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Aims: This study aimed to examine the relationship between heart failure knowledge, self‐efficacy, social support, grit and self‐care behaviour in patients with heart failure and to identify factors associated with patients' self‐care behaviour. Background: Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines. Design: This descriptive cross‐sectional study was designed based on Bandura's Social Cognitive Theory. Methods: This study included 138 patients who were diagnosed with heart failure in an outpatient department of cardiology at a tertiary hospital in Korea. Data were collected between July and October 2020 using a structured questionnaire and electronic medical records. Data were analysed using the SPSS/WIN 27.0 program. Results: Grit had the strongest association with self‐care behaviour among patients with heart failure, followed by social support, self‐efficacy and heart failure knowledge. These variables accounted for approximately 52% of the variance in self‐care behaviour. Conclusions: Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. Based on the social cognitive theory, nursing intervention programmes that can simultaneously manage cognitive (knowledge and self‐efficacy), social and environmental (social support) and behavioural support (grit) factors should be developed and applied to nursing practices to promote self‐care. Summary statement: What is already known about this topic? Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines.Social cognitive theory is conceptualized as cognitive, social, environmental and behavioural in nature.Self‐care behaviour can be influenced by multi‐dimensional factors, including cognitive factors, such as knowledge and self‐efficacy, and social and environmental factors, such as social support. What this paper adds? Grit—a behavioural supporting element—was confirmed as a factor influencing the self‐care behaviour of patients with heart failure. The implications of this paper: Interventions for enhancing patients' grit should be developed; self‐efficacy, social support and heart failure knowledge for patients with heart failure should be considered in clinical nursing settings.Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a valid and reliable new intensive care unit nursing classification tool, including direct and indirect nursing activities, by measuring the nursing intensity provided to patients. Background: Prior tools primarily examine patients' medical records or disease severity/interactions, systematically failing to reflect comorbidity risk factors. Design: The Delphi technique was used to test the content validity of the Korean Patient Classification System on Nursing Intensity for Critical Care Nurses (KPCSNIC). Methods: Data were collected from four hospitals in two provinces from 26 December 2017 to 30 January 2018. To verify construct validity, staff nurses classified 365 patients, comparing differences by medical department and type of stay. To verify interrater reliability, data collectors and the head nurses of three intensive care units classified 87 patients. Results: The KPCSNIC had 8 categories, 44 nursing activities and 105 criteria. Reliability was high (r =.84). Construct validity was verified by revealing differences according to medical department and type of patient. Using total scores, four KPCSNIC groups were identified. Conclusion: The KPCSNIC developed in this study can support staffing for nursing intensity by providing more specific evaluation criteria. Moreover, it reflects nursing intensity, including direct and indirect nursing activities. Summary statement: What is already known about this topic? In order to secure the quality of nursing care, it is important to allocate an appropriate number of nurse staffing based on nursing demand and nursing time reflecting to the number and severity of patients, and shift of work.The patient acuity tools used in Korea are limited as they primarily examine patients' physiological characteristics based on medical records or quantify disease severity and interactions, systematically failing to reflect risk factors for comorbidities.The intensive care unit patient classification tool that is currently used underestimates clinical nursing intensity, as it does not realistically evaluate patient‐related disease factors and indirect nursing activities. What this paper adds? This study developed a new patient classification tool that reflects patients' clinical characteristics and classified them according to nursing intensity.In addition to direct nursing activities, indirect nursing activities that were invisible and difficult to measure can be scored using this tool. The implications of this paper: Since this tool enables quantitative measurement of nursing workload, data using this tool can be used as evidence for invoicing for nursing care fees, previously calculated as a percentage of inpatient fees per day.This study was conducted in a first‐grade hospital with a high level of nurse staffing. To secure the validity and reliability of the tool, additional research is needed, using the tool in a greater number and wider range of hospitals. [ABSTRACT FROM AUTHOR]

Aim: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum. Methods: A quasi‐experimental design and convenience sampling technique were used. The participants (fourth‐grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self‐efficacy were outcome variables. Results: Significant improvements in handover performance ability, handover clinical judgement ability and handover self‐efficacy were observed in the intervention group compared with the control group. Conclusion: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory‐based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students. Summary statement: What is already known about this topic? Nursing handover is considered very important for optimizing nursing performance and securing the continuity and safety of patient care.Nurse educators must develop and validate educational strategies to resolve handover deficiencies among nursing students. What this paper adds? The self‐evaluation of handover performance ability, handover clinical judgement ability and handover self‐efficacy were better in nursing students who received handover education based on situated learning theory than in the control group. The implications of this paper: Theory‐based handover education applied in a clinical practicum context can allow nursing students to improve relevant capabilities prior to graduating as a clinical nurse.Situated learning theory provides a theoretical basis upon which to support practical handover learning. [ABSTRACT FROM AUTHOR]

