Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

Purpose: This study was to develop a fall prevention program and test the effects of the program on the muscle strength, postural balance and fear of falling for elderly. Methods: This study was conducted using a nonequivalent control group pretest-posttest design. There were 21 participants in the experimental group and 22 in the control group. Data were collected from July to September 2015. Questionnaires were completed three times (at pretest and after 8 and 10 weeks). Data were analyzed using $x^2$ test, Fisher's exact test, t-test, and repeated measure ANOVA. Results: Lower extremity muscle strength and postural balance scores were significantly improved in the experimental group compared to the control group. However, fear of falling was not significantly different between the experimental and control groups. Conclusion: The study results indicate that fall prevention programs for the elderly can be useful to improve muscle strength and postural balance.

Purpose: The purpose of this study was to compare the fluid intake and output (I&O) measurement methods in order to figure out more effective and easier method for medical patients Methods: 71 hospitalized patients participated in the study. In "liquid only (LO)" method, all amount of water was summed up including any liquid types of food and IV fluids. In "whole food(WF) intake," all liquid and solid food intake and IV fluids were added up. Results: The average amount of fluid intake was 2105.29 ml for LO method and 2523.54 ml for WF method. The average amount of fluid output was 2148.98 ml. The intra-class correlations (ICC) between the intake and output measures by the two different methods was 0.803 and 0.826, respectively. The correlation between the differences of intake/output and body weight change in two different methods was r=.347 (p=.003), and r=.376 (p=.001), respectively. Conclusion: The results of this study indicate that both LO and WF method may be useful in monitoring patients' fluid balance. Given the comparability of using LO over WF, it is suggested that measuring just liquid only intake as the indicator of patient's intake is applicable in clinical setting.

Purpose: This study was to investigate the relationships between among health literacy, knowledge and self-care behavior in elderly patients with heart failure(HF). Methods: 166 patients (age ${\geq}65$ years) with HF were recruited in a cardiovascular center of an university affiliated hospital. The structured questionnaire included Health literacy, Dutch Heart Failure Knowledge Scale, European Heart Failure Self-care Behavior, Self-Care of Heart Failure Index. Data were analyzed by descriptive statistics, Chi-test, Pearson correlation analysis, t-test and ANCOVA using SPSS/WIN version 21.0. Results: Participants with the high level of health literacy were more likely to be younger (p=.001), men (p=.001), with more education (p<.001), and have a job (p=.004), and with a higher economic status (p=.005). The positive correlations between the level of health literacy, knowledge, and self-care behavior were confirmed (p<.001). Participants with the high level of health literacy showed higher level of knowledge, more self-care behavior for health maintenance, and confidence. Conclusion: This study shows that the level of health literacy may influence knowledge and self-care behavior in elderly patients with HF. In order to improve self-care behaviors in elderly patients, a strategic nursing approach based on the level of patients' health literacy needs to be considered.

Purpose: The purpose of this study was to understand the effects of verbal violence experience, social support, and coping patterns on job stress among operating room(OR) nurses. Methods: The participants were 214 operating room nurses in general hospitals. Data were collected from April 1st to May 1st in 2013 and were analyzed using a multiple regression. Results: The most influencing factor on job stress for OR nurses was verbal violence experience from doctor(${\beta}=.35$), and verbal violence experience from nurse (${\beta}=.27$) followed. Social support from co-workers was a significant factor in decreasing job stress (${\beta}=-.22$). Those three factors explained 43.0% (F=54.76, p<.001) of OR nurses' job stress. Conclusion: The findings of this study revealed that doctors' and nurses' verbal violence increased job stress of OR nurses and social support from co-workers was found decreasing OR nurses' job stress. The results of the study provides an necessity for developing an effective program for minimizing job stress of OR nurses caused by work place verbal violence.

Purpose: The purpose of this study was to describe performance and education needs related to neurologic assessment by neurologic ward nurses. Methods: The study was conducted with a cross-sectional descriptive design. Participants, 297 neurologic ward nurses working in ten major hospitals in Seoul and Gyeonggi were surveyed from September 7 to October 1, 2015. Results: The mean score for performance of neurologic assessments was 3.04 points. Performances performed with high quality were orientation exam, mental status documentation, and muscle strength of extremities in that order. Performances performed with low quality were assessment of accessory nerves, hypoglossal nerves, and cerebellum function in that order. There were significant differences according to whether there was ward education programs on neurologic assessment and teaching experiences within a year. These variables significantly affected the quality of neurologic assessment performance. The need for neurologic assessment training was 3.14 points. Conclusion: Amount of performance and demand for education on neurologic assessment, which are required in the clinical setting, were significantly high. To perform neurologic assessments with high quality, development of education program for neurologic assessment and continuous education courses are required at either the department or neurological nursing organization level.

