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Choi, Jang, Choi, Lee, Seo, and Park: Comparison of Domestic and International Research (1992-2011): Intensive Care Nursing Studies
Original Article

Korean J Adult Nurs 2015;27(4):384-396.

Published online: NaN August 2015

DOI: https://doi.org/10.7469/kjan.2015.27.4.384

Comparison of Domestic and International Research (1992-2011): Intensive Care Nursing Studies

Eun Hee Choi1, Eun Hee Jang2, Ji Youn Choi3, So Jung Lee4, Hyo Kuyng Seo4, Kyung Sook Park5

1Department of Nursing, Korean Bible University, Seoul

2Department of Nursing, Woosuk University, Wanju

3Infection Control Team, Chung-Ang University Hospital, Seoul

4Department of Nursing, Chung-Ang University Hospital, Seoul

5Red Cross College of Nursing, Chung-Ang University, Seoul, Korea

Corresponding author: Jang, Eun Hee Department of Nursing, Woosuk University, 443 Samnye-ro, Samnye-eup, Wanju 565-701, Korea. Tel: +82-63-290-1759, Fax: +82-63-290-1548, E-mail: jangeh@woosuk.ac.kr

Received 8 April 201510 August 2015       Accepted 13 August 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to describe the approaches, methods and questions asked in intensive care unit studies published in Korean journals and the American Journal of Critical Care (AJCC) from 1992 to 2011. Only quantitative studies were reviewed.

Methods

A total of 144 studies published in four Korean Journals and 521 studies published in American Journal of Critical Care (AJCC) were analyzed using descriptive statistics.

Results

The most frequently used research design reported in Korean journals were surveys (83.5%), protocol development (10.1%), and randomized controlled trials (6.2%). In AJCC, the most frequently reported design was survey research (90.4%) and randomized controlled trials (16.1%). The most frequent nursing intervention reported in the AJCC was tube care (10.8%), and in Korean journals the intervention of suctioning (10.8%). In Korea, nurses were more likely to study instrument measurements (31.0%) and positioning (13.5%). In reported studies in the AJCC there were more reports on emotional support, exercise, and measurement research.

Conclusion

There is overlap in the type of studies between the two countries in term of study design, whereas the types of nursing problems studied differed in United States and Korea. The result suggests that there were gaps and those more diverse studies and physiological measurements are needed.

Keywords: Intensive care, Nursing research, Trend

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Table 1.
Overall Analysis of Domestic Research (N=144)
Characteristic Categories Non-experimental Experimental Total
n (%) n (%) n (%)
Research type Study design ID 11 (13.9) Non-RCT 60 (92.3)  
  Review 2 (2.5) RCT 5 (7.7)  
  Survey 66 (83.5)      
  Total 79 (54.9) Total 65 (45.1) 144 (100.0)
Research participants Patients 40 (50.6) 49 (75.4) 89 (61.8)
Family 4 (5.1) 3 (4.6) 7 (4.9)
Nurse 25 (31.6) 10 (15.4) 35 (24.3)
Doctor/nurse/patients 5 (6.3) 2 (3.1) 7 (4.9)
Unit/environment 5 (6.3) 1 (1.5) 6 (4.2)
Data collection method Questionnaire 35 (44.3) 19 (29.2) 54 (37.5)
Medical record 20 (25.3) 1 (1.5) 21 (14.6)
Observation 13 (16.5) 22 (33.8) 35 (24.3)
Physiological measure 4 (5.1) 23 (35.4) 27 (18.8)
Group interview 1 (1.3) 0 (0.0) 1 (0.7)
Others 6 (7.6) 0 (0.0) 6 (4.2)
Criteria for sample size Reported 17 (21.5) 21 (32.3) 38 (26.4)
Not reported 62 (78.5) 44 (67.7) 106 (73.6)
IRB Reported 7 (8.9) 10 (15.4) 17 (11.8)
  Not reported 72 (91.1) 55 (84.6) 127 (88.2)
Permission for instrument use Reported 1 (1.3) 1 (1.5) 2 (1.4)
Not reported 78 (98.7) 64 (98.5) 142 (98.6)

ID=instrument development; RCT=randomized controlled trials; IRB=international review board.

