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Purpose: This study aimed to determine the validity and reliability of the electronic Compassion Competence Scale (e-CCS). Methods: A cross-sectional, randomized, two-period crossover design was used. Nursing students from four South Korean universities were surveyed between June 2017 and April 2018. The participants were randomly assigned to one of three groups-paper/paper, electronic/electronic, and paper/electronic or electronic/paper-and a test-retest procedure was implemented. The reliability and validity of the e-CCS were evaluated using linear weighted kappa coefficients and intraclass correlation coefficients (ICCs). Internal consistency reliability was verified using linear weighted kappa coefficients and ICCs. Pearson's correlation coefficients between the initial test and retest scores were all statistically significant. Results: The newly developed e-CCS was found to have good reliability and validity. We suggest that future research should increase sample heterogeneity by recruiting diverse age groups, nurses working in different nursing fields, and students from multiple colleges. Conclusion: This electronic instrument will help determine the differences in the level of compassion competence and devise interventions to improve compassion competence in nurses and nursing students. Further studies on enhancing compassion competence among nurses and nursing students may rely on the use of this electronic format. [ABSTRACT FROM AUTHOR]

Current advances in technology have enabled the development of a computer-based questionnaire that provides advantages over the paper-based mode of administration, such as automatic data entry, storage and calculations. However, before implementing a computer-based questionnaire, its equivalence with the original paper-based questionnaire must first be demonstrated. The purpose of this study was to evaluate the measurement equivalence of the computerized Diabetes- Specific Quality-of- Life questionnaire ( cD- QOL) with its original paper-based counterpart. A two-period crossover design was used in this study. The measurement equivalence was evaluated using quadratic weighted kappa coefficients, intraclass correlations and Cronbach's alpha comparisons. The cD- QOL was equivalent to its original paper-based counterpart. Participants preferred the cD- QOL over the paper-based questionnaire and reported that it was easy to use. [ABSTRACT FROM AUTHOR]

In this paper, we propose a community-based dance programme designed for North Korean female defectors in South Korea, with the aim of promoting their physical, psychological, and interpersonal aspects. We set up four research objectives: to look into social contexts of North Korean female refugees in South Korea, to identify the women's desire for dance experiences, to design dance classes for North Korean female refugees, and to conduct a pilot study. Based on their past and current situations and their wish to participate in dance practice, the class structure and content was developed, focusing on heightening self-awareness and stabilising mind and body; expressing their emotions and releasing psychological stresses; and enhancing their ability to interact with others. In order to assess the appropriateness and feasibility of the class structure and content, we carried out three sessions in a pilot study where twelve North Korean female refugees participated. As a result, this paper suggests the dance classes as a feasible education programme for North Korean defectors to advance their abilities to adjust to the new environment, thereby enabling them to perceive the self not as the Other in South Korean society.

Aim: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. Background: Pregnant nurses, like non‐pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. Design and Methods: This cross‐sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. Results: One‐fifth of participants were working night shifts, and more than two‐thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. Conclusion: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses. Summary statement: What is already known about this topic? Nurses in early pregnancy are exposed to work environments that can affect their reproductive health.The relationship between mental health and work environment among nurses in early pregnancy is poorly understood. What this paper adds? Despite legal guidelines, some pregnant nurses performed potentially harmful work such as night shifts, overtime and heavy lifting.There were differences in the occupational risks to which the study participants were exposed depending on hospital size.Overtime and heavy lifting were related to anxiety and fatigue in study participants. The implications of this paper: To protect nurses in early pregnancy, an appropriate maternal safety programme should be developed for hospital work environments.Education programmes should be implemented for nurses in early pregnancy on safety guidelines such as the use of personal protective equipment (PPE).Physically difficult tasks can increase fatigue and anxiety among nurses in early pregnancy, so legal and institutional regulations focusing on safe working environments should be strengthened. [ABSTRACT FROM AUTHOR]

Research has proven the effectiveness of Flipped Classrooms (FC) for a variety of settings. However, more exploration needs to be done in regards to how FC can be used effectively in foreign language classrooms. The purpose of this study was to 1) explore student perceptions of FC in a Korean university general English course and 2) provide suggestions to inform better instructional practices. The FL model applied to the study was based on the University of Texas at Austin Center for Teaching and Learning and was conducted in a general English course for one semester at a university in South Korea. Both qualitative and quantitative data was collected in the form of a questionnaire administered to 80 students at the end of the course. The results were largely positive. Over half of students felt that the FC model aided their English studies. Students felt the FC gave them more chances to communicate in English, in addition to greater participation, preparedness, and feedback. Students also reported that the FC helped them have a deeper understanding of the course content. However, some students reported some dissatisfaction with the FC. When questioned regarding the disadvantages of FC, many reported the time requirement of the online homework and quizzes in addition to the video quality and variety of activities could be improved upon. Suggestions on how to use the FC more effectively are provided at the end of the paper.

This study aims to review the development of NWCCDL Project during the last 10 years from (2005 to 2014) and evaluate the effects of NWCCDL Project on the students' satisfaction of the project and their affective domain. The research data was analyzed from the results of the questionnaires which were conducted at the end of every semester. This research paper consists of three parts. The first is to review the development of NWCCDL Project from fall semester 2005 to fall Semester 2014. The second part is to prove that the participants are satisfied with this project. The students' satisfaction was analyzed on the results of the questionnaires focusing on several items. The third part is to prove that this project is very effective in cultivating the motivation and interest of EFL learners in the Korean university-level education context. This study can give much significant implication in the ELT area. First, this research is very important in the globalized educational context because NWCCDL Project is the international distance learning project designed to improve English proficiency through the interaction between Japan and Korea university students. Second, this research shows that the participants are satisfied with this project, which implies that using ICT in ELT area can be very effective in a foreign teaching and learning context. Third, this research can show that the interaction of non-native speakers of English through distance learning is effective in cultivating the motivation and interest of EFL learners in Asian countries. So the analytic results from the students' responses through the questionnaire provide significant implications for the effectiveness of NWCCDL Project in cultivating the motivation and interest of EFL learners in the Korean university, and also for the effectiveness of non-native speakers' interaction in learning English as a foreign language in Asian countries.

