Purpose: The career ladder system is a pivotal strategy for securing excellent nurses. The aim of this study is to understand hospital nurses’ experiences of participating in the career ladder system and to explore the essence of this system. Methods: In February 22 to March 3, 2022, nurses employed at a general hospital in South Korea were selected for this study using snowball and purposive sampling. Data were collected from interviews with three focus groups, the compositions of which are as follows: group 1, 6 participants; group 2, 5 participants; and group 3, 6 participants. All interviews were recorded, transcribed verbatim, and subsequently analyzed using qualitative research methods. Results: The following six categories were derived under the overall theme of “the arduous journey to discovering a nurse’s true name”: (1) rites of passage to becoming the ideal nurse; (2) unexpected challenges in the promotion preparation process; (3) biased criteria for evaluating nursing competencies; (4) unclear changes in roles and perceptions after promotion; (5) self-discovered pride and fulfillment as a nurse; and (6) the unspoken struggles of evaluators. Conclusion The findings suggest that the career ladder system fosters nurses’ professional growth and self-actualization. However, for effective implementation, nurses’ deep understanding and systematic management of the career ladder system are essential. This study offers valuable insights and benchmarks for healthcare institutions aiming to adopt the system.

Purpose: The career ladder system is a pivotal strategy for securing excellent nurses. The aim of this study is to understand hospital nurses’ experiences of participating in the career ladder system and to explore the essence of this system. Methods: In February 22 to March 3, 2022, nurses employed at a general hospital in South Korea were selected for this study using snowball and purposive sampling. Data were collected from interviews with three focus groups, the compositions of which are as follows: group 1, 6 participants; group 2, 5 participants; and group 3, 6 participants. All interviews were recorded, transcribed verbatim, and subsequently analyzed using qualitative research methods. Results: The following six categories were derived under the overall theme of “the arduous journey to discovering a nurse’s true name”: (1) rites of passage to becoming the ideal nurse; (2) unexpected challenges in the promotion preparation process; (3) biased criteria for evaluating nursing competencies; (4) unclear changes in roles and perceptions after promotion; (5) self-discovered pride and fulfillment as a nurse; and (6) the unspoken struggles of evaluators. Conclusion The findings suggest that the career ladder system fosters nurses’ professional growth and self-actualization. However, for effective implementation, nurses’ deep understanding and systematic management of the career ladder system are essential. This study offers valuable insights and benchmarks for healthcare institutions aiming to adopt the system.

Purpose: The career ladder system is a pivotal strategy for securing excellent nurses. The aim of this study is to understand hospital nurses’ experiences of participating in the career ladder system and to explore the essence of this system. Methods: In February 22 to March 3, 2022, nurses employed at a general hospital in South Korea were selected for this study using snowball and purposive sampling. Data were collected from interviews with three focus groups, the compositions of which are as follows: group 1, 6 participants; group 2, 5 participants; and group 3, 6 participants. All interviews were recorded, transcribed verbatim, and subsequently analyzed using qualitative research methods. Results: The following six categories were derived under the overall theme of “the arduous journey to discovering a nurse’s true name”: (1) rites of passage to becoming the ideal nurse; (2) unexpected challenges in the promotion preparation process; (3) biased criteria for evaluating nursing competencies; (4) unclear changes in roles and perceptions after promotion; (5) self-discovered pride and fulfillment as a nurse; and (6) the unspoken struggles of evaluators. Conclusion The findings suggest that the career ladder system fosters nurses’ professional growth and self-actualization. However, for effective implementation, nurses’ deep understanding and systematic management of the career ladder system are essential. This study offers valuable insights and benchmarks for healthcare institutions aiming to adopt the system.

Background: Post-transplant diabetes mellitus (PTDM) is one of the most significant complications after transplantation. Patients with end-stage liver diseases requiring transplantation are prone to sarcopenia, but the association between sarcopenia and PTDM remains to be elucidated. We aimed to investigate the effect of postoperative muscle mass loss on PTDM development. Methods: A total of 500 patients who underwent liver transplantation at a tertiary care hospital between 2005 and 2020 were included. Skeletal muscle area at the level of the L3–L5 vertebrae was measured using computed tomography scans performed before and 1 year after the transplantation. The associations between the change in the muscle area after the transplantation and the incidence of PTDM was investigated using a Cox proportional hazard model. Results: During the follow-up period (median, 4.9 years), PTDM occurred in 165 patients (33%). The muscle mass loss was greater in patients who developed PTDM than in those without PTDM. Muscle depletion significantly increased risk of developing PTDM after adjustment for other confounding factors (hazard ratio, 1.50; 95% confidence interval, 1.23 to 1.84; P=0.001). Of the 357 subjects who had muscle mass loss, 124 (34.7%) developed PTDM, whereas of the 143 patients in the muscle mass maintenance group, 41 (28.7%) developed PTDM. The cumulative incidence of PTDM was significantly higher in patients with muscle loss than in patients without muscle loss (P=0.034). Conclusion Muscle depletion after liver transplantation is associated with increased risk of PTDM development.

Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001).To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach’s ⍺=.91. Conclusion K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

Purpose: The incidence and prevalence of neurodevelopmental disorders have rapidly increased, indicating an urgent need for assistance through parenting interventions. This study aimed to evaluate the effects of a sociodrama-based communication enhancement program on mothers of children with neurodevelopmental disorders.Method: A non-randomized controlled experimental study design was employed. The experimental and control groups had 16 and 18 participants, respectively. The once-a-week six-session intervention was conducted from September to November 2017, in South Korea. The effects of group, time, and group-by-time interactions among the groups were verified using generalized estimating equations with an autoregressive correlation structure. Results: There was a significant decrease in the parenting burden, alongside a significant improvement in parent-child communication and parenting competence in the experimental group compared to the control group. Conclusion The sociodrama-based communication enhancement program was found to positively influence the parenting burden, communication, and parenting competence of mothers of children with neurodevelopmental disorders. These findings suggest that sociodrama-based programs may be an effective intervention strategy for parents of children with neurodevelopmental disorders. The sociodrama-based communication enhancement program can be applied to decrease parenting burden and improve parent-child communication and parenting competence. Through continuous parenting interventions, an improvement in expressive language and an increase in the attachment behaviors of children with neurodevelopmental disabilities could be expected.

Background: Pompe disease is a rare autosomal recessive disorder caused by the deficiency of a lysosomal enzyme, acid alpha-glucosidase (GAA). Early diagnosis and initiation of treatment with enzyme replacement therapy have remarkable effects on the prognosis of Pompe disease. We performed the expanded screening for late onset Pompe disease (LOPD) at eight centers in Korea. Methods: From September 1, 2015, GAA activity were measured from both dried blood spot (DBS) and mixed leukocyte for 188 available patients. For 12 patients with low GAA activity, we performed Sanger sequencing of GAA gene. Results: Among 188 patients, 115 were males. The mean of age of symptom onset and diagnosis were 34.3 years and 41.6 years. Among 12 patients with decreased GAA activity, two patients were confirmed to have LOPD with genetic test (c.1316T>A [p.M439K] + c.2015G>A [p.R672Q], c.1857C>G [p.S619R] + c.546G>C [leaky splicing]). Other two patients had homozygous G576S and E689K mutation, known as pseudodeficiency allele. Conclusions This study is expanded study of LOPD screening for targeted Korean population. We found two patients with LOPD, and the detection rate of LOPD is 1.06%. With application of modified GAA cutoff value (0.4), which was previously reported, there were no false positive results of GAA activity test using DBS. Therefore, it could be an appropriate screening test for LOPD in especially East-Asian population, in which pseudodeficiency allele is frequent.

Background: Pompe disease is a rare autosomal recessive disorder caused by the deficiency of a lysosomal enzyme, acid alpha-glucosidase (GAA). Early diagnosis and initiation of treatment with enzyme replacement therapy have remarkable effects on the prognosis of Pompe disease. We performed the expanded screening for late onset Pompe disease (LOPD) at eight centers in Korea. Methods: From September 1, 2015, GAA activity were measured from both dried blood spot (DBS) and mixed leukocyte for 188 available patients. For 12 patients with low GAA activity, we performed Sanger sequencing of GAA gene. Results: Among 188 patients, 115 were males. The mean of age of symptom onset and diagnosis were 34.3 years and 41.6 years. Among 12 patients with decreased GAA activity, two patients were confirmed to have LOPD with genetic test (c.1316T>A [p.M439K] + c.2015G>A [p.R672Q], c.1857C>G [p.S619R] + c.546G>C [leaky splicing]). Other two patients had homozygous G576S and E689K mutation, known as pseudodeficiency allele. Conclusions This study is expanded study of LOPD screening for targeted Korean population. We found two patients with LOPD, and the detection rate of LOPD is 1.06%. With application of modified GAA cutoff value (0.4), which was previously reported, there were no false positive results of GAA activity test using DBS. Therefore, it could be an appropriate screening test for LOPD in especially East-Asian population, in which pseudodeficiency allele is frequent.

OBJECTIVES: The study purpose is to develop a content system for a healthy dietary education program for after-school care in lower grade in elementary school. METHODS: The contents of healthy dietary education in the 2015 revised curriculum and textbooks and the major education programs related to dietary life that are currently used in elementary school education were analyzed. Focus group interviews were held with field experts related to lower grade in elementary care class. Accordingly, the structuring of the education area and the detailed education contents were systematized. RESULTS: From the analysis results, the contents of curriculum, textbook, and administrative department were classified as hygiene safety, health, and culture. The goal of the educational content system was divided into three areas: nutritional dietary life, food hygiene and health, and food culture. The subjects consisted of dietary balance, healthy body weight, digestion and absorption, food hygiene, Korean agricultural products, traditional food, and table manners. The curriculum was composed of 12 content elements. CONCLUSIONS: In order to ensure that after-school care students can grow into healthy, growth-oriented and creative talents, the role of the caring guide is important, and associated guidelines are needed in the future.
Absorption ; Aptitude ; Body Weight ; Curriculum ; Digestion ; Education ; Focus Groups ; Humans ; Hygiene