resection were moderately or poorly differentiated histological type, posterior wall tumor location, tumor size larger than 3 cm, ulceration, and submucosal invasion. Delayed bleeding occurred in 49 patients (6.9%), and 12 patients (1.7%) exhibited perforations. CONCLUSIONS: ESD is an effective treatment with a high curative resection rate for EGCs that meets relatively conservative pre-ESD indications. Long-term survival outcomes should be evaluated in follow-up studies.
Cohort Studies* ; Endoscopy ; Follow-Up Studies ; Hemorrhage ; Hospitals, University ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prospective Studies* ; Retrospective Studies ; Stomach Neoplasms* ; Ulcer

BACKGROUND: This study aimed to determine the prevalence of metabolically healthy and unhealthy obesity (MHO and MUO, respectively) and examine the demographic, anthropometric, and lifestyle predictors of metabolic health status in Korean children and adolescents. METHODS: This study was based on data collected from the Korean Children-Adolescent Study in 2010. A total of 1,700 children (846 boys and 854 girls) were included in the primary cohort and classified into metabolically healthy and unhealthy groups according to factors related to the metabolic syndrome. Demographic and biochemical features were evaluated in study participants. Logistic regression estimated the odds ratios of having more fat mass among MUO compared with MHO children after adjusting for confounding factors. RESULTS: Mean body mass index was higher in the MUO group than in the MHO group (24.83 vs. 23.02 kg/m2, respectively). The proportion of obese participants was also higher in the MUO group (59.4%) than in the MHO group (20.7%). MHO children were more likely to have parents with better socioeconomic status and a higher fruit and vegetable intake compared with MUO children. Higher fat mass and percent fat was associated with MUO according to multiple logistic regression analysis. CONCLUSION: Fat mass and percent fat are associated with metabolically healthy phenotypes of obesity among children and adolescents.
Adolescent* ; Body Mass Index ; Child* ; Cohort Studies ; Fruit ; Humans ; Life Style ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatrics ; Phenotype ; Prevalence ; Social Class ; Vegetables

Pleurotus nebrodensis is an edible and commercially available mushroom in Korea. This study was conducted in order to evaluate the anticancer and immunopotentiating activities of crude polysaccharides, extracted in methanol, neutral saline, and hot water (hereafter referred to as Fr. MeOH, Fr. NaCl, and Fr. HW, respectively) from the fruiting bodies of P. nebrodensis. beta-Glucan and protein contents in Fr. MeOH, Fr. NaCl, and Fr. HW extracts of P. nebrodensis ranged from 23.79~36.63 g/100 g and 4.45~6.12 g/100 g, respectively. Crude polysaccharides were not cytotoxic against sarcoma 180, HT-29, NIH3T3, and RAW 264.7 cell lines at a range of 10~2,000 microg/mL. Intraperitoneal injection with crude polysaccharides resulted in a life prolongation effect of 11.76~27.06% in mice previously inoculated with sarcoma 180. Treatment with Fr. NaCl resulted in an increase in the numbers of spleen cells by 1.49 fold at the concentration of 50 microg/mL, compared with control. Fr. HW improved the immuno-potentiating activity of B lymphocytes through an increase in alkaline phosphatase activity by 1.65 fold, compared with control at 200 microg/mL. Maximum production of nitric oxide (14.3 microM) was recorded in the Fr. NaCl fraction at 200 microg/mL. Production of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and interleukin-6 (IL-6) was significantly higher, compared to control, and IL-6 production was highest, in contrast to TNF-alpha, IL-1beta, and positive control, concanavalin at the tested concentration of the various fractions. Results of the current study suggest that polysaccharides extracted from P. nebrodensis have a strong anticancer effect and may be useful as an ingredient of biopharmaceutical products for treatment of cancer.
Agaricales ; Alkaline Phosphatase ; Animals ; B-Lymphocytes ; Cell Line ; Fruit ; Immunomodulation ; Injections, Intraperitoneal ; Interleukin-1beta ; Interleukin-6 ; Korea ; Life Support Care ; Methanol ; Mice ; Nitric Oxide ; Pleurotus ; Polysaccharides ; Sarcoma ; Sarcoma 180 ; Spleen ; Tumor Necrosis Factor-alpha ; Water

Cellular damage caused by reactive oxygen species has been implicated in several diseases, thus establishing a significant role for antioxidants in maintaining human health. Acetone, methanol, and hot water extracts of Pleurotus citrinopileatus were evaluated for their antioxidant activities against beta-carotene-linoleic acid and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals, reducing power, ferrous ion-chelating abilities, and xanthine oxidase inhibitory activities. In addition, the tyrosinase inhibitory effects and phenolic compound contents of the extracts were also analyzed. Methanol and acetone extracts of P. citrinopileatus showed stronger inhibition of beta-carotene-linoleic acid compared to the hot water extract. Methanol extract (8 mg/mL) showed a significantly high reducing power of 2.92 compared to the other extracts. The hot water extract was more effective than the acetone and methanole extracts for scavenging DPPH radicals. The strongest chelating effect (92.72%) was obtained with 1.0 mg/mL of acetone extract. High performance liquid chromatography analysis detected eight phenolic compounds, including gallic acid, protocatechuic acid, chlorogenic acid, ferulic acid, naringenin, hesperetin, formononetin, and biochanin-A, in an acetonitrile and hydrochloric acid (5 : 1) solvent extract. Xanthine oxidase and tyrosinase inhibitory activities of the acetone, methanol, and hot water extracts increased with increasing concentration. This study suggests that fruiting bodies of P. citrinopileatus can potentially be used as a readily accessible source of natural antioxidants.
Acetone ; Acetonitriles ; Antioxidants ; Biphenyl Compounds ; Chlorogenic Acid ; Chromatography, Liquid ; Coumaric Acids ; Flavanones ; Fruit ; Gallic Acid ; Hesperidin ; Humans ; Hydrochloric Acid ; Hydroxybenzoates ; Isoflavones ; Methanol ; Monophenol Monooxygenase ; Phenol ; Picrates ; Pleurotus ; Reactive Oxygen Species ; Water ; Xanthine ; Xanthine Oxidase