The paper investigates the effects of a project-based community participation course in which students chose research topics relevant to a local community. Specifically, the students undertook the following projects: (1) creating a virtual 3D model of a local government office, (2) creating interactive digitized versions of mountain trails using geotourism, (3) determining optimal locations for trash recycling bins using network analysis, and (4) assessing the water quality of a local river. Geographic information technologies, such as GIS and Google Earth, were employed as analytical and visualization tools. The answers to a questionnaire, course evaluations, reflective journals, and interviews found that participants positively evaluated their learning experiences. In addition, the projects received favorable reviews from community members and professional geographers.

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

This study investigates a Korean English as a foreign language (EFL) student teacher education programme which is intended to develop prospective teachers' digital literacy and to help them understand innovative pedagogy of computer-assisted language learning (CALL) in Korean EFL context. This paper presents ideas of effective curriculum development for a CALL-integrated EFL student teacher training programme while helping student teachers make effective and creative use of digital technologies both in their own language learning and in their future language teaching. Local voice and insight of implementing CALL into Korean EFL educational context was provided as well as global perspectives in CALL. The results revealed that the use of CALL could promote Korean EFL student teachers' confidence in developing technological skills and pedagogical expertise. This study may have implications that this CALL-integrated EFL student teacher training course can pinpoint and fill the existing gap between the current and upcoming educational situation regarding the use of CALL in Korean EFL context and help student teachers consider themselves as confident and competent users of CALL for the future.

Students often complain about unsatisfactory experiences resulting from disproportionate contributions to collaborative projects. To improve the experience, we applied regulation theory to design a process to document regulation on a blog and examined whether such documentation enhanced students' self-regulation and co-regulation skills while working on a collaborative project. The results indicate that students improved both their self- and co-regulation skills significantly and they were highly satisfied with their experiences in the collaborative task. In addition, the content analysis performed on the documented regulation reveals that students engaged in diverse types of regulation processes through social interaction with group members. A discussion of teaching and learning strategies when using a blog in a collaborative task is included in this paper.

Background: Kuhn's model of science has been widely influential, but in this paper, it is argued that it is more appropriate to consider constructivist learning within science education as a research program in the sense used by Lakatos. Purpose/Hypothesis: This study offers teaching strategies and their corresponding instructional sequences based on Lakatosian Methodology, and examines the effects of a Lakatosian Conflict Map using pre-service elementary teachers' conceptual understandings of the causes of seasons. Design/Method: The Lakatosian Conflict Map was applied to concepts of seasonal change held by pre-service elementary teachers. Results: Most pre-service elementary teachers consistently protect their hard-core beliefs about seasonal change by offering auxiliary hypotheses related to earth's elliptical orbit and the tilt of its rotational axis in response to activities designed to promote conceptual change around knowledge related to the cause of the seasons. Specifically, the critical event rather than the discrepant event in the Lakatosian Conflict Map was conducted in a Lakatosian conflict group and these students were allowed to explicitly express their representations about the phenomena derived from these events. The result of this study is that instruction using the new Lakatosian Conflict Map produced more favorable outcomes in terms of conceptual change than traditional instruction. Conclusions: This research concludes that the Lakatosian Conflict Map can help science teachers and students resolve the conflicts between students' existing ideas and target scientific concepts.

Numerous studies have been published heralding the benefits of physical education in school education. Sport and physical activities form the major content in learning and the arrangement serves as the major source of development in students. This paper identifies "quality" as an internationally concerned issue and within the concept, the perceptual framework in learning is then placed with focus. To conduct this study, a sample of N = 799 ("11 Asian cities") physical education professionals working in different levels were invited to participate in a questionnaire survey with 37 items designed to forge the conceptualization of quality learning in physical education. Results from statistical analysis showed 24 items grouped in 3 subfactors being retained after EFA, of 37 items that were framed through content analysis to assess the quality physical education learning among the PE professionals. The retained three factors from the EFA were further assessed with robust confirmatory factor analysis (CFA). The 3-factor model demonstrated a good fit with the data (CMIN/DF = 7.367, NFI = 0.888, CFI = 0.901, PCFI = 0.748, RMSEA = 0.089). In this sample, the QPEL demonstrated an acceptable three-factor structure, internal consistency and inter-factor correlation. These items were appropriate to provide the necessary understanding of the diversified practice in the learning of quality physical education.

Lack of motivation and of real-world relevance have been identified as reasons for low interest in science among children. Game-based learning and storytelling are prominent methods for generating intrinsic motivation in learning. Real-world relevance requires connecting abstract scientific concepts with the real world. This can be done by situating learning processes in real-world contexts, and by bridging the virtual content and the real world with augmented reality (AR). We combined these ideas into a Science Spots AR platform on which context-aware storytelling science learning games can be created. As proof-of-concept we developed and evaluated Leometry game, which contains geometry problems based on the Van Hiele model. This paper's contributions are as follows: (1) concept and architecture of Science Spots AR, (2) design and implementation of the Leometry game prototype, and (3) mixed-method formative evaluation of Leometry with 61 Korean 5th grade elementary school children. Data retrieved by questionnaires and interviews revealed that the students appreciated Leometry despite its minor shortcomings, that the platform's concept is feasible, and that there is potential for building science learning games. These results are useful to educators, computer scientists, and game designers who are interested in combining context-aware learning, AR, and games.

