Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.1
Eun Mi Kim, Su Jung Choi
Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation.Method : The study uses Flexner’s professional characteristics as a framework to analyze and project the future trajectory of Korean APNs.Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context.Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.
{"title":"Reflections on the Prospects of Korean Advanced Practice Nurses : Based on Flexner’s Professional Characteristics","authors":"Eun Mi Kim, Su Jung Choi","doi":"10.34250/jkccn.2023.16.3.1","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.1","url":null,"abstract":"Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation.Method : The study uses Flexner’s professional characteristics as a framework to analyze and project the future trajectory of Korean APNs.Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context.Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"15 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.48
Eun Sook Kim, Nayeon Kim, Su Jung Choi, Nari Kim, Young Hee Kim, Jung Yoon Lee, Eun-Hye Kim
Purpose : This study aimed to identify and describe the leadership experience of advanced practice nurses (APN).Methods : Data were collected through five focus group interviews in 2022 with a total of 24 APNs in groups of 4-6 participants. All interviews were recorded, transcribed, and data were analyzed using qualitative content analysis.Results : Nine categories emerged from three main themes. First, “Roles of APN leadership” comprised a trusted clinical expert, a moderator for the entire team, a resource person for nurturing the next generation, and a change agent for improving clinical practice. Second, “Facilitators and barriers to APN leadership” included ambiguity of APN role, support system, and institutional backing. Third, “Strategies for strengthening APN leadership competencies” comprised systematic leadership education and speaking up for APNs.Conclusion : APNs are passionate about their expertise and practice, but lack the legal and organizational authority and support to provide successive leadership. Systematic education including leadership and organizational advocacy will enable APN to provide leadership that benefits patients, institutions, and the wider healthcare system.
{"title":"The Leadership Experience of Advanced Practice Nurses in a Tertiary Hospital Setting : Focus Group Interview","authors":"Eun Sook Kim, Nayeon Kim, Su Jung Choi, Nari Kim, Young Hee Kim, Jung Yoon Lee, Eun-Hye Kim","doi":"10.34250/jkccn.2023.16.3.48","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.48","url":null,"abstract":"Purpose : This study aimed to identify and describe the leadership experience of advanced practice nurses (APN).Methods : Data were collected through five focus group interviews in 2022 with a total of 24 APNs in groups of 4-6 participants. All interviews were recorded, transcribed, and data were analyzed using qualitative content analysis.Results : Nine categories emerged from three main themes. First, “Roles of APN leadership” comprised a trusted clinical expert, a moderator for the entire team, a resource person for nurturing the next generation, and a change agent for improving clinical practice. Second, “Facilitators and barriers to APN leadership” included ambiguity of APN role, support system, and institutional backing. Third, “Strategies for strengthening APN leadership competencies” comprised systematic leadership education and speaking up for APNs.Conclusion : APNs are passionate about their expertise and practice, but lack the legal and organizational authority and support to provide successive leadership. Systematic education including leadership and organizational advocacy will enable APN to provide leadership that benefits patients, institutions, and the wider healthcare system.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.99
Ha Na Rhee, Jeong Yun Park
Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome.Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test.Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p＜ .001, p= .008). The APHCHE Ⅳ was also higher in the NRHG (p＜ .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p= .003).Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.
{"title":"Comparison of Clinical Outcomes between Rebound Hyperthermia and Non-Rebound Hypertherma Groups in Postcardiac Arrest Syndrome Patients Undergoing Targeted Temperature Management","authors":"Ha Na Rhee, Jeong Yun Park","doi":"10.34250/jkccn.2023.16.3.99","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.99","url":null,"abstract":"Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome.Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test.Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m<sup>2</sup> (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, <i>p</i>＜ .001, <i>p</i>= .008). The APHCHE Ⅳ was also higher in the NRHG (<i>p</i>＜ .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (<i>p</i>= .003).Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"161 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.11
Jiyeon Kang, Hyojeong Woo
Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences.Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: “awareness of surroundings,” “frightening experiences,” “satisfaction with care,” and “recall of experiences.” We used multiple linear regression to identify factors associated with the ICU experience.Results : Low income (β = -.08, p = .016), unplanned hospitalization (β = -.09, p = .006), sedation (β = -.16, p ＜ .001), and delirium (β = -.15, p ＜ .001) reduce patients’ awareness of their surroundings. Frightening experiences are associated with being female (β = -.07, p = .027), experiencing delirium (β = -.15, p ＜ .001), and longer stays in the ICU (β = -.14, p ＜ .001). Using sedatives decreases satisfaction with care (β = -.08, p = .048). Living alone (β = -.08, p = .013) and using painkillers (β = -.08, p = .020) reduces recall of experiences.Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.