Table 2.
Overall Analysis of International Research (N=521)
Characteristic Categories Non-exp perimental Experimental Total
n (%) n (%) n (%)
Research type Study design ID 35 (9.6) Non-RCT 130 (83.0) 521 (100.0)
  Survey 331 (90.4) RCT 25 (16.1)  
  Total 366 (70.2) Total 155 (29.8)  
Research participants Patients 221 (60.4) 143 (92.3) 364 (69.9)
Family 10 (2.7) 4 (2.6) 14 (2.7)
Nurse 85 (23.2) 7 (4.5) 92 (17.7)
Doctor/nurse/patients 38 (10.4) 0 (0.0) 38 (7.3)
Unit/environment 12 (3.3) 1 (0.6) 13 (2.5)
Data collection method Questionnaire 114 (31.1) 11 (7.1) 125 (24.0)
Medical record 108 (29.5) 8 (5.2) 116 (22.3)
Observation 0 (0.0) 74 (47.7) 74 (14.2)
Physiological measure 58 (15.8) 60 (38.7) 118 (22.6)
Group interview 31 (8.5) 0 (0.0) 31 (6.0)
Others 55 (15.0) 2 (1.3) 57 (10.9)
Criteria for sample size Reported 20 (5.5) 4 (2.6) 24 (4.6)
Not reported 346 (94.5) 151 (97.4) 497 (95.4)
IRB Reported 144 (39.3) 51 (32.9) 195 (37.4)
  Not reported 222 (60.7) 104 (67.1) 326 (62.6)

ID=instrument development; RCT=randomized controlled trials; IRB=international review board.

Table 3.
Keyword Classification of Domestic Research
Domain Classification Variables 1992~ 1999 2000~ 2003 2004~ 2007 2008~ 2011 Total
n (%) n (%) n (%) n (%) n (%)
Human Patients Critical illness (42), elderly (2), respiratory (2), 15 (32.6) 18 (22.2) 24 (25.0) 31 (25.8) 88 (25.7)
cardiovascular (8), neurologic (12). intubation          
/tracheostomy (6), ventilator (14), transplantation(1)          
Family Ill patient family (7) 0 (0.0) 4 (4.9) 2 (2.1) 2 (1.7) 8 (2.3)
Nurse Nurse (32), new nurse (2), advanced practice nurse (2) 6 (13.0) 12 (14.8) 14 (14.6) 18 (15.0) 50 (14.6)
Health Patient emotion Stress (1), anxiety (4), discomfort (1), emotional 3 (6.5) 2 (2.5) 2 (2.1) 2 (1.7) 9 (2.6)
reaction(1), experience (2)          
Nurse emotion Stress (2), attitude (4), perception(1), knowledge (5), 0 (0.0) 3 (3.7) 4 (4.2) 6 (5.0) 13 (3.8)
turnover intention(1),          
Family emotion Burden(2), stress (2), anxiety (1), experience (2), 1 (2.2) 2 (2.5) 2 (2.1) 2 (1.7) 7 (2.0)
satisfaction(2)          
Sleep Affect factor (5), sleep enhancement nursing (3) 2 (4.3) 1 (1.2) 2 (2.1) 3 (2.5) 8 (2.3)
Pressure ulcer Affect factor (1), intervention(1), assessment scale (3), 2 (4.3) 2 (2.5) 1 (1.0) 1 (0.8) 6 (1.7)
current status (1)          
Delirium Nurse knowledge (1), risk factor (2), protocol (1) 0 (0.0) 0 (0.0) 1 (1.0) 3 (2.5) 4 (1.2)