Liver fibrosis is a chronic liver disease and lots of people in Korea are suffered. There are many efforts to find candidates to suppress liver fibrogenesis and several chemical-induced model or bile duct ligation model have been used to research and develop hepatic fibrogenic suppressor. From the previous study about functional effects of turnip which cultivated in Kangha Island, we got the feasibility which turnip might be able to inhibit heptatic fibrogenesis. TAA is a representative hepatic fibrosis inducer, repeated 7-weeks i.p. injection of it results in hepatic fibrosis. We compared the level of hepatic fibrosis in TAA-turnip group, TAA group, and vehicle control group. Nodules-formed by TAA were observed; they were rarely shown in vehicle control group, observed in most area in TAA group, but only shown in periportal regions in TAA-turnip group. These results were confirmed through Masson's trichrom stain; fibrous structures increased in TAA group (fibrosis score: 4) but significantly decreased in TAA-turnip group (fibrosis score: 2-3). In conclusion, we got the result that turnip water extract has a potency to protect TAA-induced hepatic fibrogenesis but it is necessary further study to find its mechanism.
Bile Ducts ; Brassica napus ; Fibrosis ; Korea ; Ligation ; Liver ; Liver Cirrhosis ; Liver Diseases ; Water

OBJECTIVE: Intrauterine growth is influenced by multiple factors like genetic, nutritional, environmental and hormonal factors. As birth weight is reported to be related to perinatal morbidity and mortality, we aimed to compare umbilical cord blood adiponectin, IGF-I, IGFBP-1, insulin and leptin levels between small for gestational age (SGA) and appropriate for gestational age (AGA) neonates at birth to investigate the influence of these factors on birth weight and ponderal index. METHODS: We investigated retrospectively 30 pregnant women with SGA and 30 pregnant women with AGA who delivered at Ewha Womans University Hospital and their babies from January 2007 to December 2007. Fetal umbilical cord venous blood adiponectin, IGF-I, IGFBP-1, insulin and leptin levels from SGA and AGA neonates were obtained at the time of delivery. The definition used to identify cases of SGA was individual birth weight ratio of less than 10th percentile and the definition of ponderal index (PI) was [BW (g)/ (height (cm))3]x100. RESULTS: Umbilical cord blood adiponectin, IGF-I and IGF/IGFBP ratio were significantly lower (P<0.05) in SGA than AGA. And umbilical cord blood IGFBP-1 were significantly higher (P<0.05) in SGA than AGA. But there was no significant difference in umbilical cord blood insulin and leptin levels between SGA and AGA neonates. Positive correlation was noted between adiponectin and IGF-I, IGF/IGFBP ratio, insulin and leptin. Negative correlation was noted between adiponectin and IGFBP-1, IGF-I and IGFBP-1. On multiple regression analysis, adiponectin and IGF-I were significant factors associated with body weight (BW), but only IGFBP-1 was significant factor associated with PI. CONCLUSION: These results suggest that fetal adiponectin, IGF-I, IGFBP-1 may have an important role in regulation of intrauterine growth and we will expect that evaluation of adiponectin and IGF-I in SGA may be helpful in prediction of neonatal outcome, and IGFBP-1 may be useful in diagnosis of asymmetric intrauterine growth retardation (IUGR).
Adiponectin ; Birth Weight ; Body Weight ; Female ; Fetal Blood ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant, Newborn ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Leptin ; Parturition ; Pregnant Women ; Retrospective Studies ; Umbilical Cord

PURPOSE: We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. METHODS: HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected to 70degrees HUT for 45 minutes. The testees were divided into 2 groups: group I (children) comprising 39 children in the age range 7-12 years (mean, 10.59+/-1.60 years) and group II (adolescents) comprising 121 adolescents in the age range 13-20 years (mean, 15.93+/-2.28 years). Positive result rates of the HUT and types of hemodynamic response to the test in the 2 groups were compared. RESULTS: Of the 160 testees, 92 (57.5%) showed positive HUT results; they showed 3 patterns of response to tilting. Twelve patients showed a predominantly vasodepressor response; 10 patients showed a cardioinhibitory response; and 70 patients showed a mixed response. The positive result rates were 43.6% (17/39) and 62.0% (75/121) in groups I and II, respectively. Mixed response was the predominant positive hemodynamic response in both the groups. CONCLUSION: The HUT is a useful diagnostic tool for evaluating the condition of pediatric patients, including adolescents, with syncope. Further, it may be considered as the first step for evaluating the condition of such patients.
Adolescent ; Child ; Hemodynamics ; Humans ; Resin Cements ; Syncope