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Aims and objectives: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross‐cultural perspective. Background: Persons with serious or life‐limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well‐being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. Design: A quantitative, cross‐sectional, observational cross‐cultural comparison was undertaken. Methods: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness‐related variables were also assessed using paper‐and‐pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. Results: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self‐reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. Conclusions: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. Relevance to clinical practice: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in‐depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs. [ABSTRACT FROM AUTHOR]

Purpose: This study examined whether the individual and organisational factors of ecological systems theory are associated with job satisfaction among nurses in South Korea. Background: Nursing shortages and high turnover rates are a global issue in healthcare settings, and job satisfaction is significantly associated with the turnover intention of nurses. Therefore, efforts to promote job satisfaction are needed to decrease the high turnover rates among nurses and promote care quality and patient safety. Design: A cross‐sectional study was performed. This paper adhered to the STROBE guidelines. Methods: A sample of 438 nurses working in five secondary or tertiary hospitals was surveyed. The study instruments included work–life balance, resilience, insomnia and job satisfaction. Results: Using multilevel analysis, both individual and organisational factors were associated significantly with job satisfaction, and variance at the group level accounted for 19.98% of the total variance of job satisfaction. Among the individual factors, marital status and work–life balance were significantly associated with job satisfaction. At the organisational level, the group mean resilience score was significantly associated with job satisfaction (p <.05). Conclusion: The psychosocial characteristics of individual nurses and their affiliated groups (nursing units) were significant in explaining the job satisfaction of nurses. Relevance to clinical practice: Both individual‐focused and group‐focused interventions are needed to improve job satisfaction and decrease the turnover intention. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of spousal support and parent–nurse partnership on caregiver burden of parents of children with chronic disease. Background: With the trend of increasing the global number of children with chronic diseases, the parental caregiver burden has become increasingly prevalent. Design: Cross‐sectional study. Methods: The study participants included 115 parents of children diagnosed with chronic disease at a general hospital in South Korea. The study duration was 4 June 2021–30 April 2022. Self‐reported measures included the parent–nurse partnership scale, the Korean version of the Parenting Alliance Inventory and the family caregiver burden scale. T‐tests, ANOVA, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 26.0. This study followed STROBE guideline. Results: Parental caregiver burden was significantly negatively associated with spousal support and parent–nurse partnership. Factors significantly influencing caregiver burden were parental alcohol consumption; child's inherited metabolic disease, cardiovascular disease, disease relating to haematological tumours or kidney disease diagnosis; child's health perceived as poor by parents; child's dependency perceived as high by parents; hospitalization recency; and low spousal support. These factors accounted for 65% of caregiver burden. Conclusion: Parental caregiver burden was related to spousal support and parent–nurse partnership, but the primary factor affecting caregiver burden was spousal support. Relevance to clinical practice: The results highlighted the role of healthcare professionals in educating parents of children with chronic diseases to facilitate spousal support and have implications for nursing and community‐based interventions to reduce parental caregiver burden. Furthermore, they underlined that policymakers and other stakeholders should pay attention to the parental caregiver burden through government‐based, family‐centered strategies. Patient or public contribution: Parents of children with chronic disease were recruited to perform the self‐administered survey in the phase of data collection. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationships among occupational stress, recovery experience and turnover intention among nurses caring for patients with coronavirus disease 2019 (COVID‐19). Background: The high turnover intention among nurses affect patient safety quality of patient care. Design: The cross‐sectional study design was used. This study was guided by STROBE. Methods: Convenience sampling identified 202 registered nurses working in the COVID‐19 wards of three tertiary general hospitals in two cities in South Korea. The collected data were analysed using SPSS version 26.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The moderating effects of recovery experience on the pathway in which occupational stress of the participants affects turnover intention were verified using model 1 of the SPSS PROCESS macro proposed by Hayes. Results: The recovery experience did not significantly mediate the relationship between occupational stress and turnover intention. However, it had significant moderating effect on the relationship between occupational stress and turnover intention (β =.005, 95% CI [.001,.010]). The effect of occupational stress on turnover intention was dependent on recovery experience. Conclusion: The results revealed that occupational stress among nurses caring for patients with COVID‐19 affect the turnover intention and the level of recovery experience moderates this relationship. Thus, not only during the COVID‐19 pandemic but also during challenging times of various infectious disease outbreaks, hospitals can enhance the health and well‐being of nurses and promote the retention of nursing staff. Implications for the profession: During the COVID‐19 pandemic, nurses have been exposed to understaffing and overwhelming workloads. However, policies for nurses' welfare and benefits are still insufficient, even as the pandemic comes to an end. The results of this study indicate that sufficient rest and appropriate nursing personnel are of utmost importance to nurses. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore how the characteristics of patients and caregivers affect self‐care in patients with Parkinson's disease (PD). Design: A multicentre cross‐sectional study. Method: We followed the STROBE checklist. Parkinson's disease patients aged 50 years and older and their caregivers were recruited from two tertiary hospitals and the Korean Parkinson's Disease Association website. Patient characteristics, including social support, relationship quality with caregivers, self‐care efficacy and self‐care, were analysed. Caregiver characteristics were also evaluated, including caregiving duration, social support, relationship quality with patients, contribution to patients' self‐care efficacy and contribution to patients' self‐care. Results: The characteristics of patients and caregivers (103 pairs) were hierarchically regressed into patient self‐care domains (maintenance, monitoring and management). Most patients and caregivers gave a self‐care efficacy and self‐care management rating of moderate. In three regression models, patient self‐care efficacy was positively related to three domains of patient self‐care. Self‐care maintenance decreased as patients' disease duration increased. Self‐care monitoring was positively related to the education level of patients and caregiving duration. Self‐care management showed an inverse relationship with caregiving duration and a positive relationship with caregiver contribution. Conclusion: Self‐care efficacy was important in promoting PD patients' self‐care maintenance, monitoring and management. The contributions of caregivers were also critical in increasing PD patients' self‐care management. Implications for the profession and patient care: To increase patients' self‐care efficacy and self‐care, educational interventions containing information about the disease, symptom management, and problem‐solving should be implemented. Since caregivers are deeply involved in patients' self‐care, educational interventions for caregivers should also be provided. Impact: This study closed the literature gap by examining the self‐care efficacy and self‐care of Korean PD patients. Findings demonstrated the importance of caregiver roles on patients' self‐care and health. Patient or public contribution: Two tertiary hospitals and the Korean Parkinson's Disease Association assisted during the recruitment process. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine Korean registered nurses' level of perceived knowledge and practice of venous thromboembolism risk assessment as well as prevention, self-efficacy in venous thromboembolism care and actual knowledge of venous thromboembolism. Background For hospitalised patients, venous thromboembolism is a preventable clinical disorder. Caring for venous thromboembolism patients requires coordination across multiple providers and settings. Clinical nurses can play a major role in improving venous thromboembolism prevention care, assessing venous thromboembolism risks and providing appropriate prophylactic measures to those who are at risk for venous thromboembolism. Design A cross-sectional descriptive study. Methods Anonymous paper-based surveys were conducted for a convenience sample of registered nurses' ( n = 452) from two university-affiliated hospitals in South Korea. Results The majority of participants indicated that their overall self-rated venous thromboembolism knowledge was 'fair', while only 2·4% rated it as 'very good' or 'excellent'. The overall mean score of the venous thromboembolism knowledge questions was 50·9 (±13·0) of a possible score of 100. The mean score of self-efficacy in practising venous thromboembolism prevention/prophylaxis was 3·0 (based on a one to five Likert scale). The self-reported venous thromboembolism assessment performance on patients varied among clinical units. Only 9·3% of participants reported having received in-service venous thromboembolism education from their hospital. Conclusions The findings showed that overall venous thromboembolism knowledge and self-efficacy in venous thromboembolism prevention practices of Korean registered nurses' were not highly rated. Korean nurses demonstrated a lack of knowledge about venous thromboembolism, particularly in the areas of venous thromboembolism prophylaxis measures and venous thromboembolism diagnosis methods. Relevance to clinical practice Focused education on venous thromboembolism prevention and risk assessment should be considered a component of continuing education for Korean nurses. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the effects of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurses' job dissatisfaction, burnout and turnover intention. Background: Registered nurse staffing status and work environment are suboptimal in nursing homes worldwide. Nursing home care aims to maximise residents' quality of life. However, evidence on the impact of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurse outcomes in nursing homes is limited. Design: This is a cross‐sectional observational study. Methods: A total of 513 residents and 117 registered nurses from 39 nursing homes in South Korea participated in surveys. The main measures included registered nurses' staffing levels, work environment, education levels, residents' quality of life, registered nurses' job dissatisfaction, burnout and turnover intention. We analysed data using the generalised estimating equations and reported the study using the STROBE checklist. Results: Overall, the residents' quality‐of‐life score was 13.7 ± 2.6 (out of 17). Residents in nursing homes with a higher number of registered nurses or with work environment evaluated as 'mixed' or 'better' (compared with 'poor') had a higher quality of life. Regarding nurse outcomes, 74.4% of the registered nurses were dissatisfied with their current jobs, 12.0% had burnout and 18.8% had a turnover intention. Registered nurses working in 'mixed' or 'better' work environment were less likely to have job dissatisfaction. Registered nurses' education levels did not have a statistically significant effect on the resident and nurse outcomes. Conclusions: Registered nurse staffing levels and work environment should be considered important for improving residents' quality of life and nurses' job satisfaction. Relevance to Clinical Practice: Regulation and policy reforms are needed to increase the registered nurse staffing levels and to create a good work environment in nursing homes. Patient or Public Contribution: Nursing home residents and registered nurses participated in the surveys of this study. Registered nurses facilitated resident recruitment by identifying and introducing the study to residents who were eligible for study participation. Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is considered as a major health problem for women, and the prevalence is increasing over the world. Research to improve their quality of life is necessary. Purpose: This study was to examine the body image and self‐esteem of breast cancer patients who underwent breast reconstruction in order to determine whether these affect their quality of life. Methods: A cross‐sectional descriptive design was employed. This study was conducted on 140 patients who underwent breast reconstruction following breast cancer surgery at S University Hospital in Gyeonggi‐do, South Korea. Measures were the general characteristics list, body image scale, self‐esteem scale, and the Korean version of the Functional Assessment of Cancer Therapy‐Breast Cancer Version 4 for quality of life. Data were analysed using descriptive statistics, Pearson correlation coefficient, linear regression, and process macro bootstrapping for mediation effect. Data were collected from October 2020 to March 2021. Results: The path regression coefficient was 1.59 (p <.001), and the direct effect of body image on the quality of life was 1.34 (p <.001) considering the effect of self‐esteem, which is a parameter. This confirmed that self‐esteem mediates body image and quality of life. The explanatory power of self‐esteem for quality of life was 54%. Conclusion: This study suggests that body image and self‐esteem are important factors in the quality of life of breast cancer patients who underwent breast reconstruction. Also, the self‐esteem has a mediating effect in the relationship between body image and quality of life. Relevance to clinical practice: In clinical practice, nurses should focus on the body image and self‐esteem of breast cancer patients who have undergone breast reconstruction in order to improve their quality of life. Patient or public contribution: This cross‐sectional descriptive design study was conducted on patients who underwent breast reconstruction following breast cancer surgery at hospital in South Korea. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this study was to examine work‐related stress, nurse–physician collaboration and clinical reasoning competence to identify the factors that affected the triage competence of emergency room nurses. Background: A quick and accurate treatment plan for patients is first determined by a triage nurse. Triage competence is an indispensable requirement for emergency room nurses. Design: A cross‐sectional design was adopted. Methods: The participants comprised 156 emergency room nurses in South Korea who had more than 1 year of experience working in an emergency room. The collected data were analysed using SPSS 28.0. Self‐reported data were collected via the Korean Nursing Stress, Nurse–Physician Collaboration, Nurse Clinical Reasoning, Emergency Room Nurse Triage Competence assessing work‐related stress, nurse–physician collaboration, clinical reasoning competence and triage competence. In the analyses, multiple regression analysis using the enter method was conducted. We have followed through the STROBE checklist for the preparation of this manuscript. Results: Triage competence significantly differed according to the age (F = 9.93, p <.001), clinical experience (F = 18.82, p <.001), emergency department experience (F = 12.07, p <.001), triage experience (t = 4.40, p <.001) and if nurses had a triage certificate (t = 4.85, p <.001). The factors that influenced triage competence included clinical reasoning competence (β =.36, p <.001), emergency department experience (β =.21, p =.006), work‐related stress (β =.18, p =.007) and nurse–physician collaboration (β = −.17, p =.009); these factors accounted for 38.1% of the variance in triage competence. Conclusion: The results of this study show that efforts to improve triage competence should be based on clinical reasoning. In addition, an effective plan should be devised to improve nurse–physician collaboration and work‐related stress. Relevance to Clinical Practice: Education programmes should be developed to enhance clinical reasoning competence in order to improve triage competence. In addition, a method for managing work‐related stress among nurses in emergency departments and programmes to enhance collaborative physician–nurse relations should be developed. [ABSTRACT FROM AUTHOR]