Ethics Organ donation(1), DNR (1), 0 (0.0) 1 (1.2) 1 (1.0) 1 (0.8) 3 (0.9)
terminating of life support (2)          
Pain Nurse back pain (1) 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.8) 1 (0.3)
Environment Infection control UTI (6), BSI (1), hand hygiene (6), MRSA (6), VRE (1), 3 (6.5) 9 (11.1) 8 (8.3) 8 (6.7) 28 (8.2)
MDR (1), VAP(5), others (2)          
Nursing administratio workload(2), performance (2), 0 (0.0) 4 (4.9) 5 (5.2) 5 ()4.2) 14 (4.1)
on nurse-to-patient ratio(2), role (3), nursing cost (1),          
program(1), national health insurance (1), others (2)          
Nursing Intervention Family intervention(2), adequacy (2), procedure 3 (6.5) 9 (11.1) 17 (17.7) 14 (11.7) 43 (12.5)
effect (1), intervention effect (16), oral care (3),          
position (2), music therapy (1), tube care (3),          
CRRT (1), simulation (1), others (9)          
Instrument APACHE (5), patient severity classification tool (3), 5 (10.9) 6 (7.4) 1 (1.0) 8 (6.7) 20 (5.8)
assessment scale (2), NIC(1), practice environment          
scale (1), admission/discharge criteria (1), ulcer risk          
assessment scale (2), national health insurance (1),          
delirium protocol (1), MPM(1), others (2)          
Suction Closed suction(3), suction method (3), 0 (0.0) 2 (2.5) 2 (2.1) 3 (2.5) 7 (2.0)
survey of suction performance (1)          
Restraints Nurse attitude (1), nurse education(1), 1 (2.2) 1 (1.2) 2 (2.1) 3 (2.5) 7 (2.0)
knowledgement (1), development (3), survey (1)          
Prognosis Mortality (2), recovery rate (1), scale comparison(1), 0 (0.0) 1 (1.2) 2 (2.1) 3 (2.5) 6 (1.7)
ulcer incidence rate (1), GCS (1)          
Nutrition Feeding tube (2), enteral feeding (4), 2 (4.3) 2 (2.5) 1 (1.0) 1 (0.8) 6 (1.7)
intake/output (1)          
Airway care Unplanned extubation(2), endotracheal tube secure(2) 0 (0.0) 0 (0.0) 2 (2.1) 2 (1.7) 4 (1.2)
Survey Analgesic administration(1), restraints (2), 0 (0.0) 1 (1.2) 2 (2.1) 1 (0.8) 4 (1.2)
pressure ulcer (1)          
Ventilator patient characteristic (1), weaning (1), information (1) 1 (2.2) 1 (1.2) 0 (0.0) 1 (0.8) 3 (0.9)
Physiological Vital sign(1), ICP(1), oxygen saturation(1) 1 (2.2) 0 (0.0) 1 (1.0) 1 (0.8) 3 (0.9)
measure            
Catheter Patency (1) 1 (2.2) 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.3)
Total     46 (100.0) 81 (100.0) 96 (100.0) 120 (100.0) 343 (100.0)

