Consultation In General Hospital Research Articles

Educational needs for virtual reality-based simulation training in the nursing care of adult respiratory patients: an explanatory sequential mixed-methods study.

We aimed to ascertain the current state of and needs for virtual reality (VR)-based simulation training in the care of adult respiratory patients. Learning to care for patients with infectious respiratory disease is crucial in nurses' practical education. Thus, studies on the state of VR-based simulation-training are required. We used an explanatory sequential mixed-methods design. The sample included 122 new nurses at two advanced general hospitals and five educators at a nursing college. The educational needs of virtual reality-based simulation education were measured by the tool developed in this study. Research data were collected from August 31 to September 26, 2022. Quantitative data were subjected to a descriptive analysis, while qualitative data were subjected to content analysis. The new nurses in this study had a mean age of 24.51 years and total clinical experience of 11.18 months; 82.8% of the participants had experience in adult respiratory patient care, and 94.3% were aware of the need for this training. In the qualitative data analysis of six new nurses, all participants had experience with simulation training and were aware of its need. Moreover, all participants wanted repeated VR-based simulation training using real clinical cases. Regarding the qualitative data analysis of five nursing college educators, most of them had experience providing and receiving simulation training, and they were aware of its need in caring for respiratory patients. They reported the need for VR learning spaces that reflect the clinical environment, alongside sufficient duration and frequency of learning. Our findings could help develop simulation training programs for nursing students to assist adult respiratory patients. We provide a basis for developing VR-based simulation training for respiratory care by studying the current state of and demand for nurses' VR-based simulation training. The results can contribute to improving the quality of nursing for adult respiratory patients.

Development and evaluation of an external second victim support program for nurses: a single-group feasibility study

BackgroundPsychological support programs can help nurses who involved in patient safety incidents. However, most of these programs are operated internally by healthcare providers and utilize peer supporters, which may take a long time to implement. Therefore, there is a need to develop programs that can be used by healthcare providers in healthcare institutions that have difficulty implementing their own programs. This feasibility study aimed to develop an external support program for nurses as second victims and to examine the feasibility, acceptability, and impact of the program.MethodsThis study was conducted using a single-group pretest-posttest design. Nurses who experienced patient safety incidents were recruited through posters at three advanced general hospitals, as well as open online recruitment and via a research agency panel from September 2020 to April 2021. The 11 participants attended a total of three one-on-one counseling sessions. Feasibility was evaluated based on participant recruitment and retention, resource availability, program procedures, and the practicability of data collection. Acceptability was assessed through program satisfaction and participant feedback. Psychological impact was measured using the Impact of Event Scale-Revised Korean version.ResultsOut of 26 applicants, 11 (42.3%) completed the program, with 10 (38.5%) participants completing both pre and post-program surveys. Most participants responded that they were satisfied with the program and expressed their intention to recommend the program to others and participate in it again if similar situations arise. The participants’ median total IES-R-K score decreased significantly from 30.0 to 16.0 (p = 0.028, r = 0.67).ConclusionThis study demonstrates the feasibility of an external second victim support program and provides preliminary data suggesting its potential to alleviate the psychological impact of participants. To overcome the limitations of this study, it is necessary to conduct additional controlled trials with a longer follow-up period and a larger sample size.

An exploratory study of nursing tasks that induce physical and mental stress among hospital nurses

BackgroundNursing tasks are major contributing factors of nurses' stress. Identifying these stress-inducing tasks by hospital and department is the first step in devising practical strategies to address this issue. ObjectivesThis study aimed to develop a nursing task list by categorizing nursing tasks and identifying the ones that induced physical and mental stress among hospital nurses. MethodsThis descriptive exploratory study was conducted. In the first phase, the nursing task list was formulated based on a literature review and an expert content validity verification. In the second phase, the stress-inducing (both physical and mental) nursing tasks in different departments at two types of hospitals were investigated from 775 nurses. The data were analyzed using descriptive statistics, t-test, χ2 test and ANOVA performed using SPSS/WIN 26.0. ResultsThe nursing task of “exercise and position change” was identified to cause the highest physical stress across all five departments in both advanced general hospitals and general hospitals. Similarly, the nursing task “explanation of patients' condition upon request from the patients' family members” induced the greatest mental stress in both advanced general hospitals and general hospitals. Finally, “substitution for physicians: prescription” was identified as the greatest mental stress-inducing nursing task in general hospitals. ConclusionBased on a nursing task list developed, we determined which nursing tasks induce physical and mental stress in different departments at two types of hospitals. This foundational work will be crucial for exploring practical strategies to relieve nurses' stress.

