This study aimed to assess intensive care unit (ICU) nurses' experiences caring for delirious patients and the empirical evaluation of the clinical feasibility of the confusion assessment method (CAM) for ICU (CAM-ICU). In Korea, neither regular assessment of early-stage delirium nor preventive interventions are carried out properly in the ICU. This study was conducted using a qualitative research design with focus group interviews. Nurses received training about the CAM-ICU, and used it to assess surgical ICU patients for the presence of delirium during a 5-month period. None of the nurses had heard of the CAM-ICU before the study, and many complained that it was very challenging to use. One positive outcome of the CAM-ICU trial was that the clinical interest in delirium increased. The CAM-ICU could be used to facilitate communication once the instrument becomes well-known among health care professionals.
Institutional discrimination matters. The purpose of this longitudinal communitybased participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community-based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less "[when]different cultural ways of doing things were shared, the project did not support my way" from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed-rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems.
A user-centered, Web-based depressive symptoms management system might be particularly useful in Korea, where those who seek mental health care face stigmatizing and where personal computers and the Internet have reached saturation levels. The purpose of this article is to describe the development process of a Web-based system for depressive symptom management through user-centered design principles. Our design process included four distinct phases: a needs assessment, analysis, design/development/testing, and the application release. The final revised website was released with the URL address, "http://www.baejy.com/smiles/". In the 3 years since the site was made available publicly, it is notable that 161,604 Koreans have accessed this website, either for educational purposes or for managing their depressive symptoms. A Web-based depressive symptom management system with a high degree of usability was developed. This website can be used to assess depressive symptoms and to serve as an intervention strategy to improve mental health.
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