Purpose: The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. Methods: The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. Results: Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. Conclusion: Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.
Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of four nursing sensitive nursing outcomes selected from the Nursing Outcomes Classification (NOC). Outcomes for this study were 'Knowledge: Diet', 'Knowledge: Disease Process', 'Knowledge: Energy Conservation', and 'Knowledge: Health Behaviors'. Method: Data were collected from 183 nurses working in 2 university hospitals. Fehring method was used to estimate outcome and indicators' content and sensitivity validity. Multiple and stepwise regression were used to evaluate relationships between each outcome and its indicators. Result: Results confirmed the importance and nursing sensitivity of outcomes and their indicators. Key indicators of each outcomes were found by multiple regression. 'Knowledge: Diet' was suggested for adding new indicators because the variance explained by indicators was relatively low. Not all of the indicators selected for stepwise regression model were rated for highly in Fehring method. The R² statistics of the stepwise regression models were between 18 and 63% in importance by selected indicators and between 34 and 68% in contribution by selected indicators. Conclusion: This study refined what outcomes and indicators will be useful in clinical practice. Further research will be required for the revision of outcome and indicators of NOC. However, this study refined what outcomes and indicators will be useful in clinical practice.
Nursing is indeed a practice discipline with experiential learning in clinical practice areas comprising an overwhelming portion of a Nursing Student's education. The statement is used to provide a basis for discussion of some issues involved in relation to clinical nursing education. However the lack of substantial research in the area of clinical nursing education would suggest that this 'heart' of the nursing student's professional education has olng been ignored. The purpose of this study is to critically review and analysis then suggest effective approaches of clinical nursing education. First. the curriculum can be developed by faculty consistently. Curriculum design begins with the writing of philosophy and the selection of objectives for the program. The philosophy must include a statement of beliefs and intrinc values about human being. nursing and teaching learning process. Second. faculty practice can be narrowed practice-theory gaps. Third. clinical teaching strategies can be used many different methods in order to facilitate development of clinical judgement and decision making. Fourth, clinical teacher's rols can influence student's learning attitude and intrinsic value; relating to students as mature individuals; creating an atomosphere where in the student felt comfortable approaching the instructor; providing support crisis situations. Fifth. clinical nursing evaluation can be developed the integrated models.
Purpose: The purpose of this study was to assess the importance and sensitivity to nursing interventions of six sensitive nursing outcomes selected from the Nursing Outcomes Classification. The outcomes in this study were Self-Care: Activities of Daily Living, Self-Care: Instrumental Activities of Daily Living, Treatment Behavior: Illness or Injury, Knowledge: Health Promotion, Caregiver Performance: Direct Care, and Caregiver Physical Health. Method: Data were collected from 97 visiting nurses working in public health centers located in a province and a capital city. The Fehring method was used to estimate outcomes and indicators for content validity. Simultaneous multiple regression and stepwise regression were used to evaluate relationships between each outcome and its indicators. Results: Results confirmed the importance and nursing sensitivity of the outcomes and their indicators. Multiple regression revealed key indicators of each outcome. Self-Care: Instrumental Activity of Daily Living needed to be revised. Neither all of the indicators nor the indicators showing the highest importance and contribution ratio were selected as independent variables for the stepwise regression model. The R2 of the regression models ranged from 29 to 56% in importance by selected indicators and from 56 to 83% in contribution. Conclusion: Further research is needed for the revision of outcomes and their indicators.
This study was designed to investigate the changes of nurses' role model, perceptions toward occupation, and self actualization value in terms of the phases of socialization process. Two hundred and sixty nine nurses working in clinical settings were randomly selected from 15 general hospitals despersed over Seoul and Kyungki province. Data were gathered by the standardized Perceptual Orientation Test, the Self-actualization Test, and Questionnaires on role models and phases of socialization process developed by the investigators from October 1985 to March 1986. The data were analysed by ANOVA and Pearson's Correlation Coefficient. The results were as follows: 1. The average time period required for the shift of phases of socialization process were; phase Ⅰ, role adjustment, took average 10 months of employment: Phase Ⅱ, interpersonal adjustment, 12 months: and Phase Ⅲ, role conflict, 15 months respectively. Conflict resolution, phase Ⅳ, began to take place 18 months of employment; and shifted to phase V, internalization and self-actualization at 25 months of employment. 2. Throughout 5 consecutive phase, the number of immediate superior nurse model was dominantly the highest among the role models. The number of head nurse role model increased at phase Ⅱ, phase Ⅲ, and phase Ⅳ. Respondents with school model in phase I tended to transfer to work model at phase Ⅱ. 3. The perceptions toward occupation were not significantly influenced by the Phases of socialization process. 4. The score of self-actualization value was not significantly influenced by the phases of socialization process. 5. In regard to perceptions toward occupation, nursing director model group showed significantly lower score in phase I (p<.01). 6. The comparison of self-actualization value between the 5 phases revealed significant difference in phase I: in particular among respondents with school model at p<.05. To conclude: 1. The phase Ⅲ of socialization process is the period of role conflict which occur at 15 months of employment, an6 conflict resolution, phase Ⅳ, begins at 18 months of employment on the average in clinical settings. 2. The immediate superior nurse and the head nurse are important role models for nurses all through their socialization process.