This paper explores the quality of school life (QSL) of two 'model pupils' in Programme for International Student Assessment (PISA) tests, Finland and Korea, and investigates students' views on the central aspects of QSL ("general satisfaction," "peer relations" and "teacher-student relations") using PISA 2012 data. It also seeks to interpret how specific institutional and sociocultural aspects are linked to QSL. The analyses show that Finnish and Korean adolescents' views on QSL are less positive compared with the OECD average; Finnish adolescents' views on QSL are more positive than those of Korean adolescents regarding "general satisfaction" and "peer relations" but are not clearly related to "teacher-student relations." Since Finnish and Korean adolescents' views on QSL partly differ from those of their Nordic and East Asian counterparts, the distinct Nordic or East Asian image of QSL could not be revealed in the study. This article proposes that QSL demands more attention in the era of 'rankings and benchmarked educational models', with consideration to the universality and uniqueness of institutional, sociocultural and historical factors of one's own and others' schooling.

Purpose: The purpose of this paper is to empirically examine the fundamental process through which transformational leaders play a significant role in employees' knowledge sharing by investigating mediating roles of individual affects, particularly psychological empowerment, organizational commitment and organizational citizenship behavior (OCB). Design/methodology/approach: Structural equation modeling, including confirmatory factor and path analysis, is conducted to test proposed hypothesis. Findings: The results of this study indicate significant direct effects of transformational leadership on psychological empowerment, organizational commitment and OCB. Moreover, transformational leadership also shows an indirect effect on employees' OCB, which, in turn, is identified as the primary factor that influences knowledge sharing. However, organizational commitment does not provide a significant influence on knowledge sharing. These findings highlight the importance of mediating roles, particularly OCB, to predict employees' knowledge-sharing intention. Originality/value: Identifying structural determinants of knowledge sharing is an important scholarly agenda. In particular, the mechanisms and processes by which leadership exerts influence to motivate employees to share knowledge deserve scholarly inquiry, and there, is a need for more research to understand the mechanisms and processes through which leadership influences individual motivation and attitudes toward pro-social behaviors, such as knowledge sharing.

Purpose: This study aimed to evaluate senior baccalaureate nursing students' knowledge and visual differentiation ability for the pressure injury classification system (PICS) and incontinence-associated dermatitis (IAD). Methods: A cross-sectional survey was conducted using a paper-based questionnaire with 120 senior baccalaureate nursing students in South Korea. Data were collected using a knowledge test (KT) and a visual differentiation tool (VDT) based on 21 photographs with clinical information related to PICS and IAD. Results: Students had relatively high KT scores (62.6%), and low VDT scores (35.6%). Critical issues in this study were nursing students' lack of an adequate visual differentiation ability to accurately assess the stage of pressure injury and IAD and their higher level of confusion in identifying unstageable, deep tissue injuries, and IAD compared to stage 1-4 injuries. Satisfaction with education (r=.20, p<.05) and exposure to various teaching methods (r=.21, p<.05) exhibited significant correlations with higher VDT scores. Conclusion: The findings of this study suggest that increasing students' satisfaction with their education and applying various teaching methods can contribute to the improvement of visual differentiation ability in PICS. [ABSTRACT FROM AUTHOR]

This paper explores the underlying construct of both the English proficiency test for pilot and air traffic controller radiotelephony communication developed and administered in Korea and the ICAO language proficiency testing policy on which the test in Korea is based. It does so by canvassing the opinions of Korean airline pilots and air traffic controllers through 400 questionnaire and 22 interview sources. Results reveal a lack of fit between the policy construct and the reality through which the goals and objectives of the policy are accomplished and strong disapproval of the ICAO's espoused construct and the associated Korean English test from language users in the target domain. This study confirms the importance of eliciting views from such stakeholders (i.e., domain experts) who are well-placed to determine what really matters for communicative success in the context of concern.

Pervasive worlds are computing environments where a virtual world converges with the physical world through context-aware technologies such as sensors. In pervasive worlds, technology is distributed among entities that may be distributed geographically. We explore the concept, possibilities, and challenges of distributed pervasive worlds in a case study--an exergame entitled Running Othello. Combining a board game with sensor-enhanced physical activity, Running Othello aims at motivating young players to be physically active. Based on the analyzed literature and mixed-method evaluations of Running Othello, the following contributions emerged: (i) a total of 13 design principles for distributed pervasive exergames, (ii) the players' perceptions with distributed gameplay, (iii) an analysis of development challenges, and (iv) four dimensions of distribution in Running Othello. Player evaluations were conducted on university students and on children and young adults participating at a science festival. These results are useful to scholars and developers interested in the concept of pervasive worlds. With this exploratory paper, we have taken the first steps toward comprehending the conceptualization, design, implementation, and evaluation of distributed pervasive worlds.

In South Korea, "Damunwha" students (students from multicultural family backgrounds) have difficulties at school because of others' derogatory perception of them and the different linguistic and cultural settings. In light of this issue, this paper addresses the "Damunwha" students' identities and participation within the language communities from a community of practice perspective and a critical pedagogy perspective. Four students (two from international marriage families and two from immigrant workers' families), their teachers, and their supervisors participated in the study from March to April 2013. The findings suggest that "Damunwha" students' participation in Korean society depends on their resources, others' perception of the participants' identities, and cultural capital. The findings show that students are losing their connection with their first language communities and that their linguistic resources and cultural diversity are undervalued. The study implies that cultural sensitivity should be promoted and that explicit support for "Damunwha" students is needed.

When students look at their classmates in the classroom, consciously or unconsciously, they see competitors both for academic recognition and social success. How do they fit in relation to others and how do they succeed in achieving both? Traditional views on the drive to succeed and the fear of failure are well known as motivators for achieving academic success but is it that simple a dichotomy? Do students also view success through a fear of success and a purposeful intent to fail--referred to in this text as the drive to fail? Students recognize the importance of social position in class but how is this perceived and will they sacrifice social position for academic standing or vice versa? This paper considers these issues by analyzing the results of a student survey and opinions offered by the students. The discussion considers the survey, academic standing, social position, cultural variables, perception of success and failure, and concluding comments.

