[논문]Effects of an Algorithm-based Education Program on Nursing Care for Children with Epilepsy by Hospital Nurses

Lee, Jung Hwa; Ju, Hyeon Ok; Lee, Yun Jin

doi:10.4094/chnr.2019.25.3.324

Effects of an Algorithm-based Education Program on Nursing Care for Children with Epilepsy by Hospital Nurses 원문보기

CHNR : Child health nursing research, v.25 no.3, 2019년, pp.324 - 332

Lee, Jung Hwa (Pusan National University Yangsan Hospital) , Ju, Hyeon Ok (Department of Nursing, Dong-A University) , Lee, Yun Jin (Department of Pediatrics, Pusan National University Children's Hospital, School of Medicine, Pusan National University)

Abstract ▼ AI-Helper

Purpose: Epilepsy is the most common neurological disorder in childhood. Hospital nurses, who are the first to recognize seizures in epilepsy patients in the ward environment, possess expertise related to epilepsy and play a central role in epilepsy management. The purpose of this study was to develop an algorithm-based education program and to improve nurses' knowledge and self-efficacy related to providing nursing care to children with epilepsy. Methods: The education program consisted of lectures on the definition, cause, classification, diagnosis, treatment, and nursing of epilepsy based on a booklet, as well as practice using an algorithm for nursing interventions when a child experiences a seizure. Twenty-seven nurses working at pediatric neurological wards and a pediatric emergency room participated in the education program. The data were analyzed using descriptive statistics and the paired t-test. Results: Nurses' knowledge and self-efficacy showed a statistically significant improvement after participation in the education program on nursing care for children with epilepsy. Conclusion: The application of this education program for hospital setting is expected to improve nurses' capability to care for children with epilepsy, thereby contributing to a higher quality of nursing.

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문제 정의

The purpose of this study was to develop an algorithmbased education program for hospital nurses caring for children with epilepsy and to investigate the effects of the education program.
The purpose of this study was to improve nurses’ knowledge of epilepsy and self-efficacy related to caring for children with epilepsy by providing them with an algorithm-based education program about how to care for children with epilepsy.
In medicine, several studies have explored algorithmbased education [13,22], but in nursing there is a lack of research on this topic. This study will contribute to expanding algorithm-based education programs to help nurses make decisions.

가설 설정

1) Hospital nurses would have better knowledge of epilepsy after participation in the education program.
Hypothesis 1 stated that clinical nurses would have better knowledge about nursing care for children with epilepsy after participation in the algorithm-based education program. Statistically significant differences in the nurses' knowledge of epilepsy were found before and after participation in the education program.
Hypothesis 2 stated that clinical nurses would have better self-efficacy related to providing nursing care to children with epilepsy after participation in the algorithm-based education program. Statistically significant differences were found in the nurses' self-efficacy before and after participation in the education program.