Factors Related to Post-traumatic Stress Disorder Symptoms Among Intensive Care Unit Nurses

PurposeTo identify the factors affecting the post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses. The variables include event experiences, cognitive flexibility, and co-worker support. MethodsA survey was conducted among 153 ICU nurses working in a general hospital or an advanced general hospital. The questionnaire was completed between October and December 2018, and 153 copies were used for the final analysis. Data were analyzed using multiple linear regression to determine the factors associated with PTSD symptoms among ICU nurses. ResultsThe level of PTSD symptoms of ICU nurses was 1.20±0.82 out of 4. Full PTSD, signified by a total score of 25 or more, was reported by 45.1% of the study's 153 participants. The significant influencing factors of PTSD symptoms among ICU nurses were the “experience of traumatic events”, “trusted alliance”, which is a sub-area of “coworker support,” and both “control” and “alternative”, which are sub-areas of “cognitive flexibility.” The explanatory power (49.8%) was statistically significant. ConclusionThese results suggest that a program to enhance the cognitive flexibility and coworker support of ICU nurses needs to be developed to reduce the PTSD symptoms of ICU nurses.

의료시설의 유니버설디자인 적용 실태에 관한 연구

The purpose of this study is to examine previous studies with the aim of accommodating the needs of various users of domestic medical facilities and improving accessibility and usability of facilities, and to analyze obstacles in stages according to access to medical facilities and medical lines through current status surveys and expert interviews, and to propose a user-centered universal design approach. In order to present basic data on the universal design of medical facilities, this study first reviewed regulations applicable to domestic law and considered the classification system of medical facilities through consideration of laws related to domestic and foreign medical facilities. In addition, interviews with experts and users were conducted to identify the necessity of applying universal design to medical facilities and problems with current medical facilities, and problems and improvement directions were presented through a current survey of a total of 15 medical facilities from hospitals to advanced general hospitals. Through this, the laws related to the construction plan of medical facilities provided the basis for providing evidence, design, and installation guidelines from the perspective of universal design through the Building Act, the Medical Act, the Convenience Act for the Disabled, and the Fire Protection Act. Second, it is intended to derive elements necessary for the composition and planning of unit spaces such as ward space, treatment rooms, and examination rooms that are not presented in laws and guidelines. Third, medical facilities should be improved from a universal design point of view, taking into account the access and use of all users, and appropriate facilities and facilities for the contents stipulated by the Convenience Act, such as the disabled, are essential. In this respect, this study attempted to lay the basic foundation for the application of universal design in medical facilities, and it is expected to be used as basic data for medical service planning and medical facility construction planning in the future.

Determinants of workload-related clinician stress levels in general hospital consultation liaison psychiatry services during the COVID-19 pandemic in England and Ireland. Short report

ObjectiveTo explore workload-related stress levels experienced by consultation liaison psychiatry (CLP) staff in England and Ireland, and factors relevant to such a burden, during the COVID-19 pandemic. MethodsData were obtained for England and Ireland from a European survey among CLP services in general hospitals spread via CLP networks (11th June - 3rd October 2021). The heads of respective CLP services in general hospitals responded on behalf of each service, on 100 CLP hospital staff in total. Dependent variable: workload-related stress levels in CLP services due to COVID-19 (0–10 point scale). Independent variables: hospital size, CLP service size, degree of hospital involvement in COVID-19-related care, and the number of support options available to hospital staff. Spearman's rho correlation analyses were performed. ResultsThere was a significant association between the hospital's involvement in COVID-19-related care and workload-related stress levels as reported by CLP staff: r(22) = 0.41, p = 0.045, R2 = 0.17. There were no significant associations between workload-related stress levels and other variables including staff support (p = 0.74). ConclusionOur findings suggest that perceived workload-related stress levels of CLP staff during the COVID-19 pandemic can be an indicator of COVID-19 involvement of the hospitals. Staff support seemed not to alleviate work stress in the context of the pandemic. Healthcare policies should improve working conditions for CLP hospital staff that play an essential role from a population health perspective. Rigorous measures may be needed to ensure mental healthcare provision remains tenable and sustainable in the long term.

