Development and Effects of a Nursing Education Program Using Virtual Reality for Enhancing Clinical Decision-Making Ability in Respiratory Disease Nursing Care

Purpose: This study was conducted to develop and examine the effects of a nursing education program using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care by assessing students’ confidence in performance, clinical decision-making ability, practice flow, class evaluations, and simulation design evaluations.Methods: This study was developed based on the Jeffries simulation model and 5E learning cycle model, blending a virtual reality simulation and high-fidelity simulation. The participants were 41 third-year nursing students with no virtual reality and simulation education experience. The experimental group (n=21) received the virtual reality program, while the control group (n=20) received traditional simulation education. Data were collected from March 8 to May 28, 2021 and analyzed using SPSS version 27 for Windows.Results: Statistically significant differences were found between the experimental group and the control group post-intervention in confidence in performance (F=4.88, p=.33) and clinical decision-making ability (F=18.68, p＜.001). The experimental group showed significant increases in practice flow (t=2.34, p=.024) and class evaluations (t=2.99, p=.005) compared to the control group.Conclusion: Nursing education programs using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care can be an effective educational strategy in the clinical context.

Factor Influencing Learning Outcome in Nursing Education Using Gamification: A Scoping Review

Purpose: This review explored trends in studies on learning outcomes in nursing education using gamification, to provide directions for future research.Methods: This scoping review was conducted according to the Joanna Briggs Institute's guidelines. The literature search date was February 1, 2021.Results: Thirty-two studies were included. The largest proportion of studies were quantitative descriptive studies, including qualitative mixed methods (34.4%). More studies applied gamification in practical classes (53.1%) than in theoretical classes. Virtual simulation games (37.9%) and simple quiz games (34.4%) were most often used. Commonly used gamification elements included scores/points, feedback, badges, countdowns, challenges, competitions, and levels. Two themes emerged regarding the impact of gamification on learning: learners’ experiences and achievement outcomes with cognitive, affective, and psychomotor subthemes. Nursing education using gamification improved engagement, motivation, and learning achievement. However, there was less evidence for affective and psychomotor outcomes than for cognitive outcomes.Conclusion: Gamification can be an effective educational strategy if educator's have sufficient understanding and readiness and appropriate gamification elements are applied to nursing education. Further research should investigate knowledge retention in the cognitive domain, collaboration and empathy in the affective domain, and the improvement of nursing skills using new technologies in the psychomotor domain.

Relationship between Social Network Characteristics, Flow in Class, Communication Skills, and Problem-solving Skills of Nursing Students in Simulation Nursing Education: Focusing on Social Network Analysis

Purpose: The purpose of this study was to investigate the relationship between social network characteristics, flow in class, communication skills, and problem-solving skills of nursing students in simulation.Methods: For this study a descriptive survey design was used. Participants were 100 nursing students who attended in 2 university and completed the self-report questionnaire. Data were collected from October 14 to December 6, 2019 and were analyzed with SPSS 26.0, AMOS 21.0 and Netminer 4 evaluation version.Results: It was confirmed that the task advice network centrality of nursing students fully mediates their communication skills and affects their problemsolving skills and that friendship network centrality completely mediates flow in class and communication skills, and affects problem-solving skills. Task advice network centrality, friendship network centrality, flow in class, and communication skills were found to explain problem solving skills by 51.8%.Conclusion: In order to increase the problem-solving skills of nursing students in simulation nursing education, a strategy to improve their flow in class and communication skills is essential and it suggests the need to make it part of the curriculum. In addition, in order to increase the communication skills of nursing students, it is necessary to be careful when making a team to minimize the team members isolated within the team so that smooth interaction can occur.