{"title":"Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study","authors":"Jiyeon Kang, Hyojeong Woo","doi":"10.34250/jkccn.2023.16.3.11","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.11","url":null,"abstract":"Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences.Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: “awareness of surroundings,” “frightening experiences,” “satisfaction with care,” and “recall of experiences.” We used multiple linear regression to identify factors associated with the ICU experience.Results : Low income (β = -.08, <i>p</i> = .016), unplanned hospitalization (β = -.09, <i>p</i> = .006), sedation (β = -.16, <i>p</i> ＜ .001), and delirium (β = -.15, <i>p</i> ＜ .001) reduce patients’ awareness of their surroundings. Frightening experiences are associated with being female (β = -.07, <i>p</i> = .027), experiencing delirium (β = -.15, <i>p</i> ＜ .001), and longer stays in the ICU (β = -.14, <i>p</i> ＜ .001). Using sedatives decreases satisfaction with care (β = -.08, <i>p</i> = .048). Living alone (β = -.08, <i>p</i> = .013) and using painkillers (β = -.08, <i>p</i> = .020) reduces recall of experiences.Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"58 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.34
Hyeon-Ju Lee, Youn-Jung Son, So Eun Jang
Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD.Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects metaanalysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0).Results : The systematic review included 11 RCTs (n = 591, average age 60.2–76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions.Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.
目的:运动可以预防慢性肾病(CKD)患者的恶化和心血管疾病的进展。本综述旨在确定最好的运动方式，并总结运动对老年透析前CKD患者身体和肾功能的有益影响。方法:系统检索PubMed、Embase、CINAHL、Cochrane Library、Web of Science、SCOPUS和国内数据库，检索截至2023年2月发表的评估运动干预对老年透析前CKD患者影响的随机对照试验(RCTs)。随机效应荟萃分析。使用Cochrane随机对照试验偏倚风险评估工具(RoB 2.0)评估偏倚风险。结果:系统评价纳入11项rct (n = 591，平均年龄60.2 ~ 76)，其中8项可纳入meta分析。运动在提高身体功能中的峰值耗氧量和膝关节肌力方面具有显著意义，在肾脏功能中也具有改善肾小球滤过率的作用。结论:运动对老年透析前CKD患者的身体和肾脏功能有有益的影响。在未来，有必要通过细分类型，强度，持续时间和交付来验证运动的有效性。
{"title":"Effectiveness of exercise for improving physical and renal function in older adults with pre-dialysis chronic kidney disease: A systematic review and meta-analysis","authors":"Hyeon-Ju Lee, Youn-Jung Son, So Eun Jang","doi":"10.34250/jkccn.2023.16.3.34","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.34","url":null,"abstract":"Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD.Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects metaanalysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0).Results : The systematic review included 11 RCTs (n = 591, average age 60.2–76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions.Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":" 35","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135863082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.34250/jkccn.2023.16.3.109
Gyoo Yeong Cho, Hye Ri Bae
Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals.Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé’s test, and Pearson’s correlation coefficient.Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p＜.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p＜.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p＜.001).Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing lifesustaining treatment decisions are made.
{"title":"Awareness of good death, perception of life-sustaining treatment decision, and changes in nursing activities after decision to discontinue life-sustaining treatment among nurses in intensive care units at tertiary general hospitals","authors":"Gyoo Yeong Cho, Hye Ri Bae","doi":"10.34250/jkccn.2023.16.3.109","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.3.109","url":null,"abstract":"Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals.Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé’s test, and Pearson’s correlation coefficient.Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, <i>p</i>＜.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, <i>p</i>＜.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, <i>p</i>＜.001).Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing lifesustaining treatment decisions are made.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"21 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135863629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.34250/jkccn.2023.16.2.67
Y. Cho, Kyoung Suk Lee
Purpose : The 2020 Dietary Guidelines Advisory Committee specifically noted that meal frequency is associated with risks for cardiovascular disease, type 2 diabetes, and all-cause mortality, although the current evidence on meal frequency is conflicting. As meal frequency itself is affected by various factors, the aim of the study was not only to examine its relationships with cardiometabolic risk but also to identify the mediating effects of dietary quality.Methods : This study used a descriptive correlational design. In all 8,141 healthy adults participated in the study. Measurements included meal frequency, cardiometabolic risk, and diet quality. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and process macro bootstrapping model 4.Results : The meal frequency was 3.52±0.61 times per day, the risk of cardiovascular metabolic diseases was 0.01±0.61 points, and the diet quality was 62.08±13.87 points. In mediation analysis, the effect of meal frequency on cardiometabolic risk score was completely mediated by diet quality.Conclusion : Improved diet quality in healthy adults should be considered when designing meal frequency interventions aimed at reducing their cardiometabolic risk, as the effect of meal frequency support on cardiometabolic risk was found to be mediated by diet quality.
