• Title/Summary/Keyword: care sensitivity

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Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit (외상중환자의 욕창 위험사정 도구의 타당도 비교)

  • Choi, Ja Eun;Hwang, Sun-Kyung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.26-38
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    • 2019
  • Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • v.25 no.2
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

Implementation of point-of-care platforms for rapid detection of porcine circovirus type 2

  • Chiao-Hsu Ke;Mao-Yuan Du;Wang-Ju Hsieh;Chiu-Chiao Lin;James Mingjuh Ting;Ming-Tang Chiou;Chao-Nan Lin
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.28.1-28.11
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    • 2024
  • Background: Porcine circovirus type 2 (PCV2) infection is ubiquitous around the world. Diagnosis of the porcine circovirus-associated disease requires clinic-pathological elements together with the quantification of viral loads. Furthermore, given pig farms in regions lacking access to sufficient laboratory equipment, developing diagnostic devices with high accuracy, accessibility, and affordability is a necessity. Objectives: This study aims to investigate two newly developed diagnostic tools that may satisfy these criteria. Methods: We collected 250 specimens, including 170 PCV2-positive and 80 PCV2-negative samples. The standard diagnosis and cycle threshold (Ct) values were determined by quantitative polymerase chain reaction (qPCR). Then, two point-of-care (POC) diagnostic platforms, convective polymerase chain reaction (cPCR, qualitative assay: positive or negative results are shown) and EZtargex (quantitative assay: Ct values are shown), were examined and analyzed. Results: The sensitivity and specificity of cPCR were 88.23% and 100%, respectively; the sensitivity and specificity of EZtargex were 87.65% and 100%, respectively. These assays also showed excellent concordance compared with the qPCR assay (κ = 0.828 for cPCR and κ = 0.820 for EZtargex). The statistical analysis showed a great diagnostic power of the EZtargex assay to discriminate between samples with different levels of positivity. Conclusions: The two point-of-care diagnostic platforms are accurate, rapid, convenient and require little training for PCV2 diagnosis. These POC platforms can discriminate viral loads to predict the clinical status of the animals. The current study provided evidence that these diagnostics were applicable with high sensitivity and specificity in the diagnosis of PCV2 infection in the field.

Effects of Long Term Care Hospital Care-givers' Fall Prevention Self Efficacy and Fall Prevention Health Belief on Fall Prevention Awareness (요양병원 간병사의 낙상예방효능감과 낙상예방건강신념이 낙상예방인지도에 미치는 영향)

  • Jung, Ji-Young;Park, Yoon-Ji;Jung, Gye Hyun
    • The Journal of the Korea Contents Association
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    • v.15 no.2
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    • pp.333-343
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    • 2015
  • The purpose of this study is to investigate the factors that affect the fall prevention awareness of care-givers working at long-term care hospitals. A convenience sampling method was used to select care-givers who worked at 7 different long term care hospitals which were located in D city and N city. Data were collected from July 2014 to August 2014. 200 data were used for analysis out of 215 data which were collected. The hierarchical regression analysis reveals the following results: Firstly, the effects of care-givers' education level, certificate status, period of work experience and fall-related learning hours on their fall prevention awareness level were statistically significant. Secondly, among fall prevention health beliefs, perceived benefit, perceived disability, perceived sensitivity and self-efficacy were positively related to the level of fall prevention awareness. Thirdly, while such factors as perceived benefit, perceived sensitivity and self-efficacy showed positive effects on the fall prevention awareness, the period of work experience had negative effects. The regression model shows the power of explanation of 31.7 percents. In conclusion, the study suggests a fine-tuned program to improve care-givers' fall prevention awareness in a way of promoting fall prevention self-efficacy, perceived benefits and perceived sensitivity while considering the care-givers' period of work experience.

Validation of the Nursing Outcomes Classification (NOC) to Nursing in Korea (간호결과 분류체계의 타당성 검증 - 지역사회 간호결과를 중심으로 -)

  • Lee, Eun-Joo
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.523-531
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    • 2002
  • 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.

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Diagnostic Accuracy of the Quidel Sofia Rapid Influenza Fluorescent Immunoassay in Patients with Influenza-like Illness: A Systematic Review and Meta-analysis

  • Lee, Jonghoo;Song, Jae-Uk;Kim, Yee Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.3
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    • pp.226-236
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    • 2021
  • Background: Although the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) is widely used to identify influenza A and B, the diagnostic accuracy of this test remains unclear. Thus, the objective of this study was to determine the diagnostic performance of this test compared to reverse transcriptase-polymerase chain reaction. Methods: A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of this test for identifying influenza A and B were determined using meta-analysis. A sensitivity subgroup analysis was performed to identify potential sources of heterogeneity within selected studies. Results: We identified 17 studies involving 8,334 patients. Pooled sensitivity, specificity, and DOR of the Quidel Sofia rapid influenza FIA for identifying influenza A were 0.78 (95% confidence interval [CI], 0.71-0.83), 0.99 (95% CI, 0.98-0.99), and 251.26 (95% CI, 139.39-452.89), respectively. Pooled sensitivity, specificity, and DOR of this test for identifying influenza B were 0.72 (95% CI, 0.60-0.82), 0.98 (95% CI, 0.96-0.99), and 140.20 (95% CI, 55.92-351.54), respectively. The area under the HSROC for this test for identifying influenza A was similar to that for identifying influenza B. Age was considered a probable source of heterogeneity. Conclusion: Pooled sensitivities of the Quidel Sofia rapid influenza FIA for identifying influenza A and B did not quite meet the target level (≥80%). Thus, caution is needed when interpreting data of this study due to substantial betweenstudy heterogeneity.