Aim: The study purpose was to investigate effects of a cognitive rehabilitation programme on cognitive function, self‐management and quality of life in patients with chronic obstructive pulmonary disease. Background: Cognitive impairment is frequently observed in chronic obstructive pulmonary disease patients, and it interferes with many aspects of self‐management, which is fundamental to disease management and quality of life. Design The design is quasi‐experimental. Methods: Data collection was performed between June 2018 and March 2019. Study participants were 60 in‐ or out‐patients with chronic obstructive pulmonary disease. The cognitive rehabilitation programme involved six 30‐min sessions administered over a period of 2 weeks and consisted of six areas: attention, memory, language, visuospatial perception, executive function and problem solving. Cognitive function, self‐management and quality of life were measured at three times (preintervention and immediately and 4 weeks after intervention). Results: Cognitive function, self‐management and quality of life were found to be significantly improved over time after administration of the cognitive rehabilitation programme. However, no significant improvement was observed in the control group. Conclusions: Our findings support the potential usefulness of cognitive intervention to promote cognitive function, self‐management ability and quality of life in patients with chronic obstructive pulmonary disease. Summary statement: What is already known about this topic? Cognitive impairment interferes with many aspects of self‐management, such as monitoring symptoms, adherence to medication regimens and the maintenance of healthy lifestyles, which are fundamental to the management of chronic obstructive pulmonary disease (COPD).Despite the importance of cognitive functions, few studies have been attempted to the investigate effects of cognitive rehabilitation programmes in COPD patients. What this paper adds? Cognitive function, self‐management and quality of life were significantly improved over time after administration of the cognitive rehabilitation programme. The implications of this paper: Our findings support the importance of cognitive rehabilitation intervention for improving cognitive function, self‐management ability and quality of life in COPD patients.The present study also provides a resource for an effective cognitive rehabilitation programme that can be used by nurses or other clinical practitioners to improve cognitive function in COPD patients with cognitive impairment. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to investigate potential factors that influence nursing performance in South Korean intensive care units (ICUs). Background: As nursing performance is directly related to patient outcomes in the ICU setting, identifying factors related to nursing performance at various levels could contribute to improving those outcomes. Method: A cross‐sectional descriptive design was employed with a convenience sample of 177 nurses having worked at least 6 months in an ICU. Data were collected from 2 to 16 March 2018. Results: Workplace incivility from supervisors and patients and their families was negatively related to nursing performance, whereas a relation‐oriented culture and task‐oriented culture were positively related to nursing performance. The factors that predicted nursing performance were nurse age and a task‐oriented culture. Conclusion: Based on study findings, hospitals should focus on mitigating workplace incivility to help improve the nursing performance. Also, hospitals should develop strategies to assess organizational culture and foster relation‐ and task‐oriented culture to maximize nursing performance. SUMMARY STATEMENT: What is already known about this topic? Nursing performance is an important predictor of patient outcomes in intensive care units.Although multiple factors affect nursing performance, previous studies have addressed those factors only individually or in pairs. What this paper adds? This article assesses multiple factors that influence nursing performance in the intensive care unit setting, including interactional, organizational and societal factors. Among those factors, workplace incivility of supervisors and of patients and their families was negatively correlated with nursing performance.Organizational factors such as relation‐oriented and task‐oriented culture were positively correlated with nursing performance.Greater nurse age and working in a task‐oriented culture predicted greater nursing performance. The implications of this paper: Nursing managers should foster a task‐oriented culture for intensive care unit nurses to enhance their practice performance and thus improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the nursing stress factors, which affect turnover intention in hospital nurses. Background: Nursing stress is known to be an important predictor of turnover intention in nurses. Although nurses experience various sources of stress across work environments, cultures, and generations, little is known about the stress factors affecting turnover intention in nurses. Design A descriptive cross‐sectional design was employed. Methods: A total of 329 nurses were recruited through convenience sampling from 27 hospitals in South Korea. Data were collected from May to November 2018 using a questionnaire. Results: Among the stress factors, stress from patients and their families, workload stress, stress from conflicts with supervisors, and stress from conflicts with peers were associated with turnover intention in hospital nurses. These variables explained 40.0% of the variance in turnover intention among hospital nurses. Conclusions: Stress from interpersonal relationships with patients and their families, supervisors, and peers may have a considerable impact on turnover intention. To reduce nursing turnover intention, coping strategies to reduce stress from patients and their families should be established. It is necessary to provide programmes that foster interpersonal relationship skills in the workplace. Nurse managers may encourage communication among nurses to establish positive relationships. SUMMARY STATEMENT: What is already known about the topic? Nurses' turnover continues to remain a challenging issue across work environments, cultures, and generations.Nursing stress has a great impact on turnover intention in hospital nurses. However, little is known about the stress factors that affect turnover intention in nurses. What this paper adds? Among the nursing stress factors, stress from patients and families had a strong effect on turnover intention in hospital nurses, followed by stress from workload, conflicts with supervisors, and conflicts with peers. The implications of this paper: Our findings suggest that stress from interpersonal relationships might have a considerable impact on turnover intention.Coping strategies to reduce stress from patients and family need to be first established to reduce the turnover intention in hospital nurses.Nurse managers should be aware of the effects of interpersonal relationships on turnover intention and encourage communication among nurses to establish positive relationships. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the role of clinical research coordinators (CRCs) and identify the importance and performance of the role as well as the factors that affect the professional recognition of their role. Methods: A total of 102 CRCs from 10 hospitals were recruited for a survey. The Clinical Trial Nursing Questionnaire scale developed by Ehrenberger and Lillington was used to collect data for the importance–performance analysis. The importance and performance data were plotted on a two‐dimensional grid, and multiple stepwise linear regression analysis was used to determine the influencing factors on the CRC role. Results: The influencing factors on the importance of the CRC role were frequency of protocol assessment, implementation and evaluation and professional nursing role performance. The influencing factors on performance were formal education and training in clinical research, institutional career ladder system for professional development and identification as a principal investigator in research studies. The influencing factor on the professional nursing role perception was the lower component of the 'performance of professional nursing role'. Conclusion: Formal educational preparation, identification as a principal investigator in research studies and clear career progression are supportive factors to the professional recognition of CRC as a specialized nursing role. Summary statement: What is already known about this topic? Clinical trials ultimately contribute to improving public health.A clinical trial process should cover a number of tasks, such as provision of study information to patients, recruitment of patients, screening and obtainment of their consent.Clinical trial nurses affect the quality of clinical trials, but little is described about the scope and contribution of their roles in clinical trials. What is already known about this topic? This study explored the role of clinical research coordinators (CRCs) and their professional role recognition in the wake of policy changes in South Korea since 2015.Formal education, role delineation and career ladder schemes are critical factors to the career advancement of CRCs, as shown in the study results.Identifying the changes and effects of the relevant policy has implications to the South Korean context and beyond, serving as a reference for countries considering setting up CRC roles or establishing an educational system for CRCs. The implications of this paper: Formal education, role delineation and career ladder schemes are critical factors to the career advancement of CRCs.To improve the performance and professional awareness of CRCs, a government‐led system and policies on formal education and career ladder are needed so that CRCs can fulfil their role in improving public health. [ABSTRACT FROM AUTHOR]