The Relationships among Social Support, Bowel Function Symptoms and Uncertainty in Rectal Cancer Patients

Purpose: This study examined the mediating effect of bowel function symptoms in the relationship between social support and uncertainty in rectal cancer patients.Methods: In total, 132 rectal cancer patients were recruited online. Data were collected from October 1, 2020 to October 31, 2020 using on-line questionnaires and were analyzed using the t-test, analysis of variance, Pearson correlation coefficients and bootstrapping for mediation.Results: Social support had a significant and positive effect on bowel function symptoms and a negative effect on uncertainty. Bowel function symptoms had a significant negative effect on uncertainty; and showed a statistically significant mediating effect in the relationship between social support and uncertainty. In other words, social support had direct and indirect effects on uncertainty.Conclusion: In rectal cancer patients, social support attenuated bowel function symptoms and showed direct and indirect effects on uncertainty. Therefore, to increase the social support of rectal cancer patients, the patients’ family, friends, and meaningful others should be involved in providing nursing. In order to reduce bowel function symptoms, which have a mediating effect, rectal cancer patients need to be well aware of the symptoms of bowel function that change after surgery. Systematic pre- and post- operative education would be help reduce uncertainty.

The Effects of Classes using Virtual Reality Simulations of the Hospital Environment on Knowledge of the Hospital Environment, Academic Self-efficacy, Learning Flow, Educational Satisfaction and Academic Achievement in Nursing Students

Purpose: This study examined the effects of virtual reality (VR)-based fundamental nursing education on nursing students’ knowledge of the hospital environment, academic self-efficacy, learning flow, educational satisfaction, and academic achievement.Methods: In total, 137 nursing students participated in this non-equivalent control group pretest-posttest study, with 69 and 68 in the experimental and control groups, respectively. Differences in the dependent variables between the two groups before and after the intervention were compared using the independent-sample t-test and Mann-Whitney U test.Results: The VR intervention group showed significantly higher knowledge of the hospital environment (t=3.88, p<.001), educational satisfaction (z=-3.82, p<.001), and academic achievement (z=-2.54, p=.011) than the control group.Conclusion: These findings indicate that VR-based education is an effective intervention for improving knowledge of the hospital environment, educational satisfaction, and academic achievement in nursing education.

The Influence of Self Esteem and Sexual Communication on Sexual Satisfaction of Colorectal Cancer Women with Ostomy

Purpose: The purpose of this study was to identify the influence of self-esteem and sexual communication on sexual satisfaction among female colorectal cancer patients with ostomy.Methods: A cross-sectional descriptive study was conducted using self-reported online questionnaires. The participants were 85 women with colorectal cancer who had undergone ostomy formation surgery. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, correlation coefficients, and hierarchical multiple regression with SPSS version 26.0.Results: The mean sexual satisfaction score was 2.79±0.73 (range, 0~5). There was no significant relationship between self-esteem and sexual satisfaction. Sexual communication had a significant correlation with sexual satisfaction (r=.83, p<.001) and was a strong predictor of sexual satisfaction (β=.83, p<.001).Conclusion: The findings of this study indicate that colorectal cancer patients with ostomy experience low sexual satisfaction and that sexual communication is a meaningful factor for sexual satisfaction. Accordingly, nurses need to factor in sexual issues when caring for patients, and should encourage both patients and their partners to participate in education related to sexual health. It will also be helpful to inform patients about the importance of sexual communication with their partners as a sustainable intervention.

Changes in Empathy of Nursing College Students: A Cohort Longitudinal Study

Purpose: This study aimed to identify changes in sub-areas of empathy over the 4 years from admission to graduation of nursing college students.Methods: This descriptive survey study was conducted using a longitudinal cohort design. The participants in this study were 158 South Korean nursing students attending a university in Chungcheongbuk Province or Gyeonggi Province, all of whom passed the certification evaluation for the 4-year nursing educational institute. Data from 126 participants were analyzed. The level of empathy was measured five times from March 2012 to December 2015. Empathy was identified using a multi-dimensional measurement tool consisting of four sub-constructs of cognitive and emotional aspects: (1) perspective taking, (2) fantasy, (3) empathic concern, and (4) personal distress. Data were analyzed using SPSS version 25 to provide descriptive statistics of the participants’ general characteristics and empathy level and to perform repeated-measures analysis of variance for the sub-constructs empathy.Results: Perspective taking (F=13.08, p<.001) and personal distress (F=5.24, p=.001), but not fantasy or empathic concern, showed significant differences over time.Conclusion: Cognitive empathy (perspective taking) and emotional empathy (personal distress) improved. Intervention programs should be developed to maintain and strengthen changes in empathy in nursing education.