Background. Among the surgical methods for lumbar disc herniation, open lumbar microdiscectomy is considered the gold standard. Recently, percutaneous endoscopic lumbar discectomy is also commonly performed for lumbar disc herniation for its various strong points. Objectives. The present study aims to examine whether percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy show better results as surgical treatments for lumbar disc herniation in the Korean population. Methods. In the present meta-analysis, papers on Korean patients who underwent open lumbar microdiscectomy and percutaneous endoscopic lumbar discectomy were searched, both of which are surgical methods to treat lumbar disc herniation. The papers from 1973, when percutaneous endoscopic lumbar discectomy was first introduced, to March 2018 were searched at the databases of MEDLINE, EMBASE, PubMed, and Cochrane Library. Results. Seven papers with 1254 patients were selected. A comparison study revealed that percutaneous endoscopic lumbar discectomy had significantly better results than open lumbar microdiscectomy in the visual analogue pain scale at the final follow-up (leg: mean difference [MD]=-0.35; 95% confidence interval [CI]=-0.61, -0.09; p=0.009; back: MD=-0.79; 95% confidence interval [CI]=-1.42, -0.17; p=0.01), Oswestry Disability Index (MD=-2.12; 95% CI=-4.25, 0.01; p=0.05), operation time (MD=-23.06; 95% CI=-32.42, -13.70; p<0.00001), and hospital stay (MD=-4.64; 95% CI=-6.37, -2.90; p<0.00001). There were no statistical differences in the MacNab classification (odds ratio [OR]=1.02; 95% CI=0.71, 1.49; p=0.90), complication rate (OR=0.72; 95% CI=0.20, 2.62; p=0.62), recurrence rate (OR=0.83; 95% CI=0.50, 1.38; p=0.47), and reoperation rate (OR=1.45; 95% CI=0.89, 2.35; p=0.13). Limitations. All 7 papers used for the meta-analysis were non-RCTs. Some differences (type of surgery (primary or revisional), treatment options before the operation, follow-up period, etc.) existed depending on the selected paper, and the sample size was small as well. Conclusion. While percutaneous endoscopic lumbar discectomy showed better results than open lumbar microdiscectomy in some items, open lumbar microdiscectomy still showed good clinical results, and it is therefore reckoned that a randomized controlled trial with a large sample size would be required in the future to compare these two surgical methods. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the relationships among patient safety competency, systems thinking and missed nursing care. Background: Patient safety competency and systems thinking are important nurse attributes that promote patient safety. Missed nursing care is known to negatively impact patient safety. However, how nurses' patient safety competency and systems thinking relate to missed nursing care is unknown. Methods: A cross‐sectional survey design was used to collect data from nurses practicing in two general hospitals in South Korea. Data were collected between 3 March and 17 April 2020. Questionnaires were distributed to nurses providing direct care in general and specialty units. Patient safety competency, systems thinking and missed nursing care were measured using reliable and valid instruments. A total of 432 complete sets of data were used in final analysis. Results: Higher patient safety competency of nurses was associated with lower missed nursing care. Systems thinking partially mediated the relationship between knowledge of patient safety competency and missed nursing care, and attitudes of patient safety competency and missed nursing care. Conclusions: The knowledge, skills and attitudes sub‐scales of patient safety competency showed somewhat different effects in the relationship between missed nursing care and systems thinking, suggesting that each attribute may tap into a separate aspect of patient safety. Summary statement: What is already known about this topic? Patient safety can be threatened when nurses are not competent to provide safe care to patients.Systems thinking is an essential nurse attribute that enhances patient safety competency.Greater missed nursing care has been associated with negative patient outcomes including adverse events such as medication error, fall with injury and patient mortality. What this paper adds? Higher patient safety competency of nurses was associated with less missed nursing care.Nurses' systems thinking had a mediating effect on the relationship between the patient safety knowledge and attitude competencies and missing nursing care.Nurses' systems thinking had the effect of reducing missed nursing care, but only when nurses exhibited patient safety knowledge and attitude competencies. The implications of this paper: By enhancing patient safety competency, missed nursing care can be reduced and negative patient outcomes may decrease accordingly.Strategies to increase systems thinking should be applied as a way to reduce missed care and increase patient safety. [ABSTRACT FROM AUTHOR]

Background: With the proliferation of the internet and the development of internet‐based healthcare interventions, eHealth is expected to be an effective complement to traditional healthcare services. However, without understanding the characteristics of the user population, eHealth itself can isolate older adults. Aim: This study aims to identify the characteristics of internet use and the factors associated with eHealth use among older adults. Methods: A secondary data analysis was conducted from a cross‐sectional descriptive study. A convenience sample of 186 community dwelling older adults was recruited at two senior welfare centres in Korea. The data collected included demographic characteristics, health related characteristics, internet use, eHealth use and eHealth literacy. Multiple linear regression was utilized to determine factors related to eHealth use. Results: Among 186 respondents, 98 reported that they used the internet. Internet usage was associated with educational attainment, marital status, cognitive function and possession of internet‐enabled devices. The results of multiple regression analysis showed that greater eHealth usage was related to more positive perception of eHealth usability and better eHealth literacy among older adults. Conclusion: Educational programmes for older adults should be developed to facilitate digital capability and eHealth literacy. Useful and effective online health resources that are easy to use should be also developed. Summary statement: What is already known about this topic? With an ageing society, health promotion and management of chronic diseases are becoming increasingly important; thus, the social burden of healthcare is expected to increase.eHealth can help individuals manage chronic disease effectively and promote changing behaviours for better health, but older adults may not be able to use the internet and eHealth. What this paper adds? This paper identified the factors related to internet use in adults aged 65 and over: higher educational level, married/partnered marital status, better cognitive function and possession of internet‐enabled devices.This paper identified factors facilitating eHealth use: older adults who perceived eHealth as more useful and had better eHealth literacy used eHealth more frequently. The implications of this paper: Education for older adults to enhance their skills to use internet‐enabled devices and increase their capability to interpret health‐related information can facilitate eHealth accessibility and enable them to take advantage of the benefits of health technologies.Useful online health resources that are evidence‐based and easy‐to‐use can encourage older adults to use eHealth. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate the relationship between transformational leadership (TL) and the innovative behavior of Korean workers. To this end, this paper also examines whether knowledge sharing and perceived organizational support (POS) influence the above causal relationship. Design/methodology/approach – The paper used a cross-sectional design, with questionnaires administered to 356 employees working in Korea manufacturing firms to test the relationship between TL and innovative behavior through knowledge sharing and the moderating role of POS. Findings – TL was significantly related to both employee innovative behavior and knowledge sharing. The results also shown that knowledge sharing mediated and POS positively moderated the relationship between TL and innovative behavior of employees. Research limitations/implications – Future research should examine antecedents of knowledge sharing and measure the effect of TL in other level such as team level, to enhance generalizability. Data should be also collected longitudinally, to extend the current cross-sectional design. Practical implications – Understanding the link between TL and innovative behavior with mediating and moderating factors can provide useful information to increase positive leadership outcomes and innovation performance. Originality/value – The findings point toward a positive relationship between TL and innovative behavior with mediating and moderating factors. In doing so, the paper adds to a body of work where innovative behavior was connected with leaders’ behavior and organizational-level predictors. [ABSTRACT FROM AUTHOR]