Purpose: This study aims to investigate the cross-sectional association of company size and self-rated health using representative data on Korean workers. Methods: We used the data from 2,884 wage workers collected by Korean Labor and Income Panel Study (17th). The association between company size and self-rated health was analyzed using logistic regression with covariates including demographic characteristics, work environment, job satisfaction, and health-related behaviors. Resulst: Odds ratio (OR) for better health status among workers in large-sized company was 1.351 (CI. 1.054~1.731), compared to workers in small-sized company. We performed three separate models stratified by firm size (small, medium, and large companies). Occupation variables showed different effect on health depending on firm sizes. OR for better health of white-color job (referred to blue-color job) was 1.693 in medium-sized company model but it was 0.615 in large company model. OR for better health of the workers working shift work showed 0.606 in large company model but it was not significant in small and medium company models. Conclusion: We found that small-sized company workers have significantly poor self-rated health compared to large-sized firm workers. This study revealed that there exist differences among health related factors depending on firm sizes.
Nursing as it is practiced and taught, historically has been viewed as natural science. There are new movements to create a paradigm of nursing in the human sciences. A natural science methodologies elicit quantitative data from observable phenomena and reveal causal relationships. Human science methodology is the study of Unitary Man's participative experience in a situation, the simultaneity paradigm. In a theory of nursing rooted in human science assumptions about man and health are synthesized, and the practice of nursing is continuously expanded through research. To find independent nursing interventions especially cognitive nursing intervention models it has been necessary to consult a multitude of journals and text sources for references, and no one nursing textbook can be used in help patients achieve nursing goals. The goals of nursing in the simultaneity paradigm focus on the quality of life from the person's perspective. Cognitive interventions based on the person's perspective were selected from those that colleagues deemed appropriate to nursing and those that were identified in the nursing literature. They were supportive nursing care, reminiscence, meditation, relaxation and imagery. Nurses have been reluctant to make diagnoses, implement actions, and assume responsibility for this actions and this is of concern but can be understood because nurses have had little exposure to action and lack an intervention armamentarium from with which to choose actions to achieve nursing goals. Efforts in nursing education and nursing service are required to remedy this problem. Nurses must be convinced of the challenge and excitement associated with autonomous functioning. It is a characteristic of the true professional. Traditionally, nursing has prescribed one method for handling a situation. Fundamental nursing texts usually only present one way to handle a situation, because alternative interventions to achieve a client goal may be available. Considerably more research is necessary before these can be prescribed. However, unless a first step is taken, progress will not be made. The quality of health care or nursing care is enhanced when nurses transform dilemas into commited action. This is apparent from widespread experiences of nurses.
Purpose: The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. Methods: The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. Results: After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. Conclusion: The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.
Purpose: This study reviewed the pathophysiological mechanisms of cellular aging caused by psychological stress and aimed to establish a biobehavioral theoretical framework for nursing interventions to promote autonomic balance based on these mechanisms. Methods: A comprehensive literature review was conducted. Results: A review of the literature showed that the stress response increases the secretion of catecholamines and glucocorticoids, resulting in a greater allostatic load. This load induces inflammatory reactions and oxidative stress, shortening telomere length and damaging mitochondrial DNA, which can lead to cellular aging. Based on this mechanism, a biobehavioral theoretical framework for nursing interventions was established. This framework focuses on delaying or inhibiting the cellular aging process by acting on the stress response stage and improving autonomic balance. Conclusion: According to the proposed biobehavioral theoretical framework, stress-relieving nursing interventions may act on the mechanism of cellular aging caused by stress responses. We believe that this framework could expand our understanding of the biobehavioral aspects of stress and would facilitate efforts to use biomarkers to evaluate the effectiveness of stress-related nursing interventions at the cellular level.
Purpose: To test whether a hope carries the influence of pain to health related quality of life in patients with cancer. Method: 114 cancer patients recruited with. Data were collected through the Visual analog Scale, the Herth Hope Index, and the SF-36 Standard Korean Version. Results: The results showed that the measurement variables (pain, hope and health-related quality of life) were all significantly interrelated. The results of MedGraph revealed that the full mediation effect of hope in the relation between pain and mental component summary of quality of life was significant. Conclusion: These results imply that hope need to be considered in planning intervention programs for the enhancement of quality of life in patients with cancer.
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