Factors Affecting Entrepreneurial Intention of Clinical Nurses in Korea: A Cross-sectional Study

Objectives: The purpose of this study was to identify the factors influencing the entrepreneurial intention of clinical nurses.Methods: The study subjects were 173 nurses working at the advanced general hospital located in G city. Data collection was conducted from May 18th to June 3rd, 2022. Data analysis were analyzed using percentage, mean and standard deviation, independent t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression with the SPSS 25.0.Results: Entrepreneurial intention had a significant positive correlation with attitude toward entrepreneurship, subjective norm toward entrepreneurship, perceived behavior control toward entrepreneurship, innovativeness, proactiveness, risk-taking incentives and entrepreneurial self-efficacy. As a result of a hierarchical multiple regression analysis, gender (β= 0.09, <i>p</i>= 0.046), turnover intention (β= 0.01, <i>p</i>= 0.016), attitude toward entrepreneurship (β= 0.51, <i>p</i>< 0.001), and proactiveness (β= 0.16, <i>p</i>< 0.016) were found to significantly influence entrepreneurial intention of clinical nurses. The explanatory power of the model was 70.5% (F = 35.87, <i>p</i>< 0.001).Conclusions: Entrepreneurship for nurses can broaden the range of career options available to nurses, and it can be a way to broaden their practice experience and provide a work-life balance. It is necessary to devise measures to activate nursing entrepreneurship based on the results of this study.

Effects of Nursing Work Environment on Intention to Stay of Hospital Nurses: A Two-Mediator Serial Mediation Effect of Career Motivation and Job-Esteem

This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses. Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program. The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r= .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09~.59]) and job-esteem (B = 0.27 [.04~.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem. In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses' motivation for career development and recognition of the nursing profession through improvement of the nursing work environment.

Related Factors to Readmission of Heart Failure Patients at an Advanced General Hospital in Korea

Objectives: This study was to provide supporting data to identify related factors of heart failure patients readmission. Methods: This study is a retrospective study of secondary data analysis using electronic medical record of patients who were discharged from advanced general hospital diagnosed with heart failure from April 2017 to March 2020. Results: A total of 267 (14.4%) of 1,857 heart failure patients was readmitted. Age, initial body weight, body weight change, pulse rate, hospitalization for 6 months prior or emergency room visit, number of medications, blood sampling result, main diagnosis of ER, and ACEI/ARB medication were found to be significantly related to readmission. As a result of multivariate logistic regression analysis, each increase in the number of discharge medications, the readmission rate increased by 3.0% (OR = 1.030, p &lt; 0.001). For each increase in Na level at admission and discharge, the readmission rate decreased by 5.4% (OR = 0.946, p = 0.021), 6.6% (OR = 0.934, p = 0.028). For each increase in the CRP level, the readmission rate decreased by 1.1% (OR = 0.989, p = 0.049) and AUC was 0.735. Conclusions: Based on the high-risk factors of readmission for heart failure patients identified in this study, patients centered nursing interventions should be developed to promote self-care practices.