Aims: This descriptive, exploratory, correlational analysis investigated patients with type 2 diabetes and their diabetes knowledge, depression, diabetes‐management self‐efficacy, and social support and sought to determine the effects of these factors on psychological insulin resistance among type 2 diabetes patients in South Korea. Methods: This descriptive cross‐sectional study included 136 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding demographic and disease‐related characteristics as well as scores on the Diabetes Knowledge Tests, Center for Epidemiologic Studies Depression Scale, Diabetes Management Self‐efficacy Scale, Social Support Scale, and Psychological Insulin Resistance Scale, between September and December 2017. Data were analysed using descriptive statistics, independent t‐tests, a one‐way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. Results: The total score for psychological insulin resistance was 60.92 ± 14.75 of a maximum of 90. Stepwise multiple regression showed that diabetes knowledge, diabetes‐management self‐efficacy, social support, absence of diabetes complications, and depression explained 38.6% of the variance in psychological insulin resistance. Conclusion: Diabetes knowledge was found to have the largest influence on psychological insulin resistance, followed by social support, absence of complications, depression, and diabetes‐management self‐efficacy. Development of interventions that consider all these factors is required, and the effects of such interventions should be tested through further research. SUMMARY STATEMENT: What is already known about this topic? Patients with diabetes in Korea have been reported to have relatively high levels of psychological resistance to insulin therapy compared with their counterparts in the West.Previous studies on factors associated with psychological insulin resistance have considered only a limited number of factors and have simply analysed the association between these factors. The full range of disease‐related factors that can affect psychological insulin resistance has not been considered.Research on the psychological insulin resistance of patients with type 2 diabetes, and the factors that affect it, is currently lacking in Korea. What this paper adds? The level of psychological insulin resistance of Korean patients with type 2 diabetes was found to be higher than that of patients from other countries.Diabetes knowledge was found to have the most significant influence on the psychological insulin resistance in Korean patients with type 2 diabetes, followed by social support, absence of diabetes complications, depression, and diabetes‐management self‐efficacy. The implications of this paper: Levels of psychological insulin resistance among patients with type 2 diabetes should be monitored, and nursing education programs should be developed that are tailored to patients' level of psychological insulin resistance.Diabetes knowledge, social support, diabetes complications, depression, and diabetes‐management self‐efficacy should be systematically monitored to reduce the level of psychological insulin resistance in patients with type 2 diabetes. Development of detailed interventions that consider these factors may be helpful, and their effectiveness should be tested through further research. [ABSTRACT FROM AUTHOR]