Factors Associated with Intention to Comply with Infection Control Guidelines in Physicians and Nurses: An Analysis Based on the Theory of Planned Behavior

Purpose: This study aimed to identify factors affecting physicians and nurses’ intention to comply with healthcare-associated infection control guidelines, based on the theory of planned behavior.Methods: This study was a cross-sectional, descriptive survey. Data were collected using self-report questionnaires from 169 doctors and nurses at a tertiary hospital. Pearson correlation analysis and multiple regression analysis were used to analyze the factors influencing intention to comply with healthcare-associated infection control guidelines.Results: The mean score of intention to comply with infection control guidelines was 17.17±2.60 points (possible range 3-21 points). The intention to comply with infection control guidelines was positively associated with subjective norms and perceived behavioral control over compliance with healthcare-associated infection control guidelines. In the multiple regression analysis, perceived behavioral control was the only significant predictor of intention to comply with healthcare-associated infection control guidelines.Conclusion: In order to encourage doctors and nurses to comply with infection control guidelines, it is necessary to provide resources, enhance the work environment, and utilize strategies to increase perceived behavioral control over compliance with infection control guidelines.

Factors Influencing the Quality of Life among Family Caregivers of the Elderly with Dementia

Purpose: The purpose of this study was to identify quality of life of family caregivers and to investigate factors positively and negatively affecting family caregivers’ quality of life.Methods: Participants were 153 family caregivers taking care of dementia elderly. Collected data were general characteristics, quality of life, care burden, depression, social support, family relationship, and problematic behaviors. Data were analyzed using descriptive statistics, independent t-tests, Pearson correlation coefficient, and multiple regression.Results: Mean age of participants was 58.70±13.88. The average scores of main variables for family relationship, social support, quality of life, care burden, problematic behaviors and depression were 3.99±1.08, 3.34±0.84, 3.00±0.63, 1.96±0.51, 1.48±1.06, 1.17±0.71 and 1.13±0.61, respectively. In regression analysis, depression (β=-.20), subjective health (β=.26), social support (β=.23), education level (β=-.20), and care burden (β=-.22) accounted for 59.1% of the variance in quality of life.Conclusion: To increase quality of life for family caregivers, interventions should be focused on reducing depression and care burden, enhancing caregiver’s health and social support. especially for family caregivers who received lower education.

Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards

Purpose: This study investigated differences in the clinical outcomes of cardiopulmonary resuscitation (CPR) of patients hospitalized in general wards according to the operation of a rapid response team.Methods: This retrospective study included 122 patients over the age of 19 who were admitted to general ward of a hospital located in Suwon, between July 1, 2015 and December 31, 2019, and received CPR during the operating hours of the rapid response team. The collected data were analyzed by descriptive statistics, the x2 test, Fisher's exact test, and one-way analysis of variance using SPSS for Windows version 25.0.Results: The proportion of nurses who were the initial responders to cardiac arrest was 79.1% during the extended-operation period. 41.2% during the pre-operation period, and 42.2% during the limited-operation period (p<.001). The rate of good neurological recovery at discharge post-CPR was 25.0% in patients who received CPR during the pre-operation period, 36.4% during the limited-operation period, and 87.5% during the extended-operation period (p=.042).Conclusion: This study identified clinical outcomes in patients who received CPR according to the operation status of the rapid response team. These results are expected to help in the further implementation of rapid response teams.