{"title":"Mediating Effects of Diet Quality between Meal Frequency and Cardiometabolic Risk among Korean Adults: Data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES)","authors":"Y. Cho, Kyoung Suk Lee","doi":"10.34250/jkccn.2023.16.2.67","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.2.67","url":null,"abstract":"Purpose : The 2020 Dietary Guidelines Advisory Committee specifically noted that meal frequency is associated with risks for cardiovascular disease, type 2 diabetes, and all-cause mortality, although the current evidence on meal frequency is conflicting. As meal frequency itself is affected by various factors, the aim of the study was not only to examine its relationships with cardiometabolic risk but also to identify the mediating effects of dietary quality.Methods : This study used a descriptive correlational design. In all 8,141 healthy adults participated in the study. Measurements included meal frequency, cardiometabolic risk, and diet quality. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and process macro bootstrapping model 4.Results : The meal frequency was 3.52±0.61 times per day, the risk of cardiovascular metabolic diseases was 0.01±0.61 points, and the diet quality was 62.08±13.87 points. In mediation analysis, the effect of meal frequency on cardiometabolic risk score was completely mediated by diet quality.Conclusion : Improved diet quality in healthy adults should be considered when designing meal frequency interventions aimed at reducing their cardiometabolic risk, as the effect of meal frequency support on cardiometabolic risk was found to be mediated by diet quality.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"163 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86195401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.34250/jkccn.2023.16.2.42
Yi-Kyung Ha
Purpose : This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients.Methods : Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants.Results : Quantitative analysis showed that most participants demonstrated a “being skillful” level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time.Conclusion : To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.
{"title":"Nursing Students’ Clinical Judgment and Performance in Simulation of Recognizing and Responding of the Deterioriating Patient ; a retrospective mixed-methods","authors":"Yi-Kyung Ha","doi":"10.34250/jkccn.2023.16.2.42","DOIUrl":"https://doi.org/10.34250/jkccn.2023.16.2.42","url":null,"abstract":"Purpose : This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients.Methods : Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants.Results : Quantitative analysis showed that most participants demonstrated a “being skillful” level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time.Conclusion : To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.","PeriodicalId":16247,"journal":{"name":"Journal of Korean Critical Care Nursing","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91208711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.34250/jkccn.2023.16.2.28
Mi Hyeon Jo, Hye-Ran Choi
Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU).Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher’s exact tests, and logistic regression were performed to analyze the data.Results : Among the 154 subjects, there were a total of 198 medical device–related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45).Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.
目的:本研究旨在探讨重症监护病房(ICU)患者与医疗器械相关的压力损伤的特点及相关危险因素。方法:对462例ICU患者资料进行回顾性分析。统计分析包括独立t检验、Fisher精确检验和逻辑回归。结果:154例受试者中，医疗器械相关压力损伤(MDRPI)共198例。2期和深部组织压伤最为常见。MDRPI最常见于面部，鼻胃管是其主要原因，其次是气管内管。MDRPI包括男性的危险因素(优势比(或)= 1.78,95%可信区间[CI] = 1.12 - -2.83),部门入住ICU的时候(或= 4.29,95% CI -9.15 = 2.01),重新入住ICU(或= 0.43,95% CI -0.73 = 0.25),应用体外膜肺氧合的机器(或= 2.72,95% CI -6.95 = 1.06),许多医疗设备(或= 1.16,95% CI -1.30 = 1.05),影响肌肉收缩的药物管理局(或= 2.33,95% CI = 1.19 - -4.60),和镇静剂使用(或= 2.53,95% CI -5.45 = 1.17)。结论:这些结果有助于确定MDRPI的特征和相关危险因素。认识ICU患者发生MDRPI的危险因素并制定预防策略至关重要。
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Pub Date : 2023-06-30DOI: 10.34250/jkccn.2023.16.2.54
K. Kang, Mihae Im, Miyoung Jang, Jaewoon Lee, Okjong Lee
Purpose : Developing infection control capabilities during the COVID-19 pandemic was critical. This study aimed to develop a simulation program to control patients with COVID-19 in nursing students and examine the effects on COVID-19 knowledge, COVID-19 nursing intention, self-efficacy learning, and clinical performance.Methods : The study used nonequivalent control group pretest-posttest design. Sixty nursing students were recruited from two different colleges using purposive sampling. For the intervention group(n=30), the pretest was administered before the simulation program, involving six sessions of online lectures and simulation practices. Immediately, the posttest was conducted following the program.Results : COVID-19 knowledge (t=9.87, p ＜.001), COVID-19 nursing intention (t=4.45, p ＜.001), learning self-efficacy (t=6.49, p ＜.001), and clinical performance (t=6.77, p ＜.001) increased significantly after the program, revealing the positive effect of the COVID-19 infection control simulation program in nursing students.Conclusion : The results of the study and the curriculum may be used as practical evidence for COVID-19 infection control in nursing schools and medical institutions.
目的:在2019冠状病毒病大流行期间，发展感染控制能力至关重要。本研究旨在开发一个模拟程序来控制护生中的COVID-19患者，并研究对COVID-19知识、COVID-19护理意愿、自我效能学习和临床表现的影响。方法:采用非等效对照组前测后测设计。采用有目的抽样方法，从两所不同学院招募60名护理专业学生。对于干预组(n=30)，在模拟程序之前进行预测，包括六次在线讲座和模拟练习。项目结束后立即进行了后测。结果:新冠肺炎知识(t=9.87, p <.001)、新冠肺炎护理意愿(t=4.45, p <.001)、学习自我效能感(t=6.49, p <.001)、临床表现(t=6.77, p <.001)在培训后均显著提高，显示了新冠肺炎感染控制模拟培训对护生的积极影响。结论:研究结果和课程设置可作为护理学校和医疗机构实施COVID-19感染控制的实践依据。
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