The Effects of Communication Ability, Job Satisfaction, and Organizational Commitment on Nursing Performance of Intensive Care Unit Nurses

Purpose : This study aimed to provide basic data for developing strategies to improve the nursing performance of nurses working in the intensive care unit by identifying the degree of their communication ability, job satisfaction, organization commitment, and nursing performance, and the relation between each of these variables in the intensive care unit by examining the factors affecting nursing performance.Methods : The participants comprised of 150 nurses working in the intensive care unit in two advanced general hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, the Scheffé test, Pearson’s correlation coefficients, and multiple regression analysis using the SPSS/WIN 25.0 program.Results : Nursing performance of the participants was positively correlated with communication ability (r=.64, &lt;i&gt;p&lt;/i&gt;&lt;.001), job satisfaction (r=.26, &lt;i&gt;p&lt;/i&gt;&lt;.001), and organization commitment (r=.29, &lt;i&gt;p&lt;/i&gt;&lt;.001). Factors significantly influencing the participants’ nursing performance included academic background (&lt;i&gt;β&lt;/i&gt;=.16, &lt;i&gt;p&lt;/i&gt;=.032) and communication ability (&lt;i&gt;β&lt;/i&gt;=.50, &lt;i&gt;p&lt;/i&gt;&lt;.001). The explanatory power of these variables for nursing performance was recorded at 49.9% (F=19.04, &lt;i&gt;p&lt;/i&gt;&lt;.001).Conclusion : The use of various programs in the hospital and the development of effective communication ability with medical staff and other departments among nurses will help improve nursing performance, cooperation with other departments, and patient care.

Factors Associated With Post-Traumatic Growth in Korean Survivors of Childhood Cancer.

To analyze the effects of hope and self-efficacy on post-traumatic growth in survivors of childhood cancer in Korea and to identify factors affecting post-traumatic growth. Data of 117 survivors of childhood cancer aged 11 years or older either in treatment or follow-up recruited by convenience sampling at an advanced general hospital in Korea were analyzed. Using a self-reported structured questionnaire, data on hope, self-efficacy, and post-traumatic growth were analyzed using Pearson's correlation. Differences in post-traumatic growth according to general and disease-related characteristics (obtained from the survivors and their parents) were analyzed using t tests and analysis of variance. Factors affecting post-traumatic growth were investigated using multiple regression analysis. Post-traumatic growth showed significant positive correlations with hope and self-efficacy. Factors that significantly affected post-traumatic growth were presence of siblings, high economic status, and hope. To improve post-traumatic growth in survivors of childhood cancer, interventions should be developed to enhance hope. In addition, more efforts are necessary in terms of interventions to improve post-traumatic growth in survivors of childhood cancer without siblings or with low economic status.

Priority Need Analysis for Career Level-Based Nursing Management Competency Development of Advanced General Hospital Nurses

Priority Need Analysis for Career Level-Based Nursing Management Competency Development of Advanced General Hospital Nurses

Factors Affecting Radiation Protection Behaviors among Emergency Room Nurses.

This study aimed to examine factors affecting radiation protection behaviors among emergency room nurses by assessing knowledge about radiation protection and attitude towards radiation protection, employing a cross-sectional design. Subjects were a convenience sample of 129 nurses working in the emergency rooms of three advanced general hospitals. Data were collected using self-report questionnaires and analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. There were significant relations between knowledge about radiation protection and attitude towards radiation protection (r = 0.34, p < 0.001), knowledge about radiation protection and radiation protection behaviors (r = 0.37, p < 0.001), and attitude towards radiation protection and radiation protection behaviors (r = 0.33, p < 0.001). The factors affecting radiation protection behaviors were radiation protection knowledge (β = 0.12, p = 0.045), attitude towards radiation protection (β = 0.17, p = 0.009), the experience of radiation protection education (β = 0.27, p < 0.001), and wearing of protective equipment (β = 0.29, p < 0.001). The governments, hospital administrators, and radiation protection agencies should strengthen their radiation defense environment to protect emergency room nurses from radiation. Research and development of radiation defense equipment and the medical examination of emergency room nurses should be carried out, radiation defense behavior protocols should be developed, radiation defense education opportunities should be provided, and the use of defense equipment should be encouraged.