Background: Despite the many advantages of flipped learning, it is challenging for educators to ensure that students complete the pre‐class learning assignments before the in‐class session. Objectives: Using a learning analytics approach, this study analysed students' pre‐class video‐watching behaviour in flipped learning with a focus on learners' resource management strategies, procrastination, and repeated video‐watching. Methods: For the empirical study, three types of data (i.e., log data, survey and exam) were obtained from 70 undergraduate students who were enrolled in pre‐service teacher program designed in a flipped classroom including pre‐class videos and in‐class session. Results and conclusions: The findings showed significant differences between the non‐procrastination group and procrastination group in their video watching time and resource management strategies. Those who watched the pre‐class videos at home/dorm greatly outnumbered those who did not, and they performed better than students who watched the pre‐class videos in other locations. What are the major takeaways from the study?: This finding highlights the importance of resource management strategies in terms of the time and study environment to promote success in flipped learning courses. However, the number of times students accessed the pre‐class videos or watched the videos before class was not correlated with learning achievement. The reason for re‐watching pre‐class videos is a suggested future direction so instructors can design effective flipped learning courses. Lay Description: What is already known about this topic?: Flipped learning is a type of blended learning that combines two teaching and learning modes: face‐to‐face learning and online learning. The effectiveness of flipped learning has also been demonstrated in many empirical studies and meta‐analyses.Despite the many advantages of flipped learning, it is challenging to ensure that students complete the pre‐class materials before class.Data‐driven decisions based on the learning analytics approach can help instructors revise the in‐class activities more adoptively and individual learners can be more engaged in flipped learning. What this paper adds?: Using a learning analytics approach, this study analysed students' pre‐class video‐watching behaviour in flipped learning with a focus on learners' resource management strategies, procrastination, and repeated video‐watching.We also examined the correlations among pre‐class video‐watching behaviour variables and learning achievement.This study highlights the following: (1) The no‐procrastination group had better resource management strategies than the procrastination group; (2) students who watched pre‐class videos at home outperformed those who watched them in other locations: (3) the number of times students accessed pre‐class videos was not correlated with learning achievement; and (4) whether or not students watched pre‐class videos prior to the in‐class sessions was not correlated with learning achievement. Implications for practise and/or policy: Although flipped learning gives students considerable autonomy in terms of when and where to watch pre‐class videos at their convenience, it is necessary to help students develop resource management strategies by providing role models, best practises, and statistics in previous flipped learning classes.Research findings suggest that instructors should provide guidelines and learning strategies on how to review or repeat the pre‐class videos to improve the quality of learning.To encourage students to repeat the videos, the pre‐class videos should be short and concise. [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]

Background: Preschool‐age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children. Objective: To determine the effectiveness of the mobile‐type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents. Design: This study used a three‐group, randomized controlled trial pre‐post design. Setting(s): This study was conducted in the pediatric ward of three general hospitals in Korea. Participants: A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention. Methods: Hospitalized preschool‐age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper‐based intervention, whereas the control group received the usual intervention. Participants' outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention. Results: Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups. Conclusions: Using the SKH app is easy to attract the interest of preschool‐age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future. Clinical Relevance: It is thought to contribute to the prevention of preschool‐age children's safety incidents in pediatric wards. [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: This study examined the effect of an individualized educational intervention on the knowledge, attitudes and self‐management ability after 12 weeks for outpatients with atrial fibrillation. Methods: A randomized control‐group pretest‐post‐test experimental design was used. Elderly outpatients with atrial fibrillation aged over 65 years were recruited from a university hospital in Korea. The experimental group received a 50‐min individualized education on self‐management, one telephone counselling after 8 weeks and maintenance of a self‐management diary for 12 weeks. Data were collected from November 2017 to April 2018 and analysed using SPSS 22.0 for descriptive statistics and hypothesis testing. Results: The participants' mean age was 71.9 (4.6) years. Compared to the control group (n = 29), the experimental group (n = 31) showed a significantly greater improvement in knowledge regarding atrial fibrillation and stroke prevention (t = −2.27, p =.027) and self‐management behaviours (t = −8.02, p <.001). There were no significant group differences in attitudes towards atrial fibrillation. Conclusion: The findings suggest that education for elderly people with atrial fibrillation should be individualized, focusing on self‐management in daily life to prevent cardiovascular complications. Future research is needed to confirm the long‐term effects of such education programmes. SUMMARY STATEMENT: What is already known about this topic? Older adults with AF tend to lack the knowledge and have inadequate self‐management skills regarding their illness. Their awareness of AF should be raised, especially regarding cardiovascular complications, such as stroke and heart failure, and prevention of complications.Patients with AF, mostly older people and those with comorbid conditions, need to be educated on the different approaches apart from the usual education to prevent developing strokes. What this paper adds? Individualized education focused on self‐management to prevent cardiovascular complications was more effective in increasing the knowledge and self‐management behaviour among Korean older adults with AF compared with those patients receiving routine medical education.Education for patients with AF should be tailored to meet the needs of older adults and those with comorbidities and focus on self‐management to prevent cardiovascular complications in daily life. The implications of this paper: Individualized education and telephone counselling can help improve knowledge of complications and self‐management among elderly people with AF.Health care professionals need to provide periodical counselling and education to elderly people with AF to enhance their self‐management behaviour in daily life to prevent cardiovascular complications. [ABSTRACT FROM AUTHOR]