The Relationship among Moral Sensitivity, Self-leadership, Fatigue and Compliance with Standard Precautions of Intensive Care Nurses (중환자실 간호사의 도덕적 민감성, 셀프리더십, 피로도와 표준주의지침 수행과의 관계)

  • Park, Ju Young;Woo, Chung Hee
    • Journal of Digital Convergence
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    • v.18 no.9
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    • pp.229-237
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    • 2020
  • The study was done to identify relations among moral sensitivity, self-leadership, fatigue and compliance with standard precautions and to identify the influencing factors on compliance with standard precautions for intensive care nurses. Data were collected from 153 intensive care nurses in March 2019 and were analyzed using Descriptive statistics, Pearson correlation coefficients, and Stepwise multiple regression with SPSS/WIN 24.0 version. The compliance with standard precautions has positive correlation with their self-leadership (r=.17, p=.042). The self-leadership (β=.17, p=.042) was a significant predictor of the compliance with standard precautions. It was statistically significant (R2=.03, F=4.21, p=.042). Based on the findings of this study, each institution needs to make efforts to strengthen the capacity of nurses for self-leadership.

Effects of Moral Sensitivity and Self-Assertiveness on Ethical Decision-Making Confidence of Nurses Working in Long Term Care Hospitals (요양병원간호사의 도덕적 민감성과 자기주장성이 윤리적 의사결정 자신감에 미치는 영향)

  • Kim, Ji-Ah;Kang, Young-Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.144-153
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    • 2020
  • This study evaluated the moral sensitivity, self-assertiveness, ethical decision-making confidence and their correlations, and the factors that influence ethical decision-making confidence among nurses working in a long-term care hospital. Overall, 149 nurses working in a long-term care hospital in G Province were evaluated. The date was collected from November 30 2019 to December 18, 2019 and analyzed using SPSS/WIN 21.0 program. The mean of moral sensitivity among nurses was 4.94, the mean of self-assertiveness was 3.17 and the mean of ethical decision-making confidence was 3.49. The self-assertiveness will, according to the general characteristics, was significantly different according to experienced moral distress, and there was a significant difference in the degree of ethical decision-making confidence according to social positions and experience of ethical education. There were positive correlations between the ethical decision-making confidence and moral sensitivity (r=.382, p<.001) and self-assertiveness (r=.224, p<.01). Regression analysis revealed that the factors that significantly influenced ethical decision-making confidence were moral sensitivity, self-assertiveness and ethical education during nursing practice, which explained 25.0% of variance in ethical decision-making confidence. Therefore, to improve ethical decision-making confidence of nurses, programs should be developed that improve moral sensitivity and self-assertiveness by promoting ethical education.

A Study on Difference of Teacher-Child Interaction in Relation to Professionalism Awareness Level and Sensitivity Level of Early Childhood Teacher's : With a Focus on 3~5 year old Homeroom Teacher's (유아교사의 전문성 인식 수준 및 민감성 수준에 따른 교사-유아 상호작용의 차이 : 만 3~5세 담임교사를 중심으로)

  • Jang, Yun Jeong;Hwang, Yoon Sook
    • Korean Journal of Child Education & Care
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    • v.17 no.2
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    • pp.181-203
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    • 2017
  • The purpose of this research is to reveal the difference of teacher-child interaction in relation to professionalism awareness and sensitivity level of early childhood teachers. To this end, we used professionalism awareness, sensitivity, teacher-child interaction as parameters for 226 early childhood teachers in Jeonbuk province. Here are the results : First, we investigated the difference of professionalism awareness, sensitivity, teacher-child interaction in relation to the background of early childhood teachers, and it differs by the age, career, educational level of the teachers. Second, we made group comparison to see the difference of teacher-child interaction depending on professionalism awareness level of teachers, and teachers with high professionalism awareness showed meaningfully higher emotional, verbal, behavioral interaction level than lower group. Third, we made group comparison to see the difference of teacher-child interaction depending on sensitivity level, and teachers of high sensitivity shows meaningfully higher emotional, verbal interaction than lower group. This result could be potential data to ameliorate the quality of teacher-child interaction, and it implies that the improvement of professionalism and sensitivity level could contribute to professional performance capability of teachers.

Factors Affecting Ethical Sensitivity Among Nursing Students: Secondary Data Analysis

  • Lee, Jung Min;Min, Hye Young;Kim, Yoonjung
    • International Journal of Advanced Culture Technology
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    • v.9 no.4
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    • pp.204-212
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    • 2021
  • Ethical sensitivity is a basic competency required for nursing students to work as professionals who will care patients in the clinical field after graduation. Therefore, efforts are needed to improve the knowledge on ethical sensitivity in undergraduate education. This study aimed to identify the demographic characteristics that influence ethical sensitivity among nursing students. This study was a secondary analysis that referred to a previous work measuring ethical sensitivity in nursing students. The participants were 128 nursing students, who had experienced clinical practicums. Among the participants, those who were third-year (t=2.345, 95% CI=[1.24, 14.64], p=0.021), female (t=2.635, 95% CI=[3.65, 25.69], p=0.009) and were satisfaction with major (t=-2.389, 95% CI=[-16.54, -1.50], p=0.019) consistently reported significantly higher mean scores on ethical sensitivity. The explanatory power of the model was 13.3%. Gender (Exp (B)=0.875, 95% CI=[0.804, 0.952], p=0.002) and year at universtiy were the strongest predictors of ethical sensitivity (Exp (B)=0.921, 95% CI=[0.873, 0.971], p=0.002). Based on the results, an appropriate ethics education that considers the following issues should be provided for undergraduate nursing students: both genders' perspectives, seniors' further development, and students experiencing low satisfaction with their major. Future nursing education should consider these individual demographic characteristics to develop nursing students' ethical sensitivity that will further affect their ethical behavior and ultimately improve the quality of nursing.