• Title/Summary/Keyword: Evidenced-based Practice

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Hospital Nurses' Uses of Evidence, and Barriers to and Enablers of Evidenced-based Practice (병원 간호사들의 근거활용 경험 및 장애요소와 촉진요소에 대한 탐색)

  • Hwang, Jee-In
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.2
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    • pp.292-303
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    • 2013
  • Purpose: The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals. Methods: Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology. Results: Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'. Conclusion: The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.

Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy (항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

The Characteristics of Evidence in Evidence-based Design Research and Their Implications to the Evidence-based Practice of Healthcare Architecture - Focused on Health Environments Research & Design Journal (근거기반설계 연구의 근거 특성과 의료건축의 근거기반실무를 위한 시사점 - HERD의 연구경향 분석을 중심으로)

  • Kim, Duksu
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.4
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    • pp.21-30
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    • 2022
  • Purpose: To prove the credibility of EBD, it is necessary to define concepts regarding the nature of credible knowledge and the hierarchy of evidence. In addition, the relationship between EBD and EBP needs to be addressed through a practical viewpoint. Methods: The systematic review is applied to define the nature of knowledge and the characteristics of research papers in architectural EBD while analyzing the field of study, knowledge focus and types of keywords of the first author. Results: As a whole, the types of research focus evaluated using the most frequent keywords include function(40.86%), specialized knowledge(30.52%), professional practice(21.37%), and health(5.78%). Empirical research(83.72%) is more likely to be found than theoretical research(13.95%). The EBD research papers ranked as top-tier are only 7(2.03%) among a total of 344, while the research papers ranked in the third to fourth tiers are 276(80.23%). Implications: There is a deficiency of reliable 1-2 tier research papers. From a practical viewpoint, it would be realistic to recommend that healthcare architects appropriately evaluate the quality of EBD research and apply it in practice, rather than to conduct EBD research themselves. This systematic review illustrates the nature of EBD research.

Treatment Guidelines of Sepsis and Septic Shock (패혈증과 패혈쇼크의 치료 지침)

  • Lee, Heung Bum;Moon, Hee
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.491-498
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    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

Effectiveness of Repeated Marriage Checkups in a Family Center (정례적 결혼검진의 가족센터 적용에 관한 효과성 연구)

  • Park, Woochul
    • Human Ecology Research
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    • v.60 no.1
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    • pp.69-86
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    • 2022
  • The present study examined the effectiveness of repeated marriage checkups at intervals of six months in a Family Center in Seoul. To achieve this, the pilot study protocol (Park, 2019) was adapted, emphasizing strength-based, counseling-oriented approaches. Two couples and family therapists with master's degrees were trained and their practice was monitored to ensure program fidelity. The methods employed for the assessment of marriage checkup were an online survey, a video recording of couple problem-solving, and a clinical interview. A total of 14 couples participated in the 1st checkup, 10 of whom also completed the 2nd checkup. Couples with varying levels of marital satisfaction participated in the program. Descriptive statistics indicated gradual increases over 8-9 months in diverse indices such as marital satisfaction and relationship strength, while other indices fluctuated slightly but converged to higher levels over time. A non-parametric analysis appropriate for small samples demonstrated statistically significant increases over the 8-9 months in marital satisfaction among couples. The current study evidenced the effectiveness of repeated marriage checkups in the Family Center, which is the primary public institution for family policy and services in Korea. Repeated marriage checkups are therefore a promising way to enhance couples' relationship health and improve the family management system of the Family Center.

Nurse Practitioner Roles and Curriculums in the United States (미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰)

  • Lee Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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Factors Affecting Parents' Intention to Choose English Centers: The Role of STEM Education

  • Tran, Do-Van-Anh;Nguyen, Ngoc-Duyen;Tang, Thai-Ngoc;Le, Dinh-Bao-Nhi;Vo, Huyen-Yen-Nhi;Le, Hoanh-Su
    • Journal of Multimedia Information System
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    • v.7 no.1
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    • pp.87-96
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    • 2020
  • Parents' desire for daily English practice for students and the urge for a etter English education has led to a demand for a highly qualified educational curriculum. In addition to getting deep-dive insights into parents' decision-making process, the increasingly important role of STEM education method has been proved in accordance with plenty of evidenced-based many of previous research. This study was conducted to examine the five independent factors affecting parents' intentions when designating English centers for their children, respectively named: Facility, Teachers, Brands, Social factors and Tuition. Through a preliminary approach, 235 samples were analyzed. Analysis of the sample responses reveals the importance level of five independent factors affecting Parents' intention to choose English centers in descending order: Facilities, Teachers, Brands, Tuition and Social factors. Furthermore, a positive correlation was found between STEM and Intention to choose English centers, indicating that whether the center applies STEM-related curriculum in English courses or not, in fact, has a significant impact on parents' decision. In terms of attitude towards STEM, further statistical tests revealed an interesting finding, which is the fact that how STEM affects Intention of parents is directly proportional to the Attitude towards STEM. With the help of SPSS 20 and AMOS 20, the SEM analysis was processed in order to draw conclusions about factors impacting Intentions to choose English centers. Combining with Multi-group analysis, the major role of STEM education has been assessed in relation to plenty of correlations. In light of recent major and massive growth of English teaching market in Vietnam, several suggestions and recommendations in terms of sustainable developments have been displayed in this research.