DNR=do not resuscitation; UTI=urinary tract infection; BSI=blood stream infection; MRSA=methicilline resistant staphyllococcus aureus; VRE=vancomycin resistant enterococci; MDR=multidrug resistant; VAp=ventilator associative pneumonia; CRRT=continuous renal replacement therapy; APACHE=acute physiology and chronic health evaluation; NIC=nursing intervention classification; MPM=mortality probability model; GCS=glasgow coma scale; ICP=intra cranial pressure.

Table 4.
Keyword Classifications of the International Research
Domain Classification Variables 1992~ 1999 2000~ 2003 2004~ 2007 2008~ 2011 Total
n (%) n (%) n (%) n (%) n (%)
Human Patients Critical illness (162), cardiovascular (86), respira- 165 (35.0) 71 (34.8) 59 (29.1) 69 (31.2) 364 (33.1)
Family tory (86), ventilator (55), neurologic (13), intu-          
Nurse bation/tracheostomy (16), elderly (5) others (6)          
Ill patient family (14) 7 (16.3) 0 (0.0) 2 (0.1) 5 (2.3) 14 (1.3)
Nurse (85), APN (5), new nurse (2), 35 (7.4) 21 (10.3) 21 (10.3) 15 (6.8) 92 (8.4)
Health Patient emotion Stress (7), anxiety (9), comfort (1), depression (1), 9 (1.9) 5 (2.5) 5 (2.5) 1 (0.5) 20 (1.8)
attitude (2)          
Nurse emotion Satisfaction (5), stress (3), attitude (7), 17 (3.6) 7 (3.4) 12 (0.6) 12 (5.4) 48 (4.4)
perception (15), knowledgement (8),          
experience (4), others (6)          
Family emotion Coping (9), satisfaction (3), affect (2), distress (1) 6 (1.3) 2 (1.0) 3 (1.5) 4 (1.8) 15 (1.4)
Pain Scale (3), intervention (8), assessment (8), 14 (3.0) 3 (1.5) 4 (2.0) 2 (0.9) 23 (2.1)
knowledgement (1), others (3)          
Ethics DNR (5), advance directives (1), terminal care (4), 10 (2.1) 4 (2.0) 1 (0.5) 4 (1.8) 19 (1.7)
Organ donation (5),others (4)          
Quality of life Terminal (3), post operation(6), post discharge(1) 3 (0.6) 3 (1.5) 2 (0.1) 2 (0.9) 10 (0.9)
Sleep Affect factor(4), enhancement nursing(2), others(2) 6 (1.3) 1 (0.5) 0 (0.0) 1 (0.5) 8 (0.7)
Sedation Perception(1), level (1), affect factor (1), others (4) 1 (0.2) 4 (2.0) 0 (0.0) 2 (0.9) 7 (0.6)
Pressure ulcer Risk factor (1), predictors (2), intervention (2), 2 (0.4) 1 (0.5) 0 (0.0) 3 (1.4) 6 (0.5)
program development (1)          
Delirium Assessment (1) 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.5) 1 (0.1)
Environment Nursing administration Teamwork (12), nurse-to-patient ratio (4), 10 (2.1) 9 (4.4) 13 (6.4) 11 (5.0) 43 (3.9)
usefullness of resource (10), workload (8),          
others (9)          
Infection control UTI (1), BSI (1), VAP (11), pneumonia (4), 1 (0.2) 4 (2.0) 13 (6.4) 10 (4.5) 28 (2.5)
antibiotics (1), respiratory infection (3), hand          
hygiene (3), others (5)          
Nursing Physiological measure Hemodynamic monitoring (5), EKG (17), vital 58 (12.3) 10 (4.9) 15 (7.4) 16 (7.2) 99 (9.0)
sign (13), ICP (6), blood glucose (10), CO(11),          
blood analysis (4), others (12)          
Intervention Family (4), accuracy (3), procedure effect (10), 41 (8.7) 12 (5.9) 13 (6.4) 13 (5.9) 79 (7.2)
intervention effect (14), oral care (10), position          
(19), music (4), tube care (2), simulation          
(1),others (12)          
Prognosis Mortality (7), recovery rate (Heart disease) (18), 18 (3.8) 14 (6.9) 8 (3.9) 16 (7.2) 56 (5.1)
patient outcome (26), others (5)          
Instrument Respiratory (3). sedation (5), APACHE (3), nurse 8 (1.7) 5 (2.5) 8 (3.9) 14 (6.3) 35 (3.2)