Purpose: The purpose of this study was to develop an evidence-based nursing protocol for peripheral intravenous catheter management in hospitalized children. Methods: The preliminary protocol of this study was developed based on domestic and foreign guidelines, research, a survey and an analysis of medical records in a university hospital. It is a methodological research to develop evidence-based nursing protocol of peripheral intravenous catheter management verified by content validity by a group of specialists and users. Results: The specialists' verification of validity in the preparatory protocol had a CVI level of 0.94 and the propriety and conveniency of users had an average of $3.0{\pm}0.52$. The final evidence-based nursing protocol was composed of 5 areas (education, dressing and fixation, maintenance and replacement, observation and record, and coping to complication) with 46 specific recommendations. Conclusion: Based on domestic and foreign research and guidelines verified by specialists and users, the findings in this study provide a simple, applicable and evidence-based nursing protocol for peripheral intravenous catheter management in hospitalized children. By the clinical application of this protocol, nurse tasks in managing peripheral intravenous catheter can be performed with more scientific evidence and be standardized.

Purpose: The present study was done to identify the relationship of cultural competence, self efficacy and job stress of nurses working on wards for foreign patients. Methods: The participants were 133 clinical nurses who agreed to participate in the study and were working on wards for foreign patients in three general hospitals in Seoul. A structured questionnaire that covered the three tested constructs was conducted between Dec. 15, 2014 and Jan. 15, 2015. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficients with SPSS/WIN 21.0 program. Results: Cultural competence was found to have a significant positive correlation with self efficacy (r=.464, p<.001) and self efficacy had a significant negative correlation with job stress (r=-.397, p<.001). Conclusion: The findings of the study suggest that programs designed to nourish cultural sensitivity and cultural skills need to be developed in order to promote cultural competence. The results also suggest that in these programs to improve self efficacy and reduce job stress should be considered.

Purpose: This study was conducted to investigate the factors that influence the psychosocial adjustment of organ transplant recipients. Methods: Participants were 132 organ transplant recipients who received follow-up more than 3 months after the organ transplantation at one general hospital in Seoul. A questionnaire survey was done from November 3 to December 3, 2015. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and hierarchical multiple regression. Results: Family support, medical staff support and hope were significantly correlated with psychosocial adjustment. In the hierarchical multiple regression analysis, hope appeared to be the most important factor influencing psychosocial adjustment (${\beta}=.39$, p<.001). Conclusion: The findings show that hope had an influence on the psychosocial adjustment of organ transplant recipients. Thus, to improve psychosocial adjustment it is important for nurses to develop interventions to increase hope in organ transplant recipients.

Purpose: The purpose of this study was to construct and test a structural equation model of burnout of the critical care nurses based on the job demand-resource model. Methods: A structured questionnaire was completed by 414 critical care nurses. The relationships between concepts of job stress, empathic ability, resilience, job satisfaction, compassion fatigue and burnout were analyzed. Using SPSS WIN 22.0 and AMOS 22.0 programs, the direct and indirect effects of factors affecting burnout among critical care nurses were calculated and modelled. Results: The modified model was yielded as follows: Chi-square= 216.59, GFI= .93, AGFI= .89, NFI= .90, CFI= .93, RMSEA= .07, SRMR= .06 and showed good fit indices. Job satisfaction and compassion fatigue had mediation effects between other three exogenous variables and burnout. Conclusion: The major findings of this study indicate that it is important to develop a support program for critical care nurse in order to improve their job satisfaction and ameliorate their compassion fatigue.

Purpose: This study aims to develop Tablet PC-based multimedia educational contents on the procedures from surgery preparation to recovery for hospitalized patients who are going to undergo thoracic surgery and their families. Methods: The educational contents were created based on literature review and a survey of needs in patients and their families who were admitted to a hospital in Seoul from Dec. 2013 to May 2014. The contents were developed in conjunction with a film production company. The educational materials including texts, images, sounds, and videos were developed appling the ADDIE (analysis, design, development, implementation, and evaluation) model. Results: Two multimedia educational contents were developed for the patients with coronary artery bypass graft or lung surgery. Each content consisted of six subdivisions of self-learning for 20 minutes. The developed educational contents were completed after testing content validity by 30 medical experts. Conclusion: This study recommends that the Tablet PC-based educational contents for thoracic and cardiovascular patients and their families be used in general wards and intensive care units to relieve their anxiety before surgery and reduce postoperative complications.