Aim: Hypertension is a common condition contributing to many diseases. Factors influencing blood pressure (BP) classification for adults have changed over time. This study aimed to identify factors influencing BP classification according to gender. Methods: Data from the Sixth Korean National Health and Nutrition Examination Survey (2014) were used in this descriptive, cross‐sectional study. Participants were 1555 adults (589 men, 966 women). Measures included demographic, health‐related, and lifestyle factors. Results: Compared with the male normal BP group, in the male prehypertension group, body mass index, problem drinking, and reduced sleep duration were higher; and in the male hypertension group, age, poor subjective health status, body mass index, diabetes, problem drinking, smoking, and sodium intake were higher. Compared with the female normal BP group, age, and body mass index were higher in the female prehypertension group; and age, poor subjective health status, body mass index, menopause, and diabetes were higher in the female hypertension group. Conclusion: Hypertension and prehypertension prevention interventions for adults should be distinguished according to gender. SUMMARY STATEMENT: What is already known about this topic? The prevalence of hypertension and prehypertension has increased worldwide.Prevention and management strategies for hypertension and prehypertension are provided to clients without regard to gender. What this paper adds? Many lifestyle factors that affect hypertension and prehypertension showed differences according to gender.Drinking, sodium intake, and sleep duration were significant factors along with body mass index and diabetes in male clients.Rather than lifestyle factors, menopause, body mass index, and diabetes were significant factors in female clients. The implications of this paper: In the prevention and management of hypertension, lifestyle factors should be highlighted differently according to gender.Management of male clients should focus on reducing problem drinking, limiting sodium intake, and having enough sleep, together with weight control and diabetes prevention.Weight control, menopause, and diabetes management should be emphasized for female clients. [ABSTRACT FROM AUTHOR]

Aim: This study explored health beliefs and behaviours related to sexually transmitted infections (STIs) from the perspective of juvenile offenders with STIs in three urban cities. Methods: Data were collected using observations and in‐depth interviews between July and November, 2014. Under the supervision of probation officers, 24 juvenile offenders with STIs were interviewed. Leininger's four‐step method guided the data analysis. Findings From participants' perspectives, poor hygiene and a promiscuous lifestyle caused the STIs. The diseases were considered an adult disease with distinct symptoms and deformities, no cure, and therefore fatal. STIs were shameful for juveniles because their presence revealed sexually active behaviours. The juveniles' health‐related behaviours included neglecting their STI symptoms because they did not know they were infected, mistaking STIs for other health conditions, choosing to suffer rather than revealing their diagnosis, and keeping their genitals clean. Conclusion: A large gap emerged between juveniles' beliefs and behaviours related to STIs. Policies and education are needed to provide accurate STI information for this population. SUMMARY STATEMENT: What is already known about the topic? Juvenile offenders are at risk for sexually transmitted infections (STIs).Juvenile offenders are likely to engage in inappropriate behaviours to manage their STIs. What this paper adds? Juvenile offenders believed poor hygiene and a promiscuous lifestyle caused STIs, which were viewed as adult, fatal, deformity‐causing, and shameful diseases.STI symptoms were neglected at first or mistaken for other health conditions due to limited knowledge on STI symptom presentation.Juvenile offenders refused health care for STIs to avoid shame and kept their genitals clean as an STI treatment. The implications of this paper: Policies to provide STI screening for juvenile offenders should be developed considering the high prevalence rates of STIs and low awareness of STI symptoms in this population.Use of social media managed by health professionals could increase accessibility to STI management information among juvenile offenders.Nurse‐led clinics that focus on juveniles' sexual health could lower barriers to health care for the juvenile population. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance by identifying the safety performance predictors of nurses working in acute health care settings in South Korea. Methods: Using data from a structured questionnaire, this cross‐sectional descriptive study assessed the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance. In 2016, of the 290 nurses from nine acute care hospitals in South Korea invited to participate in the survey, 254 successfully did. Using cross‐sectional data, characteristics of hospitals and nurses were analysed with t tests, one‐way analyses of variance, Pearson correlations, and regression models. Results: On a scale of one to five, the mean job autonomy was 3.37, mean perceptions of organizational policy was 3.09, and mean safety performance was 3.75. Statistically significant positive correlations were found among job autonomy, perceptions of organizational policy, and safety performance. Multiple regression results found 44% of the variation in safety performance explained by job autonomy, length of employment, and perceptions of organizational policy. Conclusion: Job autonomy and perceptions of organizational policy were positively related to safety performance. Hospital executives and nurse managers should work to enhance job autonomy and positive perceptions of organizational policy, to contribute to improving patient safety. SUMMARY STATEMENT: What is already known about this topic? Nurses' role in patient safety is important, and factors that influence patient outcomes include organizational factors, team culture, and nurses' characteristics.Restricted job autonomy of nurses can lead to emotional exhaustion and aversion to patients.When nurses' participation in clinical decision making is limited, this can reduce the effectiveness of care and harm patient outcomes. What this paper adds? Study results indicate a need to improve nurses' job autonomy.It highlights the importance of nurses' positive perceptions of organizational policies regarding safety performance.Job autonomy is a concept acquired in a particular work environment, regardless of the size of the hospital. The implications of this paper: Hospital executives and nurse managers should be actively involved in improving nurses' job autonomy, nurses' participation in decision making, and shared governance.These efforts might broaden nurses' perspectives and facilitate their safety performance. [ABSTRACT FROM AUTHOR]