Background: This study aims to establish the mechanism by which virtual reality (VR) media characteristics affect learning transfer in a VR‐based job‐training environment. The two main determinants of learning transfer are the technology and the learner, but not many studies have considered both factors simultaneously. Objectives: This study aims to ascertain the mechanism by which VR media characteristics affect learning transfer with flow as a mediator, and to explore whether presence moderates the effect of VR media characteristics on flow. Methods: A survey of semiconductor facilities engineers who received VR‐based job training was conducted. A total of 106 responses were used in the statistical analysis. A path analysis was conducted to determine the promotional mechanism that connects VR media characteristics, flow, and learning transfer. Results and Conclusions: The results were as follows. First, VR media characteristics had a positive impact on learning transfer. Second, flow acted as a mediator in the relationship between VR media characteristics and learning transfer. Third, presence played a moderating role in the relationship between VR media characteristics and flow. Key takeaways: This study is significant as it identifies elements to consider in relation to both the technological and learner aspects of VR while designing a VR‐based job‐training programme. A corporation should consider VR media characteristics from a technological perspective, and flow and presence from a learner's perspective. Lay Description: What is already known about this topic: Corporations provide virtual reality (VR)‐based job training because of its positive impact.Interactions between the VR environment and learners impact flow.Presence is important as learner's subjective awareness affects efficacy. What this paper adds: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. Implications for practice and/or policy: VR media characteristics influence learning transfer in VR‐based job training.VR media characteristics affect flow, which, in turn, affects learning transfer.Presence moderates the relationship between VR media characteristics and flow. [ABSTRACT FROM AUTHOR]

Aggression in dating relationships is a serious problem that can have long-term negative consequences. While research had been increasing in western societies concomitant with an increasing awareness of intimate partner violence (IPV) perpetration, studies in Asian societies are still few and far between. This paper examines dating violence perpetration among college students in South Korea. Overall violence, emotional, and physical violence are examined respectively. Witnessed parental conflict is used as the main explanatory variable consistent with much of the literature on intimate partner violence perpetration, and also examines the effect of the self-conscious emotion of guilt on dating violence perpetration. Guilt had been shown in the psychological literature to be prosocial and adaptive, but its role has been largely ignored in the IPV and aggression literature. Both its direct and moderating effects on dating violence are examined. Anonymous surveys were administered to college students in four universities across four cities and four regions in South Korea. Three hundred and thirty students who have had a dating experience are included in the analyses. Results show that both witnessed parental conflict and guilt are independently related to dating violence overall, and also to emotional and physical violence. Guilt moderates the effect of witnessed parental conflict on emotional but not physical violence. A closer examination of the role of self-conscious emotions on dating aggression is important. The results extend the generally western theories of dating violence to South Korea and provide evidence of the relevance of these theories cross-culturally. [ABSTRACT FROM AUTHOR]

INTRODUCTION To explore the current situation of exposure of Korean adolescents to secondhand smoke (SHS) in households our study aimed to determine the relationship between family member smoking status, exposure to tobacco information through mass media, and household SHS exposure. METHODS The present study uses pooled data from the Korean adolescent health behavior online survey conducted in 2015, 2018 and 2021, with 157944 participants. The regression models were used to explore the association between the smoking status of households, and exposure to tobacco information through mass media, and household SHS exposure in adolescents, controlling for potential confounding factors. RESULTS SHS exposure duration of Korean adolescents in households was 0.88 days per week. The households with smokers including the father (β=1.087; 95% CI: 1.0--1.126), mother (β=1.461; 95% CI: 1.379-- 1.543), siblings (β=0.545; 95% CI: 0.493--0.597), grandparents (β=0.224; 95% CI: 0.174--0.272), and other relatives (β=0.170; 95% CI: 0.126--0.214), showed a positive association with SHS exposure in adolescents within the household. At the same time, information about anti-smoking ads on television (β= -0.042; 95% CI: -0.069 -- -0.015) and public transportation (β= -0.031; 95% CI: -0.054 -- -0.010), showed a negative association with SHS exposure in adolescents. However, broadcasts, online, and newspaper non-smoking ads were not associated with SHS exposure (p>0.05). In addition, regression models revealed that exposure to cigarette advertising in magazines (β=0.131; 95% CI: 0.097--0.166), networks (β=0.151; 95% CI: 0.127-- 0.175), convenience stores (β=0.061; 95% CI: 0.035--0.087), and supermarkets (β=0.133; 95% CI: 0.108--0.158) is associated with SHS exposure in adolescents. Finally, our study showed stronger ties between SHS exposure, family smoking, and tobacco ads in girls. The link between maternal smoking, supermarket ads, and adolescent SHS exposure intensified in 2021 compared to 2015. CONCLUSIONS Family and media were identified as potential factors associated with SHS exposure in adolescents. Therefore, publicity and education regarding household SHS hazards, and smoking bans in media, can be helpful in protecting adolescents from SHS. [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]

Extensive research on the coronavirus disease 2019 (COVID‐19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID‐19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence‐based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences. [ABSTRACT FROM AUTHOR]