(3), anxiety (1), airway care (2), weaning (1),          
others (14)          
Catheter Gastroentestinal tube (7), central venous (2), 20 (4.2) 6 (2.9) 3 (1.5) 2 (0.9) 31 (2.8)
patency (4), remove (13), others (5)          
Ventilator Characteristic (3), weaning (14), protocol (4), 12 (2.5) 4 (2.0) 9 (4.4) 3 (1.4) 28 (2.5)
outcome (5), others (2)          
Suction Closed suction (3), suction method (8), others (3) 10 (2.1) 3 (1.5) 0 (0.0) 1 (0.5) 14 (1.3)
Survey Patient characteristic (3), incidence (3), others (7) 4 (0.8) 5 (2.5) 3 (1.5) 1 (0.5) 13 (1.2)
Communication n Healthcare provider-patient (9), doctor-nurse (4) 3 (0.6) 2 (1.0) 6 (3.0) 2 (0.9) 13 (1.2)
Airway Cuff pressure (3), extubation (4), airway care (5), 2 (0.4) 2 (1.0) 0 (0.0) 8 (3.6) 12 (1.1)
Drug Bleeding (1), body temperature (1), others (6) 7 (1.5) 3 (1.5) 0 (0.0) 2 (0.9) 12 (1.1)
Nutrition Cr (1), enteral feeding (4), others (4) 3 (0.6) 2 (1.0) 3 (1.5) 1 (0.5) 9 (0.8)
Restraints Experience (1) 0 (0.0) 1 (0.5) 0 (0.0) 0 (0.0) 1 (0.1)
Total     472 (100.0) 204 (100.0) 203 (100.0) 221 (100.0) 1,100 (100.0)
Table 5.
Types of Nursing Interventions in the Experimental Studies
Intervention Domestic (N=65) International (N=155)
1992~ 1999 2000~ 2003 2004~ 2007 2008~ 2011 Total 1992~ 1999 2000~ 2003 2004~ 2007 2008~ 2011 Total
n(%) n(%) n(%) n(%) n(%) n(%) n(%) n(%) n(%) n(%)
Tube care 3(23.1) 1(6.7) 1(5.3) 2(11.1) 7(10.8) 3(3.5) 1(4.5) 2(9.5) 4(14.8) 10(6.5)
Suction 1(7.7) 1(6.7) 2(10.5) 3(16.7) 7(10.8) 8(9.4) 0(0.0) 0(0.0) 0(0.0) 8(5.2)
Protocol 1(7.7) 1(6.7) 2(10.5) 2(11.1) 6(9.2) 4(4.7) 2(9.1) 4(19.0) 3(11.1) 13(8.4)
Alternative therapy 1(7.7) 3(20.0) 2(10.5) 0(0.0)　 6(9.2) 5(5.9) 0(0.0) 1(4.5) 0(0.0) 6(3.9)
Dressing 2(15.4) 0(0.0) 2(10.5) 1(5.6) 5(7.7) 1(1.2) 0(0.0) 0(0.0) 0(0.0) 1(0.6)
Oral care 0(0.0)　 0(0.0) 3(15.8) 2(11.1) 5(7.7) 1(1.2) 1(4.5) 0(0.0) 4(14.8) 6(3.9)
Education 1(7.7) 2(13.3) 0(0.0) 1(5.6) 4(6.2) 0(0.0) 0(0.0) 0(0.0) 1(3.7) 1(0.6)
Position 1(7.7) 2(13.3) 1(5.3) 0(0.0)　 4(6.2) 12(14.1) 5(5.9) 1(4.5) 3(11.1) 21(13.5)
Restraints 1(7.7) 0(0.0) 1(5.3) 2(11.1) 4(6.2) 0(0.0) 0(0.0) 0(0.0) 1(3.7) 1(0.6)
Chest physical therapy 1(7.7) 1(6.7) 0(0.0) 0(0.0) 2(3.1) 0(0.0) 0(0.0) 0(0.0) 1(3.7) 1(0.6)
Information 0(0.0)　 0(0.0)　 2(10.5) 0(0.0)　 2(3.1) 2(2.4) 0(0.0) 0(0.0) 0(0.0) 2(1.3)
Communication 0(0.0) 0(0.0)　 2(10.5) 0(0.0)　 2(3.1) 1(1.2) 0(0.0) 0(0.0) 0(0.0) 1(0.6)
Medication 0(0.0)　 0(0.0) 0(0.0)　 1(5.6) 1(1.5) 8(9.4) 4(18.2) 1(4.5) 0(0.0) 13(8.4)
Ventilator 1(7.7) 0(0.0)　 0(0.0)　 0(0.0)　 1(1.5) 2(2.4) 2(9.1) 2(9.5) 1(3.7) 7(4.5)
Simulation 0(0.0)　 0(0.0) 0(0.0) 1(5.6) 1(1.5) 0(0.0) 0(0.0) 0(0.0) 0(0.0) 0(0.0)
Measurement 0(0.0) 0(0.0)　 0(0.0)　 0(0.0)　 0(0.0)　 31(36.5) 6(27.3) 5(23.8) 6(22.2) 48(31.0)
Eye care 0(0.0)　 0(0.0)　 0(0.0)　 0(0.0)　 0(0.0)　 1(1.2) 1(4.5) 0(0.0) 0(0.0) 2(1.3)
Emotional support 0(0.0) 0(0.0) 0(0.0)　 0(0.0) 0(0.0)　 2(2.4) 0(0.0) 2(9.5) 3(11.1) 7(4.5)
Exercise 0(0.0)　 0(0.0)　 0(0.0) 0(0.0)　 0(0.0)　 0(0.0) 0(0.0) 1(4.5) 0(0.0) 1(0.6)
Evidence based nursing 0(0.0)　 0(0.0)　 0(0.0) 0(0.0)　 0(0.0)　 0(0.0) 0(0.0) 2(9.5) 0(0.0) 2(1.3)
Others 0(0.0)　 4(26.7) 1(5.3) 3(16.7) 8(12.3) 4(4.7) 0(0.0) 0(0.0) 0(0.0) 4(2.6)
Total 13(100.0) 15(100.0) 19(100.0) 18(100.0) 6 65(100.0) 85(100.0) 22(100.0) 21(100.0) 27(100.0) 155(100.0)

Others(environment, cold therapy, bathing, feeding)

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