An analysis of patients referred to the advanced general hospital pain clinic center: multicenter study in province of Jeollabuk-do, Korea

The number of patients referred to pain clinic is increasing. The purpose of this study was to describe and understand characteristic of patients referred to the tertiary pain clinic. This study was conducted on 587 patients who had been referred to pain clinics at three university hospitals in the Jeollabuk-do region from January 2011 to December 2015. The data was retrospectively collected on a record sheet prepared in the clinic. we analyzed these patients according to their age, sex, chief complaint, pain location, coexisting disease, referring department, referral causes. There were various medical problems addressed by a pain clinic consultation. It is reasonable to develop standardized guidelines for pain management. To do so, it is necessary to identify the characteristics of the patients. A study with more patients in another area will be helpful in characterizing the patients referred to the pain clinic in Korea.

The Development and Effectiveness of a Self-Efficacy Enhancement Program for Older Adults With MCI

Purpose: This study aimed to develop a self-efficacy enhancement program and examine its effectiveness in enhancing dementia preventive behaviors by improving cognitive function, dementia knowledge, and self-efficacy, and reducing depression of older adults with mild cognitive impairment (MCI). Methods: An equivalent control group pretest-posttest design was conducted at an advanced general hospital in Seoul. Participants of older adults with MCI visiting clinics were randomly allocated to an experimental group (EG, n=16) and a control group (CG, n=16). The EG was provided with a 8-week intervention (60-minute, weekly) utilizing self-efficacy enhancement strategies and the CG received the usual care. The intervention was an integrated configuration making up of physical, cognitive, and emotional activity and followed by a 4-week maintenance during which both groups engaged in self-learning at home with a dementia preventive guidebook. Outcomes were evaluated at pretest, 1st (8th week), 2nd (10th week) and 3rd posttest(12th week). Results: There were significant differenes in cognitive functions, dementia knowledge, self-efficacy, and dementia preventive behaviors, but not in depression between two groups over the time. Regarding cognitive function’ subdomains, significant differences were observed for visuospatial/executive, attention, language, and delayed recall. Conclusions. The integrated intervention consisting of physical, cognitive, and emotional activities, not a simple merger of single intervention focused on cognitive reinforcement, was effective in improving their cognitive functions, dementia knowledge, self-efficacy, and dementia preventive behaviors. It suggests that this program can be utilized as an education program to prevent dementia for MCI in dementia support centers, public health centers, clinics, and hospitals.

Psychiatric Consultations in General Hospitals: A Scoping Review

Context: The rapid growth of psychiatric disorders requires psychiatric consultations to be provided on a greater scale, particularly for hospitalized patients. Objectives: The aim of this study was to evaluate the extent of psychiatric consultation requests in general hospitals and to identify potential gaps in the literature. Evidence Acquisition: This scoping review was based on relevant research published in Web of Science, Scopus, PubMed, Embase, and Cochrane (1977- Dec 2019). The collected literature was closely examined prior to selecting the applicable studies by means of peer review. Data were summarized within a framework of themes comprised of psychiatric consultation, prevalence of psychiatric disorders, hospital departments, diagnosis of psychiatric disorders, and nature of research prior to theoretical classification and tabulation. Results: Ultimately, 22 studies were included in this scoping review. Requests for psychiatric consultations were highest in Austria and Italy, with 22.6% and 13.6% of cases, respectively. The majority of requests were from internal and surgical departments. Consultations were requested more frequently for female patients compared to male patients. mood disorders and substance use disorder were the most diagnostic reports. Conclusions: Taking into consideration the prevalence of psychiatric disorders in patients suffering from physical illnesses, the referral rate results were considerably low. Although the frequency of psychiatric consultation reports vary widely between countries. As we limited the review to articles written in English, this may be due to selection bias. In this review, we identified that methodological differences and the use of different diagnostic criteria are major gaps that limit a definitive statistical comparison between studies.

Catatonia in clinical reality: underdiagnosed and forgotten

Catatonia is still a poorly understood, quite common, but often overlooked clinical picture. Consequences for patients are inadequate treatment, prolonged hospital stays and more serious complications. In this overview, the causes for an underdiagnosis are presented and measures for their prevention named, help for the differential diagnostic classification of catatonia is offered and the treatment is briefly explained. Catatonia is primarily associated with schizophrenia, but is also observed in other diseases such as neuroleptic malignant syndrome (MNS), in encephalitis and also in systemic diseases. Underdiagnosis can be avoided by simple measures such as a thorough physical examination, observance of verbal and non-verbal signs of catatonia, and psychiatric consultations in general hospitals. For the treatment of acute catatonia, the high-dose administration of benzodiazepines and electroconvulsive therapy are recommended.