Aim: This study aimed at identifying the factors associated with health literacy, self‐care behaviours, and quality of life among older persons with lung cancer receiving chemotherapy. Methods: This was a descriptive study. A total of 80 older persons with lung cancer receiving chemotherapy participated in this study. Data were collected from July 21 to November 3, 2016 in Korea. The Short Form of the Korean Functional Health Literacy Test, the Self‐Care Behaviours Scale, and the Functional Assessment of Cancer Therapy Scale‐Lung were used to measure functional health literacy, self‐care behaviours, and quality of life, respectively. Stepwise multiple regression analyses were conducted to analyse the data. Results: In the each regression model for the general and disease‐related quality of life, performance status, self‐care behaviours, and prior lines of treatment were identified as a predictor. However, functional health literacy was found to be a predictor only of disease‐related quality of life. Among these predictors, self‐care behaviours had the greatest impact. Conclusion: Health care providers should be aware of the effects of health literacy and self‐care behaviours on health‐related quality of life and consider the factors associated with quality of life when they take care of older persons with lung cancer receiving chemotherapy. SUMMARY STATEMENT: What is already known about this topic? Older persons with lung cancer undergoing chemotherapy may more severely experience diverse adverse effects than younger adults.Lack of health literacy and self‐care behaviours would be expected to have a negative impact on quality of life in older persons with lung cancer receiving chemotherapy.It is difficult to find studies that address the effects of health literacy and self‐care behaviours on quality of life in older persons with lung cancer receiving chemotherapy What this paper adds? The results showed that general and disease‐related quality of life was higher when the performance status was better, the level of self‐care behaviours was higher, and the prior lines of treatment were lower.Older persons with high health literacy had better disease‐related quality of life than those with low health literacy. The implications of this paper: Nurses should consider the associations between health literacy, self‐care behaviours, and quality of life when they care for older persons with lung cancer receiving chemotherapy.Customized intervention studies that can enhance self‐care behaviours and health literacy in older persons with lung cancer undergoing chemotherapy are needed. [ABSTRACT FROM AUTHOR]

Aim: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. Background: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. Methods: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. Results: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. Conclusions: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational‐level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. SUMMARY STATEMENT: What is already known about this topic? Promoting nurses professional quality of life is important in managing the quality of nursing care.Nurses with exposure to emotional labour show negative health effects, reduced willingness and ability to work, frequent absences, dissatisfaction and turnoverWorkplace violence negatively affects professional quality of life among clinical nurses. What is already known about this topic? Compassion satisfaction was highly related to organizational management systems for emotional labour and workplace violence.Burnout was associated with the magnitude of exposure to emotional labour and experience of workplace violence and negative organizational management systems for workplace violence.Secondary traumatic stress was associated with the magnitude of exposure to emotional labour and experience of workplace violence. The implications of this paper: To increase nurses professional quality of life, organizational management systems that address and reduce emotional labour and workplace violence are critical.It is necessary to develop programmes that address violence prevention education and comprehensive response strategies regarding emotional labour.Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. [ABSTRACT FROM AUTHOR]