Universities around the world face a common challenge - producing graduates with the necessary practical skills for employment. Cooperative education and work-integrated learning (WIL) make a valuable contribution to increasing graduate employability, however, there are differences in the level of cooperation from industry and government commitment. A comparative study of WIL in Germany, Australia, and South Korea, focusing predominantly on three universities, showed differences in the approaches to achieving practical experience and increasing graduate employability. The data underlying the research was derived from questionnaires, a focus group session, and the development of a descriptive, multi-case study. This allowed comparisons and contrasts between the three universities to be identified. The results and conclusions outlined in this paper aim to highlight best practice in cooperative education and WIL and provide recommendations for the future development of cooperative education, in order to improve graduate employability. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION Although previous studies have addressed the association between smoking and obstructive sleep apnea (OSA), there are few studies on the association between electronic cigarette use and OSA. Thus, we aimed to evaluate the association between the dual use of electronic and conventional cigarettes and OSA. METHODS Data from 7350 participants of the 2019-2021 Korean National Health and Nutrition Examination Survey were analyzed in this population-based study. The STOP-Bang score was calculated using eight items: snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and sex. The main independent variable was smoking behavior. A multiple logistic regression analysis was performed. Subgroup analysis was conducted to analyze the association between smoking behavior in detail and OSA, and stratified analyses were additionally performed. RESULTS Of the 7350 participants, 417 (5.7%) had a high risk of OSA, according to the STOP-Bang score. Compared to the non-smoker group, the dual user group had a 2.46-fold increase in the odds of OSA (adjusted odds ratio, AOR = 2.45; 95% CI: 1.04-5.79). Current non-smokers who were dual users in the past had increased odds of having OSA (AOR=3.61; 95% CI: 1.32-9.92). In the stratified analyses, dual cigarette use was significantly associated with OSA in females and those with a low physical activity level. CONCLUSIONS Dual users and cigarette-only users had an increased probability of developing OSA. Even if they are not currently smoking or vaping, individuals who were dual users in the past were associated with a higher risk of OSA. The association between dual cigarette use and OSA was more pronounced in females and those with a low physical activity level. While intervening for obstructive sleep apnea or investigating risk factors, new smoking methods such as vaping and dual use should be considered along with conventional smoking. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco users are categorized as single, dual, and triple users based on the number of tobacco products (cigarettes, e-cigarettes, and heated tobacco products) used. This study addressed a literature gap by examining how adult Korean tobacco users' quit attempts/plans differed based on the user type, and the associated psychosocial and subjective health-related factors. METHODS We used a questionnaire to examine participants' self-reported health, stress, health concerns, health behavior, tobacco addiction, intentions/plans to quit, and demographic characteristics. Data were analyzed using chi-squared tests, one-way analysis of variance, and multiple linear regression. RESULTS Of the 1288 tobacco users, 55.4%, 28.3%, and 16.4% were single, dual, and triple users, respectively. Self-rated health and stress were lowest among single users and highest among triple users. Most user types had intentions/plans to quit, especially triple users. Quit attempts and plans increased with increasing health behaviors and time elapsed before first tobacco use in the morning, but decreased with higher stress and self-rated addiction. CONCLUSIONS Intentions/plans to quit tobacco use varied based on the type of tobacco user. Multiple users had higher self-rated health, plans to quit, and self-reported addiction; they considered themselves healthy or engaged in healthy behaviors to offset problems from tobacco use and used multiple tobacco products to quit smoking. Highly stressed users had fewer plans to quit and used tobacco for stress relief. Thus, the provision of accurate information about tobacco products and stress management is important to promote successful quitting. [ABSTRACT FROM AUTHOR]

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The aim of this study was to investigate respondents’ satisfaction with smart device-based testing (SBT), as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M) score (M= 3.75, standard deviation [SD]= 0.69), while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07). No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer. [ABSTRACT FROM AUTHOR]

Purpose To examine the effect of auricular acupressure therapy on primary dysmenorrhea among female high school students in South Korea. Design A randomized controlled trial was employed. Methods The study sample consisted of 91 female high school students, with 45 participants in the experimental group and 46 in the control group in two regions of South Korea. The average age of the participants was 16.7 years, and the average age of menarche was 12.2 years. Auricular acupressure therapy including an auricular acupressure needle on skin paper tape was applied on an ear for 3 days during periods of extreme primary dysmenorrhea. The acupoint names were Jagung, Sinmun, Gyogam, and Naebunbi. For the placebo control group, only the skin paper tape without an auricular acupressure needle was applied on the same acupoints. Measures used were the Menstrual Distress Questionnaire to assess primary dysmenorrhea, and the visual analog scale to assess abdominal and back pain of participants. Findings There were significant differences on abdominal pain ( t = 24.594, p < .001), back pain ( t = 22.661, p < .001), and primary dysmenorrhea ( t = 32.187, p < .001) between the two groups. Auricular acupressure therapy decreased abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. Conclusions Auricular acupressure therapy was an effective intervention for alleviating abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. For feasibility of the auricular acupressure therapy in practice, it is needed to train and learn the exact positions of acupoints in ear. Clinical Relevance Health providers should consider providing auricular acupressure therapy as an alternative method for reducing abdominal and back pain, and primary dysmenorrhea in female high school students in South Korea. [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]