A predictive model on the hospital nurses' psychological well-being.

The purpose of this study is to test a structural model that analyzes and comprehensively identifies the factors that affect the psychological well-being of hospital nurses, and to reveal the direct and indirect relationships among the factors. The subjects of this study were 217 nurses working in four advanced general hospitals in Metropolitan City B and Province G with at least one experience of job rotation. Data were analyzed using SPSS 21.0. The characteristics of subjects and the reliability of the research tools were analyzed through descriptive statistics, a t-test, an analysis of variance, and correlation analyses on the research variables. A confirmatory factor analysis was performed using AMOS 21.0 to verify the fitness of the hypothetical model and hypothesis. The test of fitness of the hypothetical model yielded χ2 = 152.14, df = 72, χ2 /df = 2.11, goodness of fit index = .97, adjusted goodness of fit index = .91, normed fit index = .95, comparative fit index = .98, root mean square = .02, and root mean square error of approximation = .01, which showed that the model had a good fit and explained 63.0% of the variance in psychological well-being. The hypothesis of the study was verified: Nurses' job rotation stress has indirect effect on psychological well-being through self-efficacy, social support, optimism, and coping strategies. A practical method that can promote self-efficacy, social support, optimism, and stress-coping strategies must be established to improve the psychological well-being of hospital nurses based on this research.

Real-world experiences of apremilast in clinics for Japanese patients with psoriasis.

Psoriasis, though not an immediately life-threatening disorder, still lowers quality of life and disrupts daily functions. While many treatments for psoriasis exist, few are convenient and safe long term; even if sufficiently effective, treatments themselves often decrease quality of life and make long-term treatment adherence difficult. Approved in Japan in December 2016, apremilast was expected to function as a simple, long-term, systemic therapeutic agent for psoriasis. We report on the clinical outcomes of administrating apremilast for 2years as observed in 46 psoriatic patients at the Saruwatari Dermatology Clinic between March 2017 and February 2019. We believe the ease of clinic consultation (as compared with large general hospital consultation) draws patients who are busy or have mild symptoms, and consequently poor adherence to regular visits and treatment, reflecting realistic conditions. Major adverse events with apremilast treatment were diarrhea (37.0%) and nausea (15.3%), with most cases of diarrhea being mild. Drug survival analysis by the Kaplan-Meier method revealed a 1-year continuation rate of 46.8% and a 2-year continuation rate of 37.4%. Dermatology Life Quality Index (DLQI) scores during the observation period declined from 9.3 to 2.8 (P<0.0001) on average, with the DLQI-0/1 achievement rate being 28.6%. Based on our findings, we conclude that apremilast is suitable as a long-lasting basic treatment that is easy to prescribe in small clinics and easy to use in everyday life.

중환자실 간호사의 섬망 지식, 섬망 이미지 및 섬망 사정 정확도: 예비 연구

Purpose: The purpose of this study was to identify the general characteristics of intensive care unit nurses and investigate their knowledge and images of delirium, as well as the accuracy of their delirium assessments. Methods: This was a descriptive pilot study. The participants were 84 nurses in intensive care units in two advanced general hospitals. Data were collected using nurses’the knowledge and images of delirium and the accuracy of delirium assessment. Data were analyzed using descriptive statistics. &#x0D; Results: The mean score of nurses’knowledge of delirium was 74.6 out of 100. With regard to their images of delirium, alternatively,“uncooperative” received the highest, while “lethargy” received the lowest score on the list. The mean score of the accuracy of their delirium assessments was 60 out of 100. &#x0D; Conclusion: This pilot study’s results can serve as basic data to develop proper delirium education programs for nurses. These findings suggest that increasing nurses’knowledge about and reducing their negative images of delirium can have a positive impact on the accuracy of their delirium assessments.