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• Symptom Management to Predict Quality of Life in Patients with Heart Failure: A Structural Equation Modeling Approach
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PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease. METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program. RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program. CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.

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The main purposes of this study were to determine the interval between the onset of symptoms of myocardial infarction and treatment-seeking time and identify the factors related to the interval time. This study used a retrospective design, The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaires, which included demographic data, premonitory clinical signs and symptoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment seeking time. The results of this study are summarized as follows: 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symptoms. Patients described the characteristics of chest pain as "something very heavy pressing down "(26.2%), "felt like my chest would burst"(24.4%), or "sharp pain"(16.7%). Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have "very severe" premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39+/-0.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27+/-.39 hours and for transfer from a local hospital to the medical center was 4.75+/-.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r=-0.51, p=0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dysnea(U=115.50, p=0.01, U=132.00, p=0.04), however the severity of premonitory signs and symptoms did not have statistical significance.

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• Factors associated with needlestick and sharp injuries among hospital nurses: A cross-sectional questionnaire survey
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The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft(CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study, a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June, 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes, the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items, nutrition medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2 days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13.9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found the among the total of 571 items, there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven, IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day. which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day. but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test, the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the "stairs climbing" item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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• Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients
  Yeo Ok Yun, Min Young Kim, Woo Jeong Kim, Young Joon Kang, Ju Ok Park, Kyung Hye Park
  Journal of Korean Academy of Nursing Administration.2011; 17(1): 66.     CrossRef
• The Development of Nursing Standards for Coronary Artery Disease Patients Who Received Medical Treatment
  Won Jung Noh
  Journal of Korean Academy of Nursing Administration.2010; 16(3): 326.     CrossRef
• The Development and Effects of an Integrated Symptom Management Program for Prevention of Recurrent Cardiac Events after Percutaneous Coronary Intervention
  Youn-Jung Son
  Journal of Korean Academy of Nursing.2008; 38(2): 217.     CrossRef

The Purpose of this study was to study what effect providing the patient with preparatory concrete information had on the state anxiety depending on coping styles of patients undergoing cardiac catheterization. State Anxiety scores for 32 patients who had cardiac catheterization were examined after information was provided about the test using and audio tape. The state anxiety of patients who had a high trait anxiety level was compared to that of those who had a low trait anxiety level. The state anxiety of those who had a monitor type were compared to those of patients who had blunter type. The Trait and State Anxiety Scale of Spielberger Miller's Behavioral Style Scale, and Krantz's Health Opinion Survey and Visual Analog Scale(I, II) were used. Findings were as follows : 1. Among the demographic characteristics, gender difference of the patients was significantly different for the trait anxiety level. Female patients had higher trait anxiety level than male patients. 2. Analysis of state anxiety scores indicated that the mean score of the state anxiety prior to the test was higher than mean score of the state anxiety examined after the test. The difference was statistically significant. 3. Among the patients, 14 patients (43.7%) used monitor type, while 18 patients(56.3%) used blunter type. The means of preference for information measured on the Krantz' subscale was 2. 45. 4. The study results indicate that the state anxiety level of those who a low trait anxiety level was lower than that of those who had a high trait anxiety level. 5. State anxiety levels depending upon the kind of coping style which patients used during the test were not significantly different. This study did not identify the influence of preparatory concrete information on the state anxiety depending on coping styles, and there fore a quasi-experimental study using a large sample according to different types of information, and the amount of information, coping styles is recommended.

Clinical practice in nursing education provides an opportunity for students, through the process of applying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide advice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the precep-torship, the three-tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et al was also used to measure student competencies. The results of this study are as follows: 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t= -5.13, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that: 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse (student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their burden. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to upgrade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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• The Students’ Evaluation of Practice Sites and Preceptors in Pharmacy Experiential Education
  Jeong-Hyun Yoon, Hae Sun Suh, Nam Kyung Je
  Korean Journal of Clinical Pharmacy.2017; 27(2): 69.     CrossRef