Aim: To investigate how personal protective equipment with an attached powered air‐purifying respirator worn by intensive care unit nurses caring for COVID‐19 patients in Korea impacts nursing‐skill performance and psychosocial stress. Design: A cross‐sectional descriptive study was designed using purposive sampling. Review Methods: Online data collection was conducted from 3 March 2021–20 March 2021on 181 nurses who had worked for more than 1 month in COVID‐19 critical care settings wearing personal protective equipment with a powered air‐purifying respirator. A structured questionnaire was used to gather data on sociodemographic characteristics, attitude toward personal protective equipment, nursing‐skill performance wearing personal protective equipment and psychosocial stress. Data Sources: Data was sourced from structured questionnaire responses. Results: Nursing skill performance decreased to 63.4%, compared with normal performance. Subjects' perceptions and attitudes related to PPE scored 3.56 out of 5; 44.7% of subjects reported severe psychosocial stress, which was significantly affected by attitude toward personal protective equipment usage, nursing performance, experience caring for COVID‐19 patients and length of personal protective equipment usage per shift. Conclusion: Greater negative attitude toward usage of personal protective equipment with a powered air‐purifying respirator, results in lower nursing‐skill performance and higher the psychosocial stress of nurses responding to COVID‐19 outbreaks. Implications for the profession and/or patient care: High negative attitude toward PPE and low nursing‐skill performance due to PPE with an attached PAPR results in significant and debilitating psychosocial stress in ICU nurses responding to COVID‐19 outbreaks. To respond effectively to future infectious disease outbreaks and improve nursing performance, minimising the inconvenience and restrictions experienced by nurses wearing personal protective equipment is critical. Reporting Method: We adhered to relevant EQUATOR guidelines to report. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify and examine the relationship between the factors influencing the decision‐making ability of clinical nurses in hospitals, South Korea, and to establish a model, to verify the fit and the effect. Background: Clinical nurses are exposed to environments and situations where they make continuous decisions according to the need of direct treatment and nursing. Design: This study used a cross‐sectional descriptive design, relation prediction modelling and adheres to the STROBE guidelines. Methods: The model construction was based on the information processing theory by Hansen and Thomas (Nursing Research, 17, 436, 1968). The model consists of 5 exogenous variables (expertise, critical thinking disposition, knowledge‐sharing behaviour, nursing work environment, and decision‐making stress) and 3 endogenous variables (analytic‐systematic decision‐making type, intuitive‐interpretive decision‐making type and decision‐making ability). Participants were 274 clinical nurses, who were working at two hospitals in Seoul, South Korea. The data was analysed using SPSS WIN 18.0 and AMOS 20.0 program. Path analysis to verify the hypothetical model was used, and the fit was evaluated by χ2/df, GFI, AGFI, NFI, CFI and RMSEA. Data were collected from March to May 2017. Results: The fit index of the modified path model was χ2/df = 2.25, GFI =.972, AGFI =.929, NFI =.967, CFI =.981 and RMSEA =.068. The analytic‐systematic decision‐making type had the greatest direct effect on the clinical nurses' decision‐making ability, which is the final outcome variable, followed by significant direct and indirect effects on critical thinking disposition. Conclusion: This study suggests that the clinical nurses' decision‐making ability in hospitals were leadingly influenced by analytic‐systematic decision‐making type and critical thinking disposition. Relevance to clinical practice: In the nursing practice, nurses need to pay attention the analytic‐systematic decision‐making type and critical thinking disposition for improving decision‐making ability of clinical nurses in hospitals. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to examine and compare decision‐making preferences on end‐of‐life care for older people in Japan, the Hong Kong SAR and South Korea. Background: Cultural values and beliefs influence decision‐making on end‐of‐life care. Design: A cross‐sectional design was adopted. Methods: Community‐dwelling people aged ≥65 with additional requirements were recruited in 2016–2017 in the three regions. Their decision‐making preferences on end‐of‐life care were assessed using Pang et al.'s questionnaire. These preferences and their sociodemographic and personal experience variables were compared and analysed using univariate and multiple logistic regressions. The STROBE checklist was followed. Results: This study involved 415 participants. In all three regions, the most preferred decision maker and person with whom to discuss end‐of‐life care issues was a family member. Participants in the Hong Kong SAR were less likely to select a family member as their preferred decision maker than those in Japan (adjusted odds ratio = 0.129). Koreans were less likely to discuss end‐of‐life care issues with medical professionals than people in Japan (adjusted odds ratio = 0.278). More than 70% of the participants in each region indicated that they would not prefer to leave an advance directive to decide their end‐of‐life care. Conclusion: Older Asians prefer to make their own decisions after consulting others. Family members play an important role in helping older people plan their preferred end‐of‐life care arrangements, even acting as decision makers when older people become incapable of deciding for themselves. Relevance to clinical practice: Sufficient information should be provided to older people and their families for the older people to determine their preferred care. Helping families to understand and support the planned care and advance directives is a strategy for maximising family compliance with the care. Continuous efforts should be made to promote advance care planning and advance directives. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to identify and compare missed nursing care types and reasons between South Korea and the United States of America. Background: Patient safety has become a significant task of the healthcare delivery systems worldwide. The omission of nursing care constitutes a growing concern because it threatens both patient safety and nursing care quality. Design: This study used a cross‐sectional, descriptive and comparative design. Methods: Data were collected from registered nurses working in two university‐affiliated tertiary hospitals and a general hospital in Korea and a Midwest United States tertiary hospital. In addition, the STROBE checklist was used in this study. Results: While substantial, the level of missed nursing care reported by Korean nurses was lower than that of United States nurses. Only three nursing care activities, setting up meals, patient assessment and skin/wound care, did not significantly differed between two countries. More basic nursing care types such as ambulation, feeding and mouth care were missed more than others in both countries. The reasons for missed care differed between two countries. However, both Korean and US nurses reported labour resource problems as reasons for missed care. Conclusions: Although the types of missed nursing care differed significantly between countries, both Korean and US nurses reported labour resource problems for the top reasons for missed care. Thus, comparing missed nursing care could assist nursing administrators in developing strategies to improve care quality and patient safety. Relevance to clinical practice: The level and reasons for missed nursing care are very influential factors for patient outcomes and patient safety. Appropriate skill mix and staffing are needed to decrease extent of missed care, so that enhancing patient safety and quality of nursing care. [ABSTRACT FROM AUTHOR]

Aims and objectives: The objective of this study was to examine differences in personal characteristics, core practice competency and role stress according to levels of teaching efficacy among clinical nurse educators working in general hospitals. Background: In the clinical setting, successful adaptation to instruction among practicing clinical nurse educators is challenging. Design: Secondary analysis of data through a cross‐sectional study design was adopted. Methods: Originally, 565 nurses were recruited from general hospitals; 364 were included in this study. Participants were nurses with more than 1 year of experience in various settings from 16 general hospitals wherein nursing students trained for clinical practicum in five cities in South Korea. Self‐reported data were collected via the Teaching Efficacy, Core Practice Competency and Perceived Stress Scales assessing clinical education‐related teaching efficacy, core practice competency and role stress. In the analyses, comparison between nurses with high and low teaching efficacy was conducted. We have followed through the EQUATOR (e.g. STROBE) research checklist for the preparation of this manuscript. Results: According to univariate analysis, levels of teaching efficacy were shown to be higher with age, longer clinical careers, in those undergoing a doctoral course or with a doctorate, previous experience in providing clinical education and enrolment in continuing education for clinical education. In the multivariate analysis, enrolment in continuing education for clinical education, assessment and intervention skills, critical thinking skills, teaching skills and role ambiguity were associated with level of teaching efficacy among nurse educators. Conclusion: Based on the results of this study, we recommend that nursing administrators should foster the recognition of personal characteristics in potential clinical nurse educators or preceptors with high teaching efficacy. Relevance to clinical practice: Nurses should be supported by providing them with opportunities for professional development to enhance teaching efficacy. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock. Background: Although work environment is related to transition shock in newly licensed nurses, little is known about the factors of nursing work environment associated with transition shock. Furthermore, resilience is known to help nurses positively face workplace challenges; however, there is little evidence on the associations between resilience and transition shock in new nurses. Design: A cross‐sectional, descriptive study. Methods: Data from 163 new nurses with <12 months of work experience in the current hospital since graduation were analysed. Participants' characteristics, work environment, nurse resilience and transition shock were self‐reported. Multivariable linear regressions were performed in three steps (following the STROBE checklist). Results: The highest mean score of transition shock was obtained for the item 'I perceive the limitations of my professional knowledge in nursing care'. In the regression analysis adjusted for all variables, two factors of work environment—'nurse staffing and resource adequacy' and 'collegial nurse‐physician relationships'—were associated with transition shock. Meanwhile, resilience was not related to transition shock. Conclusions: The gap between newly licensed nurses' theoretical and practical knowledge continues to exist. Adequate nurse staffing and a positive relationship with physicians, rather than nurse resilience, were more likely to associate with new nurses' transition shock. Relevance to clinical practice: Hospitals need to provide ward‐based simulations and case‐based learning methods to enhance nurses' transition to professional practice. For nurses' transition, hospitals should make efforts to provide adequate nurse staffing and resources. Furthermore, hospitals should provide communication opportunities to build a positive collaborative culture between nurses and physicians. Unit nurse managers need to assess newly licensed nurses' perception of nurse–physician professional relationship and create an atmosphere of respect and understanding for each other. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study examined nurses' intention to allow family presence during resuscitation (FPDR) by applying the theory of planned behaviour with an extended concept. Background: Medical institutions, including nurses and other medical professionals working in emergency and intensive care units, are reluctant to allow FPDR. However, this practice reduces the family's anxiety and stress while fostering well‐being and minimises their feelings of helplessness and distress by making them believe that they have helped the patient. Design: A cross‐sectional descriptive design was used in this study. Methods: The participants were 252 nurses who had been working for at least 3 months in a general hospital in South Korea. Data were collected using self‐report questionnaires in April 2020 and were analysed using descriptive statistics, Pearson's correlation analysis and multiple regression analysis. The instruments were intention to allow FPDR (five constructs: intention to allow FPDR, positive attitude, negative attitude, subjective norm and perceived behavioural control), perception of FPDR and self‐confidence. The STROBE checklist was used for reporting this study. Results: The mean score for the intention to allow FPDR was 3.47 out of 5. The regression analysis results indicated that perception of FPDR, positive attitude and negative attitude predicted the intention to allow FPDR. Conclusions: It is necessary to develop educational programmes to change the perceptions of and attitudes towards FPDR. Additionally, written policies and protocols for FPDR in South Korea are needed to develop systematic care for patients' families during cardiopulmonary resuscitation. Relevance to clinical practice: The findings of this study provide baseline data for developing FPDR policies and guidelines that could minimise the family's distress and allow them to feel that they have helped the patient. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare two health literacy measurements' ability to assess older adults' medication adherence by using the Korean Health Literacy Screening Questions (KHLSQ) and the Modified Korean Functional Health Literacy Test (M‐KFHLT), and to identify an appropriate health literacy measurement. Background: Lower health literacy has been associated with poorer medication adherence. Thus, health professionals should evaluate the available health literacy assessment instruments they are using and choose an appropriate instrument to assess health literacy to increase older adults' medication adherence. Design: Following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, a descriptive, cross‐sectional study was conducted. Methods: From November 2017–May 2018, 116 community‐dwelling older adults were recruited in South Korea. Questionnaires were completed during a face‐to‐face interview with each participant in a private room; health literacy was assessed using the KHLSQ and the M‐KFHLT and medication adherence using the Morisky Medication Adherence Scale. Results: Health literacy assessed using the KHLSQ was found to be a predictor of medication adherence, but was not a predictor when measured by the M‐KFHLT. Having low income, multiple chronic diseases and vision problems were also significant factors related to medication adherence. Conclusions: This study suggests that health literacy was negatively associated with medication adherence. Furthermore, KHLSQ is an appropriate tool for healthcare providers to use when assessing health literacy to predict older adults' medication adherence. Relevance to clinical practice: This finding indicated that healthcare providers should select an appropriate health literacy measurement that suits their purposes and the population they serve, particularly for older adults. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the level of self‐care behaviours among patients with diabetic foot ulcers and identify factors related to their self‐care behaviours. Background: This study focused on the self‐care behaviours of patients diagnosed with diabetic foot ulcers, a complication of diabetes. Design: A cross‐sectional study design was adopted. Methods: From July–August 2018, 131 outpatients and inpatients with diabetic foot ulcers were given a survey questionnaire regarding self‐care behaviours and expected related factors at two Korean hospitals. In this study, self‐care behaviours were diabetes management and diabetic foot care. Demographic, disease‐related and laboratory characteristics were collected. The data were analysed in terms of descriptive statistics, a t test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. STROBE checklist was used as the guideline for this study. Results: Moderate levels of self‐care behaviours were found. The stepwise multiple regression analysis revealed that diabetes management was significantly related to perceived family support, experience of diabetic education, perceived stress, a problem‐focused coping style, experience of hospitalisation and comorbidity. Furthermore, diabetic foot care was significantly associated with the experience of diabetic education, perceived family support, and serum level of erythrocyte sedimentation rate and haemoglobin A1C. Conclusions: Perceived family support was the main factor affecting diabetes management, and diabetic foot care was greatly affected by the experience of diabetic education. It is necessary to develop diabetes education programmes and nursing interventions to increase family support to improve the self‐care behaviours of patients with diabetic foot ulcers. Relevance to clinical practice: Self‐care behaviours among patients with diabetic foot ulcers are important, as they affect healing of the wound and the quality of life. Further development of family‐based diabetes education or programmes is recommended to promote the self‐care behaviours of patients with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Aims and objectives: To test a hypothetical path model estimating the influence of resilience and gratitude disposition on well‐being in Korean clinical nurses and to verify the mediating effects of burnout, compassion satisfaction and job satisfaction using a multi‐mediation model. Background: To improve the well‐being of nurses, it is necessary to consider their personal and work‐related characteristics comprehensively. Design: A descriptive cross‐sectional design was used. Methods: A total of 310 clinical nurses participated in this study. A structured questionnaire was used to collect data. A path analysis using a multi‐mediation model was performed using AMOS 23.0 to test the hypothetical path model. This study adhered to the STROBE guideline. Results: The model's fit indices were adequate. Resilience and gratitude disposition both had significant direct effects on well‐being. Resilience and gratitude disposition had significant indirect effects on well‐being through the effect of burnout, compassion satisfaction and job satisfaction. Resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction explained 68.3% of the total variance of well‐being. Conclusions: Intervention programmes considering these factors may be useful to improve nurses' well‐being. Relevance to clinical practice: Nurses' well‐being should be assessed along with resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction. To improve the well‐being of clinical nurses, systematic and integrated intervention programmes need to be developed and applied, with consideration for a variety of factors related to well‐being. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify whether meaning in life has moderating and mediating effects on the relationship between depression and quality of life in patients with dysphagia. Background: Dysphagic patients typically have multidimensional problems, such as depression, which can negatively influence their quality of life. Meaning in life, therefore, can be used as a psychological resource that may enhance quality of life for these patients. Design: A descriptive cross‐sectional research design was used. Methods: Ninety patients with dysphagia were recruited for a survey from eight general and rehabilitation hospitals in Korea. The questionnaires, which included the Korean version of the Swallowing Quality of Life scale developed by Cha, the Center for Epidemiological Studies‐Depression Scale developed by Radloff, and the Purpose in Life test developed by Crumbaugh and Maholick, were used for data collection. Descriptive statistics, Hayes' PROCESS macro and Cronbach's alpha were used for data analyses. Results: Meaning in life was found to mediate the relationship between depression and quality of life in patients with dysphagia. However, the index of moderation was not statistically significant, which mean that meaning in life did not moderate the relationship between the patients' depression and quality of life. Conclusions: Meaning in life had a mediating effect on the relationship between depression and quality of life in patients with dysphagia. Thus, to improve the quality of life of patients with dysphagia, nurses should apply interventions to help them find meaning in life. Relevance to clinical practice: Meaning in life can be used as a nursing intervention strategy to improve the quality of life for patients living with dysphagia and depression. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the current state of face‐to‐face bullying and cyberbullying among nurses in the workplace and to identify the effects of nursing organisational culture on face‐to‐face bullying and cyberbullying. Background: It is important to accurately examine the current state of workplace bullying to acknowledge the gravity of the situation faced by nurses and devise prevention strategies. Electronic communication by computer or smartphone is widely used as a prompt and efficient means of facilitating nursing work; however, this leads to the possibility of cyberbullying as well as face‐to‐face bullying among nurses. Design: Descriptive cross‐sectional study. Methods: A total of 226 staff nurses working in one of five upper tertiary hospitals in Korea with a career of 10 years or shorter were surveyed using a self‐reported questionnaire. The collected data were evaluated using various statistical analyses, including hierarchical regression. Our study was applied to the STROBE checklist of items. Results: The mean face‐to‐face bullying score was 1.32 ± 0.53 and the cyberbullying score was 1.14 ± 0.37 (possible range: 1–5); most were work‐related negative experiences. The explanatory power of nursing organisational culture for face‐to‐face bullying was 6.3%, and relation‐oriented culture and hierarchy‐oriented culture were major factors affecting face‐to‐face bullying. The explanatory power of nursing organisational culture for cyberbullying was 4.3%, and relation‐oriented culture was a major factor affecting cyberbullying. Conclusions: Relation‐oriented culture had a significant effect on both face‐to‐face bullying and cyberbullying. Therefore, organisations should strive to foster a relation‐oriented nursing organisational culture in order to prevent and resolve workplace bullying among nurses. Relevance to clinical practice: Cyberbullying should be addressed as an important type of workplace bullying in nursing, which occurs via various information and communication devices. To prevent workplace bullying among nurses, various strategies that promote relation‐oriented nursing organisational cultures should be considered. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to examine the levels of symptom experiences and health‐related quality of life (HRQOL) among non‐small cell lung cancer (NSCLC) patients participating in clinical trials, and to identify the factors influencing their HRQOL. Background: It has known that lung cancer patients experience more symptoms than other cancer patients. With the introduction of new treatment for NSCLC patients, the patients have experienced different types of symptoms and it could influence their HRQOL. Design: A cross‐sectional study design was adopted. Methods: One hundred and eighteen NSCLC patients enrolled in clinical trials at two Korean tertiary hospitals participated in this study. Participants completed the Memorial Symptom Assessment Scale (MSAS) and the Short‐Form Health Survey 36 (SF‐36) version 2. Demographic, disease‐related and clinical trial‐related characteristics were collected. Descriptive statistics, t test, Mann–Whitney test, ANOVA, Pearson correlation and multiple regression were used for data analysis. STROBE checklist was applied as the reporting guideline for this study (see Supporting Information File S1). Results: The total MSAS score was relatively low, and "lack of energy" was the highest symptom level in frequency, severity and distress. The level of physical HRQOL was higher than the cut‐off score, and the level of mental HRQOL was lower than the cut‐off score. The factors affecting physical HRQOL were symptom experience, performance status and smoking history. The factors affecting mental HRQOL were symptom experiences and family income. Conclusions: Symptom experience was a main affecting factor of physical and mental HRQOL. Interventions for relieving symptom experiences should be developed, and performance status, smoking history and financial burden of lung cancer patients should be considered in clinical settings. Relevance to clinical practice: HRQOL may be improved by reducing the level of symptom experience. Healthcare professionals should assess patients' symptom experience and develop patient‐centred symptom management programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the factors influencing caregiver burden in families of hospitalised lung cancer patients. Background: Even though cancer symptoms among hospitalised lung cancer patients are serious and negatively affect caregivers, few research regarding to the factors of caregiver burden in hospitalised lung cancer patient has been carried out. Design: Cross‐sectional, descriptive and correlational study. Methods: A convenience sample of hospitalised lung cancer patients (n = 107) was recruited from K University hospital in South Korea. Family depression, social support and caregiver burden as well as patients' lung cancer symptoms were measured using peer‐reviewed and standard measurement tools. Descriptive statistics and parametric tests including stepwise regression were used to analyse the data. The STROBE guideline has been used to report this study. Results: Caregiver burden among the families of hospitalised lung cancer patients was high; the regression model for caregiver burden among participants' families was significant. Depression among families was found to be the most influential factor for caregiver burden, followed by patients' lung cancer symptoms. Conclusions: This study revealed that family caregivers' depression and patients' lung cancer symptoms were the most significant factors for families' caregiver burden. Future research should be conducted to identify the causes of depression among families of hospitalised lung cancer patients and develop management programmes to address such causes. It is also necessary to investigate the causes of increased caregiver burden that differentiate families of lung cancer patients from other cancer patients and provide education to help such families understand such causes. Relevance to clinical practice: Findings from this study show that family's depression and lung cancer symptoms were significant factors for caregivers' burden. Hence, it is suggested for the healthcare providers to find for the best solution/strategies to reduce the caregiver's burden. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the factors associated with the intention to leave among nurses in small‐ and medium‐sized hospitals and to determine the predictors about work environment and rewards. Background: Compared with large hospitals, insight into the working conditions, rewards and turnover of nurses working for these hospitals is lacking internationally. Design: Cross‐sectional study design. Methods: Data were obtained from the Korean Nurses Association's 2016 Welfare Policy and System Improvement Survey. Of the participants, data from 951 staff nurses working three shifts were analysed using hierarchical multiple regression to explore the predictors of nurses' turnover intention. This study complied with the Strengthening the Reporting of Observational studies in Epidemiology. Results: The perceived pay level satisfaction was the most obvious and persistent predictor of the intention to leave. Living benefits were shown to be scarcely satisfied, rendering considerable influence on turnover intention. Concerning aspects related to the working environment, the implementation of contract‐abiding working hours and nurse‐friendly night shift schedules reduced the turnover intention of nurses. Conclusions: Nurses in small‐ and medium‐sized hospitals are likely to have particular challenges in terms of professional growth. When fundamental rewards and basic working conditions are acceptable to nurses, their turnover can be reduced, and the professional growth can also be expected. Hospitals with a high nurse turnover rate need to preferentially verify these factors perceived by their nurses and to improve to increase nurses' retention. Relevance to clinical practice: Understanding the determinants of intention to leave can lead to the development of strategies that persuade nurses to remain employed. These findings inform policymakers, nurse managers and hospital managers of the causes of nurses' intentions to leave in small‐ and medium‐sized hospitals. Our findings also provide empirical data on the working conditions and rewards of these nurses and suggest strategies for their retention. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the association of nursing work environments and health‐promoting behaviours with shift‐work nurses' sleep disturbance. Background: Shift‐work nurses reportedly have sleep problems, which affect their sleep quality and quantity. Given the high risk of developing performance decrements and medication errors in sleep‐disturbed nurses, factors related to sleep disturbance among shift‐work nurses should be investigated. Design: A cross‐sectional secondary data analysis. Methods: Our study analysed data from 339 nurses who had been involved in rotating shift work including night shifts for more than 6 months. To examine associations of nursing work environments and health‐promoting behaviours with sleep disturbance, multiple linear regression models were generated. This study is reported in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology guideline. Results: Nurses with more collegial relations with physicians were significantly less likely to have high levels of sleep disturbance (B = −4.01, p = 0.04). Those with higher levels of sleep disturbance were significantly more likely to report less stress management (B = −9.56, p < 0.01) and higher health responsibility (B = 9.30, p < 0.01). Conclusions: To alleviate shift‐work nurses' sleep disturbance, organisational supports for collaborative relations with physician and increased healthcare accessibility are needed. Individual nurses should develop healthy lifestyles to reduce occupational stress and alleviate sleep disorders. Relevance to clinical practice: To improve shift‐work nurses' sleep, collegial relations with physicians and healthy lifestyles should be promoted. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify Zika virus‐related knowledge, attitudes to Zika virus and health motivations of pregnant women, women preparing for pregnancy and their partners, and to identify factors that influence preventive health behaviours for Zika virus infection. Background: Prevention of Zika virus infection is becoming a major worldwide public health effort. The high‐risk group for Zika virus infection comprises women who are pregnant or preparing for pregnancy. Few studies have addressed preventive health behaviours for Zika virus infection by gender. Design: This study was a descriptive cross‐sectional survey. Methods: Participants (112 males and 147 females) were selected by convenience sampling from three obstetric clinics located in South Korea. Women and their partners who visited obstetric clinics during pregnancy or preparing for pregnancy were included as subjects. Results: Factors associated with preventive health behaviours for Zika virus were checking infection status of Zika virus on destinations when planning a trip and attitudes to Zika virus in males and age, educational level, intention to travel to Zika virus endemic countries, attitudes to Zika virus and health motivation in females. Conclusions: Factors that influence preventive health behaviours for Zika virus were different by gender. However, attitudes to Zika virus were influential to both genders. Gender differences should be considered in development of health policies to improve preventive health behaviours for Zika virus. Younger and less educated women are to be targeted, and health management programmes should be developed to promote health motivation. Relevance to clinical practice: Pregnant women, women preparing for pregnancy and their partners need education and public health promotion to improve self‐management during travel to places where Zika virus is endemic. Health policies and health management programmes considering age and educational background should be developed to promote health motivation in women of childbearing age. [ABSTRACT FROM AUTHOR]

Aim and objectives: To examine nursing handoff, identify causes of handoff errors, evaluate current methods of handoff and determine the factors associated with handoff evaluation in delivery rooms and neonatal units of hospitals in South Korea. Background: Handoff is a critical communication process in clinical settings. Less attention has been paid to the handoff practice to assure safe perinatal care in hospitals. Design: This is a cross‐sectional descriptive study. Methods: A total of 291 nurses participated in the study. They completed a set of self‐reporting questionnaires containing five instruments that evaluated demographic data and current handoff strategies, experience of handoff error, causes of handoff error, perception of patient safety culture and handoff evaluation. The responses were analysed using descriptive statistics and stepwise regression modelling. Results: Perception of patient safety culture was positively related to handoff evaluation, while experience and causes of handoff error were negatively related to handoff evaluation. A regression analysis showed that degree of cooperation among departments and units, reasonable communication and processes, and frequency of reported medical errors were positively related to handoff evaluation and the lack of documented guidelines or checklists was negatively associated with handoff evaluation. Conclusions: This study suggests that hospitals should develop a standardised handoff checklist according to documented guidelines, promote cooperation among hospital units and departments, enhance communication and clarify work processes to achieve safer care to create an affirmative culture that encourages reporting of errors to keep patients safe. Relevance to clinical practice: This study highlights the importance of standardising handoff process and systems, promoting communication and cooperating with each other to foster patient safety culture in perinatal care units. [ABSTRACT FROM AUTHOR]

Aims and objectives The objective was to survey the current state of human papillomavirus ( HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27). Background Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical, anal, and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore, motivation to receive human papillomavirus vaccination is needed to protect infection. Design Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females, because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea. Methods Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge, health beliefs, demographic, and sexual history information variables relating to intentions to vaccinate were assessed. Results The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student, experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination. Conclusions To promote human papillomavirus vaccination, educational programming targeting males should include health beliefs and knowledge, emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases. Relevance to clinical practice Male high school students should be included as a major target population for school human papillomavirus education programmes, as they are at the age of commencing sexual intercourse. In addition, public health policies including human papillomavirus vaccination in the national immunisation programme are warranted. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the relationship between professionalism and professional quality of life among oncology nurses working at tertiary hospitals in Korea. Backgrounds Oncology nurses are combined with core competencies and qualities required in cancer patient care. Professionalism that means compassion satisfaction and compassion fatigue is a main concept in problem-solving strategies as motivation. Their satisfaction is representative of professionalism and professional quality of life. However, little research has focused on professionalism and professional quality of life. Design A cross-sectional study with self-administered questionnaires. Methods A total of 285 nurses from two tertiary hospitals were included. Data collection was undertaken using Korean version of professionalism scale derived from the Hall Professional Inventory Scale and professional quality of life. Data were analysed by spss 21.0 for Windows Program using t-test, anova, and multiple regression. Results The mean score of professionalism in oncology nurses was 77·98 ± 7·31. The mean professional quality of life score for compassion satisfaction, compassion fatigue and secondary traumatic stress was 33·84 ± 5·62, 28·38 ± 5·36 and 28·33 ± 5·48. Compassion satisfaction was affected by factors of professionalism with an explanatory power of 49·2%. Burnout and secondary traumatic stress were affected by factors of professionalism with an explanatory power of 39·3% and 4·8%. Conclusion The higher the professionalism leads to the higher the compassion satisfaction, the lower the compassion fatigue. The relationship between professionalism and professional quality of life for a health work environment requires further investigation. Relevance to clinical practice Our study supports the idea that enhancing professionalism can increase professional quality of life. It is necessary to develop professionalism by recognised qualifications and applied rewards in advanced nursing organisational culture. Furthermore, compassion satisfaction is increased by continuing ethical and moral education programme for clinical nurses to force professional dedication and encouraging nurses to affiliate themselves with the professional communities. Nurses are connected to professionalism affect the quality of nursing service for patients and professional quality of life for themselves. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study was to survey nursing students' Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception to examine the correlations among the variables during a Middle East respiratory syndrome outbreak. Background. Middle East respiratory syndrome is a new viral respiratory illness. Nursing students who engage in clinical practice at hospitals may have been exposed to Middle East respiratory syndrome infection during the Middle East respiratory syndrome outbreak. Design. This study was a descriptive cross-sectional survey. Methods. Participants (n = 249) were nursing students in their third or fourth year of the programme who were engaged in clinical practice for eight hours per day at the tertiary hospitals with Middle East respiratory syndrome patients. Knowledge, preventive behaviours and risk perception related to Middle East respiratory syndrome were measured using scales developed through a preliminary survey and validity testing. Results. The subjects' knowledge level of Middle East respiratory syndrome was 84-4%; their practice of preventive behaviours was rated at 44-5%; and their risk perception rating was 2-4 out of 5. Middle East respiratory syndrome-related risk perception was significantly different according to gender and Middle East respiratory syndrome education. Middle East respiratory syndrome-related knowledge was significantly correlated with preventive behaviours and risk perception. Conclusion. Considering the low scores for items regarding knowledge and preventive behaviours, it is necessary to develop effective and systematic publicity and education programmes for nursing students. Enhancing Middle East respiratory syndrome-related knowledge by considering cooperation between hospitals and universities will sharpen nursing students' risk perception of the disease and effectively increase their preventive behaviours. Relevance to clinical practice. Similar to other emerging infectious diseases, Middle East respiratory syndrome outbreaks may occur in other countries. The results of this study can be used to develop and apply efficient and feasible Middle East respiratory syndrome education programmes for nursing students during Middle East respiratory syndrome outbreaks. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Background Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. Design A cross-sectional study. Methods A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. Results There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Conclusions Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Relevance to clinical practice Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning. [ABSTRACT FROM AUTHOR]

Aims and objectives The study was conducted to investigate the levels of implementation of knowledge management and outcomes of nursing performance, to examine the relationships between core knowledge management factors and nursing performance outcomes and to identify core knowledge management factors affecting these outcomes. Background Effective knowledge management is very important to achieve strong organisational performance. The success or failure of knowledge management depends on how effectively an organisation's members share and use their knowledge. Because knowledge management plays a key role in enhancing nursing performance, identifying the core factors and investigating the level of knowledge management in a given hospital are priorities to ensure a high quality of nursing for patients. Design The study employed a descriptive research procedure. Participants The study sample consisted of 192 nurses registered in three large healthcare organisations in South Korea. Method The variables demographic characteristics, implementation of core knowledge management factors and outcomes of nursing performance were examined and analysed in this study. Results The relationships between the core knowledge management factors and outcomes of nursing performance as well as the factors affecting the performance outcomes were investigated. A knowledge-sharing culture and organisational learning were found to be core factors affecting nursing performance. Conclusion The study results provide basic data that can be used to formulate effective knowledge management strategies for enhancing nursing performance in hospital nursing organisations. In particular, prioritising the adoption of a knowledge-sharing culture and organisational learning in knowledge management systems might be one method for organisations to more effectively manage their knowledge resources and thus to enhance the outcomes of nursing performance and achieve greater business competitiveness. Relevance to clinical practice The study results can contribute to the development of effective and efficient knowledge management systems and strategies for enhancing knowledge-sharing culture and organisational learning that can improve both the productivity and competitiveness of healthcare organisations. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the impact of ageing-related stereotypic beliefs on self-efficacy and health-promoting behaviours and to test the mediating effect of self-efficacy on the relationship between ageing-related stereotypic beliefs and health-promoting behaviours in older Korean people. Background Despite the growing attention given to ageing-related beliefs that can lead to better health outcomes in old age, little is known about the associations between ageing-related stereotypic beliefs, self-efficacy and health-promoting behaviours. Design A cross-sectional, descriptive study. Methods A total of 123 community-dwelling older women were recruited from three cities in south-east Korea. Direct and indirect effects of ageing-related stereotypic beliefs on self-efficacy and health-promoting behaviours were examined using path analyses. Results Ageing-related stereotypic beliefs significantly predicted self-efficacy and health-promoting behaviours. A significant indirect effect of ageing-related stereotypic beliefs on health-promoting behaviours through self-efficacy was detected, indicating that self-efficacy mediated the detrimental impact of ageing-related stereotypic beliefs on health-promoting behaviours. Conclusions Ageing-related stereotypic beliefs function as a factor lowering self-efficacy as well as decreasing health-promoting behaviours. Self-efficacy mediates the influence of ageing-related stereotypic beliefs on health-promoting behaviours, indicating that ageing-related stereotypic beliefs decrease self-efficacy which, in turn, could lead to fewer health-promoting behaviours. The findings demonstrate the significance of ageing-related stereotypic beliefs and self-efficacy in guiding the health-promoting behaviours of older people. Relevance to clinical practice Healthcare providers should play an active role in understanding ageing-related stereotypic beliefs and decreasing the perceptual barriers to health-promoting behaviours of older people. The development of nursing interventions to improve positive attitudes towards old age and self-efficacy is essential for enhancing health-promoting behaviours. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the level of pulmonary function, number of unplanned hospital visits, knowledge level of chronic obstructive pulmonary disease ( COPD), level of anxiety and depression, and level of health-related quality of life ( HRQo L) according to COPD action plan ( AP) adherence in Korean patients with COPD. Background Previous studies reported conflicting results about the effect of COPD AP on patient outcomes, with little descriptive information. Design A cross-sectional descriptive study design was used. Methods A total of 126 patients with COPD were recruited from Chonnam National University Hospital in Gwangju city from September 2009 to March 2010. COPD action plan adherence and the levels of knowledge of COPD, anxiety and depression, and HRQoL were measured using a short COPD AP developed by the Family Physician Airway Group of Canada executive members, Bristol COPD Knowledge Questionnaire ( BCKQ), the hospital anxiety and depression scale ( HADS) and the St George's Respiratory Questionnaire ( SGRQ), respectively. Results The score of COPD AP adherence was positively associated with the level of knowledge of COPD and negatively associated with the number of unplanned hospital visits and the level of anxiety and depression. Conclusion Good adherence to COPD AP is likely related to better health outcomes in COPD. Healthcare providers may need to enhance COPD AP aspect in various COPD self-management programmes to improve the health status of patients with COPD. Relevance to clinical practice Chronic obstructive pulmonary disease AP aspect targeting frequent individual education with a written guideline would be helpful to enhance self-management in patients with COPD. [ABSTRACT FROM AUTHOR]