제안 방법

In total, 27 nurses consenting to participate in this study were personally given an explanation about its purpose and methods by the researcher and were asked to provide a written consent. Before the education session, a pretest was performed to determine the general characteristics of the participants, their knowledge of epilepsy, and their selfefficacy. Post-tests were performed to evaluate the nurses' knowledge of epilepsy and self-efficacy, immediately after the end of the education session and 1 week after the education session.
The participants practiced with nursing interventions during seizure for 20 minutes. First of all, a researcher showed two YouTube videos (https://youtu.be/vSnRdmR6xcE, https://youtu.be/TcSegvM0qOk) of children having a seizure (with or without difficulty in breathing), and she demonstrated the appropriate nursing intervention for each type of seizure according to the algorithm developed in this study. The seizure videos took 1 or 2 minutes.
First, It is necessary to study whether the effect of the algorithm- based education program for the nursing of children with epilepsy lasts longer than 1 month using a randomized control group design.
A booklet was developed by the authors for training nurses on how to provide nursing care for children with epilepsy. It was composed of 20 pages and covered the definition and causes of epilepsy, its classification and common types of seizures, and its diagnosis, treatment, and nursing care. The contents were presented in simple figures and charts so that nurses could easily understand and apply them.
It was designed to improve nurses’ knowledge of epilepsy in children and to make good use of nursing interventions when children with epilepsy experience a seizure.
Post-tests were performed to evaluate the nurses' knowledge of epilepsy and self-efficacy, immediately after the end of the education session and 1 week after the education session.
The contents were presented in simple figures and charts so that nurses could easily understand and apply them. The booklet was evaluated by a professor of child nursing at the first step. Some of the initial educational content was not for nurses, but for parents of children with epilepsy; based on feedback at this stage, all materials were changed to provide educational content for nurses.
Some of the initial educational content was not for nurses, but for parents of children with epilepsy; based on feedback at this stage, all materials were changed to provide educational content for nurses. The booklet was then evaluated by a pediatric neurologist and three nurses with more than 5 years of career experience in nursing children with epilepsy, and no further revisions were made.
The educational materials were developed through a interview with nurses on the educational needs and a literature review. The content of the educational booklet included the definition, classification, diagnosis, treatment, and nursing of epilepsy. Nursing care was developed in the form of an accessible algorithm for nurses to apply in cases of seizure in children with epilepsy, which was the area where the educational needs of the nurses were highest.
Content regarding the definition, causes, classification, diagnosis, treatment, and nursing of epilepsy was developed in the form of a booklet. The content regarding nursing care in cases of seizure in children with epilepsy, for which the nurses expressed the highest level of educational need, was developed in the form of an algorithm that provided guidance on the most appropriate nursing intervention based on the type of seizure, with the aim of making the material more applicable.
The education site and time were determined with the cooperation of the educator in the department of nursing at the hospital and the nurse manager of each ward, and one education was conducted in a seminar room within the hospital in a group setting. The material on the definition, classification, diagnosis and treatment of pediatric epilepsy was taught by a pediatric neurologist for 30 minutes, while the material on nursing care for children with epilepsy was taught for 10 minutes by a nurse, using the booklet developed by the researchers.
The participants practiced with nursing interventions during seizure for 20 minutes. First of all, a researcher showed two YouTube videos (https://youtu.
The training program in this study was a group-based education session for 27 nurses; however, as with education using case- or -simulation-based scenarios, it improved the nurses’ knowledge of epilepsy and self-efficiency.
A nurse, who had worked for more than 7 years in a pediatric neurological ward and a pediatric neurologist developed an algorithm for nursing interventions when seizures occur in children with epilepsy in hospital settings. This algorithm was evaluated by a professor of child nursing and four nurses with more than 5 years of experience in nursing children with epilepsy, and was not modified at all. The algorithm for nursing intervention during seizure for children with epilepsy was applicable to clinical practice to serve as an available guideline to consult when patients experienced difficulty in breathing (Figure 1).
This study is significant in that it developed an education program for hospital nurses caring for children with epilepsy, along with YouTube videos and an algorithm-based practical training program, which improved participants’ knowledge of epilepsy and self-efficacy in providing nursing care for children with epilepsy, a population for which limited nursing protocols and guidelines.
This study used a pre-test and post-test design to evaluate the effectiveness of an algorithm-based education program on nurses’ knowledge of epilepsy and self-efficacy related to caring for children with epilepsy.
This study utilized a pre-test and post-test design to identify the effects of an algorithm-based education program on hospital nurses’ epilepsy-related knowledge and self-efficacy.

대상 데이터

A tool for measuring knowledge of epilepsy in childhood was developed by the researcher on the basis of a literature review[1,16,17]. It was tested for content validity by a pediatric neurologist, a professor of child nursing, and three nurses who had worked for more than 10 years in pediatric neurological wards. Its content validity was confirmed, as the content validity index (CVI) was more than .
[20] was adapted to providing nursing care for children with epilepsy in this study. It was tested for content validity by a professor and a doctoral candidate of child nursing, along with three nurses who had worked for more than 10 years in pediatric neurological wards. It exhibited content validity, with the CVI being 1.
The participants in this study were nurses working in wards for the hospitalization of children with neurological disease at P National University Children's Hospital, Y city.
05 significance level on the basis of the paired two-sided t-test. This study was conducted among 27 persons, taking a dropout rate of 10% into consideration.

데이터처리

The paired t-test was carried out before and after the educational intervention to analyze the nurses' knowledge of epilepsy and self-efficacy.

이론/모형

The paired t-test was carried out before and after the educational intervention to analyze the nurses' knowledge of epilepsy and self-efficacy. All p-values were adjusted using the Bonferroni correction.

성능/효과

The nurses scored higher for self-efficacy related to providing nursing care for children with epilepsy immediately after their participation in the education program, and the scores remained elevated a week later. Auberry and Cullen [25], who applied an evidence-based seizure algorithm to nurses in the field of intellectual disability, reported that they became more confident in telephone triage.

후속연구

Second, It is necessary to encourage self-directed learning by nurses who care for children with epilepsy as part of further research on the development and effects of a web-based education program.

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표제어: PCR

동의어: Packet Collision Rate

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용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

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