Oh HS, Jeong HS, Seo WS. International Journal of Nursing Practice 2012; 18: 295-302 Non-infectious hyperthermia in acute brain injury patients: Relationships to mortality, blood pressure, intracranial pressure and cerebral perfusion pressure The present study was conducted to investigate the frequency of hyperthermia during the first 72 h after acute brain injury, and to compare subjects that developed hyperthermia with those that did not with respect to blood pressure, intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow Coma Scale (GCS) score and mortality. This study was conducted by performing a retrospective medical record review of 126 brain injury patients admitted to the neurological intensive care unit of a university hospital located in Incheon, South Korea. Our results showed that 25.4% of the subjects had hyperthermia for at least 1 day during the first 3 days of hospitalization. Hyperthermic subjects demonstrated higher mortality and ICP, and lower CPP and GCS scores than non-hyperthermic subjects, indicating a reduced cerebral blood flow. The findings may provide a possible explanation for poor clinical outcome and offer justification for the careful monitoring of body temperature in patients with acute brain injury. [ABSTRACT FROM AUTHOR]

Son Y-J, You M-A, Song E-K. International Journal of Nursing Practice 2012; 18: 260-267 Influence of Type D personality on health-related quality of life among Korean patients with end-stage renal disease The purposes of this study were to explore the prevalence of Type D personality and the impact of Type D personality (the combination of negative affectivity and social inhibition) on health-related quality of life (HRQOL) in end-stage renal disease (ESRD) patients and to determine whether this link of Type D personality to HRQOL is mediated by depressive symptoms. Patients ( n = 144) from an outpatient nephrology clinic of a university hospital participated in this cross-sectional study. The prevalence of Type D personality using Type D Personality Scale-14 was 26%. After adjustment for patients' characteristics and depressive symptoms in multivariate analysis, Type D personality was an independent predictor of HRQOL. This relation of Type D personality to HRQOL was mediated by depressive symptoms. Our findings underline that intervention should be directed towards reducing depressive symptoms in patients with Type D personality in order to improve HRQOL of ESRD patients. [ABSTRACT FROM AUTHOR]

Yoo H, Kim CJ, Jang Y, You M-A. International Journal of Nursing Practice 2011; 17: 599-606 Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases Although prior research in Western societies has revealed an association between self-efficacy and both self-management behaviours and better health status, little is known about the applicability of this association in Korean populations. We examined the differences in self-management behaviours and health status among three groups according to the level of self-efficacy (high, moderate and low). We used a descriptive and correlational design, and administrated a questionnaire to 322 Korean patients with diabetes mellitus, hypertension or arthritis at three ambulatory clinics in a university medical centre. We performed the Pearson chi-square test to test for differences in proportions, and the Kruskall-Wallis and Mann-Whitney U-tests for non-parametric measures. The level of self-efficacy was associated with self-management behaviours ( P < 0.05) and with better health status indices ( P < 0.001) except fatigue ( P < 0.277). The mean age (Mean ± standard deviation, 53.71 ± 12.60), the percentage of high level of education (62.4%) and the level of employment (51.4%) were significantly higher in high self-efficacy group than in low self-efficacy group or moderate self-efficacy group. Further study of the potential factors affecting any relationship between self-efficacy and fatigue is recommended. Self-efficacy-enhancing interventions can be beneficial for Korean chronic patients to improve their self-management behaviours and health status. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To explore working experiences of nurses during Middle East respiratory syndrome outbreak. Background: Since the first case of Middle East respiratory syndrome was reported on May 20, 2015 in South Korea, 186 people, including health care workers, were infected, and 36 died. Design: A qualitative descriptive study. Methods: Seven focus groups and 3 individual in‐depth interviews were conducted from August to December 2015. Content analysis was used. Results: The following 4 major themes emerged: “experiencing burnout owing to the heavy workload,” “relying on personal protective equipment for safety,” “being busy with catching up with the new guidelines related to Middle East respiratory syndrome,” and “caring for suspected or infected patients with caution.” Participants experienced burnout because of the high volume of work and expressed safety concerns about being infected. Unclear and frequently changing guidelines were 1 of the common causes of confusion. Participants expressed that they need to be supported while caring for suspected or infected patients. Conclusion: This study showed that creating a supportive and safe work environment is essential by ensuring adequate nurse staffing, supplying best‐quality personal protective equipment, and improving communication to provide the quality of care during infection outbreak. [ABSTRACT FROM AUTHOR]