Effects of adlay, buckwheat, and barley on transit time and the antioxidative system in obesity induced rats

  • Kim, Jung-Yun;Son, Bo-Kyung;Lee, Sang-Sun
    • Nutrition Research and Practice
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    • v.6 no.3
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    • pp.208-212
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    • 2012
  • In the present study, we examined whether four grains including adlay (AD), buckwheat (BW), glutinous barley (GB), and white rice (WR) affect the duration of food residence in the gastrointestinal tract and hepatic enzyme activities in rats fed different combinations of the grains. The rats were raised for 4 weeks on a high fat diet based on the American Institute of Nutrition-93 (AIN-93G) diets containing 1% cholesterol and 20% dietary lipids. Forty male rats were divided into four groups and raised for 4 weeks with a diet containing one of the grains. Corresponding to the dietary fiber contents of the experimental grains, gut transit time was shortest in the rats fed GB and increased in the order of BW, AD, and WR. In addition, the accumulated shortest transit time occurred in the GB group. Gut transit time affected weight gain and major organ weight, as it was closely related to the absorption of nutrients. The level of thiobarbituric acid reactive substance (TBARS) in liver was higher in rats fed WR, AD, BW, and GB, indicating that the other grains decreased oxidative stress in vivo more than WR. Glutathione, glutathione peroxidase, and glutathione S-transferase levels in the AD, BW, and GB groups were significantly higher than those in the WR group. In conclusion, reduced colonic transit time has been implicated in reducing the incidence of colon cancer, as evidenced by populations consuming diets rich in fiber. Whole grains such as AD, BW, and GB may contribute to a significant supply of antioxidants to prevent oxidative stress if they are consumed in large amounts.

Influence of Short- and Long-term High-dose Caffeine Administration on Behavior in an Animal Model of Adolescence (장단기 고용량 카페인 투여가 청소년기 동물모델의 행동에 미치는 영향)

  • Park, Jong-Min;Kim, Yoonju;Kim, Haeun;Kim, Youn-Jung
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.217-223
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    • 2019
  • Purpose: Caffeine is the most widely consumed psychostimulant of the methylxanthine class. Among adolescents, high-dose of caffeine consumption has increased rapidly over the last few decades due to the introduction of energy drinks. However, little is known about the time-dependent effect of high doses of caffeine consumption in adolescents. The present study aims to examine the short- and long-term influence of high-dose caffeine on behavior of adolescence. Methods: The animals were divided into three groups: a "vehicle" group, which was injected with 1 ml of phosphate-buffered saline for 14 days; a "Day 1" group, which was injected with caffeine (30 mg/kg), 2 h before the behavioral tests; and a "Day 14" group, which was infused with caffeine for 14 days. An open-field test, a Y-maze test, and a passive avoidance test were conducted to assess the rats'activity levels, anxiety, and cognitive function. Results: High-dose caffeine had similar effects in short-and long-term treatment groups. It increased the level of locomotor activity and anxiety-like behavior, as evidenced by the increase in the number of movements and incidences of rearing and grooming in the caffeine-treated groups. No significant differences were observed between the groups in the Y-maze test. However, in the passive avoidance test, the escape latency in the caffeine-treated group was decreased significantly, indicating impaired memory acquisition. Conclusion: These results indicate that high-dose caffeine in adolescents may increase locomotor activity and anxiety-like behavior and impair learning and memory, irrespective of the duration of administration. The findings will be valuable for both evidence-based education and clinical practice.

Exploring the Theoretical Trends of an Integrated Environmental Design (통합적 환경설계 이론 기초 연구)

  • Ahn, Myung-June;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.37 no.2
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    • pp.14-25
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    • 2009
  • We live in an age which is exponentially growing as the knowledge paradigm is changing. New sites are subject to contemporary landscape architecture function as "fields" in which this hybrid aspect is both actively practiced and becoming a catalyst for change in the area of landscape architecture. With this as its background, this study attempts to deal with how the aspect of integration in environmental design is manifested. For this purpose, the tendencies for the discussion of integration in various fields of practice were examined: planning theories, urban theories, architecture, public environment, engineering, and landscape architecture. As yet, the discussions of interdisciplinary integration, which occur in practice in these respective fields, mainly tend to be oriented toward the effective implementation of the merits of other related fields. Seen from these examples of practice, integrated design approaches can be found in the following three aspects: design objects, respective professional areas, and methodologies of approaches and design. In terms of design objects, the positions of individual design subjects present themselves as most obvious, and integration or combination of the physical targets that come to exist through design can be easily seen. Most examples of integration turn out to be this, in almost every case of which the theme and the target of expression are integrated via a small number of certain methods. In terms of professional areas, what can be mainly evidenced is how the individual subject acts when the subject designs. The strong points of professionals from each field seem to create synergy, achieving through integration optimum results. In terms of methodologies of approaches and design, there are attempts to create integrated approaches as ways of effective decision-making, in which case the integration of all of the interest parties is of primary concern. As yet, few instances have been found in which integrated design has had enough strength to be seen as a concrete design methodology based on practical examples. However, it is encouraging that theoretical approaches and the necessity for integrated design have been identified from multiple perspectives, and that a practical movement such as landscape urbanism has come into active being. The authors of this study find this point in time to be ripe for discussions on integrated practices in terms of environmental design, on the basis of the synthetic approaches mentioned above.