Aims and objectives. To identify cancer-related symptom clusters, to explore their inter-relationships and to examine the effects of single symptoms and the synergistic effects of symptom clusters on functional performance using path analysis by structural equation modelling in patients with various types of cancer. Background. Recent studies suggest that cancer patients frequently experience three or more concurrent related symptoms and that this clustering of symptoms is likely to have negative synergistic impacts on outcomes, because of the complicated dynamics of clusters. Design. A cross-sectional design. Methods. One hundred and ten patients with various types of cancer were recruited as in- and out-patients at a University Hospital in Incheon, South Korea. Data collection was performed using a questionnaire and by direct interview. Pain, insomnia, fatigue, depression and functional performance were measured. Results. The developed model was composed of antecedents, symptom clusters and outcomes. Of the symptoms often encountered as clusters in cancer patients, insomnia, depression and fatigue were found to have significant single (direct) effects on functional performance. Seven symptom clusters were identified between pain and functional performance, three between insomnia and functional performance and one between depression and functional performance. These single symptoms and symptom clusters were found to have significant synergistic effects on functional performance and to explain 24% of functional performance variance. Conclusions. Multiple cancer-related symptom clusters may occur and the dynamics within symptom clusters is complicated. Our findings provide sound evidence regarding the importance of assessing and managing clusters of symptoms simultaneously rather than focusing on single symptoms. Relevance to clinical practice. A comprehensive understanding of symptom clusters in cancer patients would help establish valid diagnostic symptom cluster entities and aid the development of subjective/objective phenotypic criteria for symptom cluster based diagnoses and of nursing care protocols for managing symptom clusters. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim was to investigate the factors affecting the self-esteem and social competence of children with attention deficit hyperactivity disorder. Background. Many studies have reported parenting variables such as parenting attitude and sense of competence have been suggested as significant determinants of socio-emotional development of children with attention deficit hyperactivity disorder. In South Korean society, the traditional culture of Confucianism is a strong influence on parenting practices and children's behaviour. However, there have been few studies that examined the relative significance of the parenting and other associated factors for self-esteem and social competence in children with attention deficit hyperactivity disorder in Korea living in a strict parenting environment. Design. This study was designed as a cross-sectional and descriptive survey. Method. The subjects were 124 pairs of mothers and their children with attention deficit hyperactivity disorder, recruited from local paediatric psychiatric clinics in South Korea. Data collection was conducted through the use of questionnaires. Results. Affectionate parenting attitude and co-morbid condition of the child were the most important predictors of self-esteem. Rejecting parenting attitude was the most important predictor of social competence. Conclusion. Higher levels of affectionate parenting attitude of mothers and non-co-morbid status of children both contributed unique variance to the overall prediction of higher self-esteem of children. Higher levels of rejecting parenting attitude of mothers contributed unique variance to the overall prediction of lower social competence in children with attention deficit hyperactivity disorder. Relevance to clinical practice. Parenting attitude is the most important factor to contribute to the healthy socio-emotional development in children with attention deficit hyperactivity disorder. Health care providers need to develop and apply a parenting skills improvement program to improve positive parenting attitudes, which will benefit self-esteem and social competence in children with attention deficit hyperactivity disorder. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the level of anxiety and uncertainty in Korean mothers of children with febrile convulsion and to indentify factors associated with maternal anxiety. In general, febrile convulsions are harmless to the child, but parents perceive the convulsion as frightening. Previous authors of a few studies suggested that providing information was helpful for parents' knowledge, attitude and fear about a febrile convulsion. This was a descriptive, cross-sectional survey. The sample comprised 102 mothers whose children had been diagnosed with a febrile convulsion and admitted to paediatric wards in five general hospitals in South Korea. The researchers gave the questionnaires to nursing departments for distribution and collection by paediatric nurses. To test differences in anxiety and uncertainty by participants' characteristics, t-tests and were conducted. Linear regression was used to identify factors associated with maternal state anxiety. Statistical significance level was set at 0·05. A multiple linear regression of maternal anxiety showed that four statistically significant predictors explained 56% of the total variations of maternal anxiety. The significant predictors were uncertainty, frequency of febrile convulsion, income and information about febrile convulsion. Among the significant variables, uncertainty was the dominant contributing factor ( p < 0·001). Anxiety in mothers of children with febrile convulsion was especially related to uncertainty, so health care providers can reduce anxiety through decreasing uncertainty. For interventions to decrease maternal anxiety, provision of information and psychosocial support are needed for parents of hospitalised children with febrile convulsions. [ABSTRACT FROM AUTHOR]

To examine the relationship of low back pain prevalence and treatment to personal and work-related characteristics among intensive care unit nurses. Back pain is the most common work-related health problem among nurses. A cross-sectional study including a survey conducted in 2007. The study sample included 1345 nurses in 65 intensive care units in 22 South Korean hospitals. Back pain prevalence was measured by the frequency of back pain (always, once a week, once a month or once in two or more months) during the past year. Multilevel logistic regression analyses were conducted to examine the relationship between back pain and personal and work-related characteristics. The mean age of nurses was 27·2 years. Overall, 90·3% of nurses had back pain at least once a month (21·9% always, 40·7% once a week and 27·7% once a month). Only 18·3% had received medical treatment for their back pain. Compared with neonatal intensive care unit nurses, who had the lowest prevalence, nurses in other specialties, excluding paediatric intensive care units, had a greater likelihood of back pain. Specialty medical (e.g. cardiology, neurology) intensive care unit nurses had the greatest probability of back pain and treatment. Perceiving staffing as inadequate and working 6 or more night shifts per month were related to a 64% increase (OR = 1·64; 95% CI = 1·16-2·33) and 48% increase (OR = 1·48; 95% CI = 1·10-1·99) in back pain, respectively. Nurses with 2-4 years of working experience in intensive care units had the greatest probability of back pain and treatment. A high prevalence of back pain was found in intensive care unit nurses, even though they comprise a very young workforce in Korea. Improving nurse staffing, reducing the frequency of night shifts and assessing risk factors in specific intensive care unit specialties are suggested to decrease back pain prevalence. [ABSTRACT FROM AUTHOR]