Background Ineffective communication of critical care nurses can lead to higher levels of burnout and negatively affect quality of patient care and patient outcomes such as higher mortality. Aim The purpose of this study is to describe the relationship between professional communication competences and nursing performance of critical care nurses in South Korea. Method This cross-sectional study collected data on 197 intensive care unit staff nurses in 3 tertiary academic medical centres in South Korea from July to November 2014. Results In the hierarchical regression analysis, the professional communication competences were the only significant predictors of nursing performance after adjusting for sociodemographic characteristics. In addition, the greater professional communication competences of nurses were associated with being older and having a higher education level, more years of overall clinical and intensive care unit experience, and a higher monthly salary. Conclusion Our findings indicate that communication skills-related training should be included in the practical education to improve nursing performance for the quality of intensive care. Further research is needed to identify the comprehensive factors on professional communication competences of nurses in intensive care units. [ABSTRACT FROM AUTHOR]

Aim The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. Methods The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Results Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Conclusion Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. [ABSTRACT FROM AUTHOR]

Aim The aim of this study is to validate a short version of the Korean functional Health Literacy Test. Background Development of a brief and valid health literacy assessment tool, with an optimal cut-off value, is essential to identify individuals with low health literacy in the Korean-speaking population. Design This is a psychometric validation study of the instrument. Methods Item response analysis using 2-parameter logistic estimates was used for item reduction. The short form of the Korean functional Health Literacy Test was validated among 170 nursing students and 129 older adults in Korea. Data were collected from December 2015 to February 2016. Receiver operating characteristic curves were constructed to classify health literacy level with the cut-off value. Results Item difficulty parameters of the short form of the Korean functional Health Literacy Test ranged from −1.33 to −0.35; item discrimination ranged from 1.91 to 4.47. Significant differences of the test score were shown between nursing students and older adults. The cut-off value of 6 out of 8 on the short form of the Korean functional Health Literacy Test showed a sensitivity of 0.79 and specificity of 0.65. Conclusion The short form of the Korean functional Health Literacy Test is a valid tool with sufficient diagnostic accuracy to assess health literacy in the Korean-speaking population. [ABSTRACT FROM AUTHOR]

Many studies have reported the negative effects of depression on adherence to antihypertensive medication. However, little is known about the mechanism underlying this relationship in elderly patients with hypertension. The aim of this cross-sectional study is to examine the mediating role of self-efficacy in the relationship between depression and medication adherence among older patients with hypertension. The data were collected from October to December 2014. A total of 255 older patients with hypertension were assessed using the Geriatric Depression Scale, the Self-efficacy for Appropriate Medication Use Scale, and the Morisky Medication Adherence Scale. Hierarchical linear regression analysis and the Sobel test were used to examine the mediating role of self-efficacy in the relationship between depression and medication adherence. Depression and self-efficacy were statistically significant predictors of medication adherence in older patients with hypertension. Self-efficacy partially mediated the relationship between depression and medication adherence. Interventions targeting self-efficacy could increase the confidence of patients in their ability to actively take their medicines. Moreover, health care providers should be aware of the importance of early detection of depression in older patients with hypertension. Future studies with longitudinal data are warranted to clarify the multidirectional relationships between depression, self-efficacy, and medication adherence. [ABSTRACT FROM AUTHOR]

Background Health-related quality of life management for patients with coronary artery disease should be considered in the context of sleep and oral health, as both associated with heart health. Aim To identify differences in health-related quality of life by sleep duration and subjective oral health among these patients and to examine factors influencing health-related quality of life. Methods A descriptive cross-sectional design using secondary data from the 2013 Korea Community Health Survey. Data were collected from August 16, 2013, to October 31, 2013, with 6454 adults with coronary artery disease aged 19 or older. Results We observed a significant difference in health-related quality of life by sleep duration, subjective oral health, and chewing discomfort. A hierarchical regression analysis identified factors affecting health-related quality of life: no smoking and no economic activity had negative effects, and highest level of education, having a spouse, no hypertension, no dyslipidemia, no arthritis, good subjective oral health, and no chewing discomfort had positive effects. Conclusion Good subjective oral health and no chewing discomfort significantly predicted health-related quality of life among study patients. To improve health-related quality of life of these patients, promotion and education regarding regular dental clinic visits is needed to ensure early interventions. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were 236 nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Data were collected from June 2013 to February 2014. In the prediction model, 33.4% of burnout was explained and 35.7% for job satisfaction. The greatest influence on burnout was handling violence, followed by verbal abuse. The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. [ABSTRACT FROM AUTHOR]

Diabetes education is a critical element of care for people with diabetes. However, the associations between diabetes education and self-care or health outcomes have not been clearly demonstrated at a national level. The aims of this study were to examine the associations of attendance of diabetes education classes with health behaviours and glycaemic control, and to understand whether these associations were moderated by level of educational attainment. Data were analysed for 456 adults from the 2012 Korea National Health and Nutrition Examination Survey V, collected from January 2010 to December 2012. No significant differences were observed between patients who had attended diabetes education classes and those who had never attended for factors such as smoking, drinking, exercise, nutrition therapy or glycaemic control. There was a significant interaction effect between receiving diabetes education and level of educational attainment on obtaining optimal glycaemic control. Attending diabetes education was positively associated with optimal glycaemic control among patients with more than a high school education but was negatively associated with it among those with less than middle school education. Diabetes education programmes need to be tailored to the needs and cognitive capacities of the target population. [ABSTRACT FROM AUTHOR]

This study was conducted to increase the frequency and level of thoroughness of hand hygiene practice by nurses, and to assess the influence of the methicillin-resistant Staphylococcus aureus (MRSA) acquired incidence rate and the MRSA colonization pressure in a medical intensive care unit (MICU). A total of 24 MICU nurses received hand hygiene education and individual feedback of hand hygiene frequency and method after a session of education, and two posteducation evaluations were followed. The frequency of hand hygiene (P = 0.001) and the methodology score of hand hygiene increased significantly (P = 0.001). The MRSA acquisition rate decreased significantly, from 11.1% before the education to 0% after (P = 0.014). The MRSA colonization pressure decreased significantly from 39.5% to 8.6% after the education sessions (P = 0.001). This indicates that providing individual feedback after hand hygiene education was very effective in increasing nurses' hand hygiene frequency and improving hand hygiene method; furthermore, it was expected to decrease health care-associated infections. [ABSTRACT FROM AUTHOR]

The objective of this study was to test nine variables which derived from the model of self-care in chronic illness and previous studies on elderly patients with hypertension. A descriptive research design was employed in this study. Totally, 306 elderly patients diagnosed with hypertension were selected from three public health centres for the study. The stepwise regression analysis was conducted by analysing predictors of self-care in elderly patients with hypertension. Statistical analyses, including correlation analysis, t-test and analysis of variance tests were conducted for seven variables. The results indicated that only four variables were significant, and the model explained 57% of the variance in self-care. Among these predictors, empowerment was the strongest predictor, followed by social support, depression and perceived severity. These findings demonstrate the significance of assessing predictors of self-care behaviour when examining patients' health behaviours and planning intervention strategies. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the cluster dyads of risk factors and symptoms and their impact on the incidence of 12 month major adverse cardiac events ( MACEs) among patients with first-time myocardial infarction ( MI). In a descriptive study, a total of 522 patients completed semi-structured interviews for data on risk factors and symptoms. Patients were followed for 12 months to determine MACEs. Latent class cluster analysis was performed to identify risk factor clusters and symptom clusters. Logistic regression analysis was performed to determine the impact of cluster dyads on 12 month MACEs. There were 436 event-free survivors and 86 patients with MACEs for 12 months. Ten risk factors and 14 symptoms were clustered into two (dyslipidemia/smoking, hypertension/diabetes dominant) and three (typical, multiple, atypical) memberships, respectively. Six cluster dyads which were generated based on the association between risk factors and symptom clusters were a significant predictor of 12 month MACEs, with the incidence occurring three times higher in a dyad of hypertension/diabetes-and-atypical symptoms than a dyad of dyslipidemia/smoking-and-typical symptoms (odds ratio = 3.10, P = 0.01), after adjustment for age, gender and a type of MI diagnosis. The information on cluster dyads suggests that health-care providers need to consider both risk factors and symptoms at hospital presentation for risk stratification to prevent adverse outcomes. [ABSTRACT FROM AUTHOR]

This study examined nurses' perceived facilitators and barriers to end-of-life ( EOL) care in clinical settings. The study participants were 383 Korean nurses working at tertiary hospitals. The nurses had an average of 7.6 years of clinical experience. The three highest-scoring facilitating items were 'family member acceptance of patient death', 'having time to prepare the family for the patient's expected death' and 'having the physician meet with the family after the patient's death to offer support and validate the given care'. The top two perceived barriers were 'families not accepting what the physician is telling them about the patient's prognosis' and 'dealing with angry family members'. Nurses who had received EOL care education showed a higher score in perception of facilitators than nurses who did not receive that education. EOL care for patients and their families is a challenge; thus, continuing education should be provided to improve nursing practice. [ABSTRACT FROM AUTHOR]