Background: Due to the global COVID‐19 pandemic, online learning became the only way to learn during this unprecedented crisis. This study began with a simple but vital question: What factors influenced the success of online learning during the COVID‐19 pandemic with a focus on online learning self‐efficacy? Objectives: The purpose of this study was to examine the structural relationship among self‐efficacy (SE) in time management, SE in technology use, SE in an online learning environment, and learning engagement. Methods: The participants of the study were 1205 undergraduates who were enrolled in a residential undergraduate program in South Korea in spring semester, 2020. The online survey was administered to collect data for this research and the survey results were analyzed using structural equation modeling. Results and Conclusions: SE in technology use had a significant but negative influence on learning engagement and had a positive impact on SE in an online learning environment. SE in time management had a significant positive impact on SE in an online learning environment and learning engagement. SE in an online learning environment also significantly influenced learning engagement. Implications: SE in technology use itself did not enhance learning engagement. In addition, indirect effects of SE in technology use and SE in time management on learning engagement through SE in an online learning environment were confirmed in this study. This indicates the influential role of SE in an online learning environment on learning engagement of online learners. Lay Description: What is already known about this topic: COVID‐19 forced almost all students to learn online.Time management plays a major role in the success of online learning.Technology self‐efficacy is a requirement in online learning.The learning engagement variable explains learning achievement and attitudes. What this paper adds: Self‐efficacy (SE) in time management and SE in technology use enhanced SE in an online learning environment.SE in technology use itself did not enhance learning engagement.SE in time management and in SE an online learning environment significantly influenced learning engagement.SE in an online learning environment mediated the relationship between SE in technology use and learning engagement as well as between SE in time management and learning engagement. Implications for practice and/or policy: It is important to promote students' online learning self‐efficacy to enhance learning engagement in online learning.Practitioners should be aware that SE in technology use improves learning engagement through SE in an online learning environment.SE in time management should be promoted for successful online learning. [ABSTRACT FROM AUTHOR]

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]

Background: An association between health literacy and health outcomes has been widely reported in the literature. However, models exploring the links between health literacy and the outcomes of health literacy need further testing. The purpose of this study was to examine the pathways of health literacy on diabetes self‐care activities amongst patients with Type 2 diabetes. Methods: A cross‐sectional survey using secondary data analysis was conducted on 155 patients with Type 2 diabetes recruited from the diabetes clinics of two university hospitals in a metropolitan city in South Korea. Structural equation modelling analysis using bootstrapping was carried out using the AMOS software. Results: Health literacy had no significant direct effect on diabetes self‐care activities. Rather, health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. Conclusion: These findings indicate that interventions intended to improve self‐care activity amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care. SUMMARY STATEMENT: What is already known about this topic? Health literacy is known to be a factor influencing self‐management of patients with diabetes.Low level of health literacy is associated with adverse health outcomes of patients with chronic illness.It is important to understand the processes through which health literacy affects health outcomes. What is already known about this topic? Health literacy had a significant direct effect on knowledge and patient activation but not on diabetes self‐care activities.Health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. The implications of this paper: Interventions intended to improve self‐care activities amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care.For patients with low health literacy, information processing should be used to facilitate the advancement of their knowledge and the subsequent influence of this knowledge on diabetes self‐care activities.Patient activation should be encouraged by nurses during interactions with patients with diabetes. [ABSTRACT FROM AUTHOR]

introduction Occupational health nurses (OHNs) in South Korea who visit the workplace periodically could play a key role in smoking cessation. It would be helpful to assess their understanding of smoking hazards and smoking cessation methods to encourage them to provide smoking intervention services at the workplace. This study aimed to investigate the knowledge of smoking hazards and perceptions of smoking cessation methods among OHNs. methods We conducted an anonymous self-administered cross-sectional questionnaire survey of 108 OHN nurses employed in an occupational health service outsourcing specialized agency with 19 regional branches in Korea from July to August 2019. We assessed the perceptions of the OHNs about smoking interventions, hazards of smoking, and perceived competence to counsel smokers according to training experience, using chi-squared tests and Fisher's exact tests. results The majority of the nurses underestimated the smoking-attributable fraction for lung cancer (78.7%), chronic obstructive pulmonary disease (64.8%), and mortality (49.0%), regardless of training experience on smoking cessation, while more than half perceived their skill and knowledge to counsel patients concerning smoking as inadequate (56.5%). However, those trained in smoking cessation interventions felt more competent in smoking cessation counselling, with 52.2% and 29.3% in the trained and non-trained groups, respectively (p=0.019). conclusions The OHNs in this study underestimated smoking hazards and perceived themselves as lacking counselling skills regarding smoking cessation interventions. It is necessary to encourage OHNs to promote smoking cessation by increasing their knowledge, skills and competence in smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Flipped learning recently gained attention as an effective instructional approach to enhance learning engagement, causing many universities to implement it. To enhance student engagement in large university classes, this study examined the effects of self‐efficacy, self‐regulation and social presence on learning engagement in a large university class using a flipped learning approach. A total of 390 undergraduates who were enrolled in a large general education class using flipped learning at a university in Korea participated in this study. The learners completed an online survey measuring the variables of this study. The research findings indicated that self‐regulation affected social presence as well as learning engagement. Self‐efficacy affected social presence and indirectly affected learning engagement through social presence. Finally, social presence affected learning engagement. Social presence also mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement. This study confirmed the significant effects of self‐regulation and social presence on students' learning engagement in large university classes. Lay Description: What is already known about this topic: Self‐efficacy is an important influential factor in learning.Self‐regulation plays a major role in the success of flipped learning.The establishment of social presence is an important factor to enhance learning engagement. Learning engagement has a significant impact on learning achievement and attitudes.Many universities still offer large classes despite students' low learning engagement. What this paper adds: Self‐efficacy indirectly affected learning engagement through social presence in flipped learning.Self‐regulation influenced both social presence and learning engagement in flipped learning.Social presence directly and indirectly affected learning engagement in flipped learning.Social presence mediated the relationship between self‐efficacy and learning engagement as well as between self‐regulation and learning engagement in flipped learning. Implications for practice and/or policy: It is important to promote students' self‐regulation for enhancing learning engagement in large university classes with flipped learning.Students' self‐regulation skills should be checked as a prerequisite for enrolling in a large flipped class. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently.Multiple HRBs might threaten adolescents' future health in adulthood.Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently.Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs.Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs.Population‐based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Introduction: There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim: To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods: This cross‐sectional study was conducted using the 2016 Korea Youth Risk Behavior Web‐based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results: Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43–4.47, 95% CI = 1.37–1.49 to 3.23–6.20) and/or who had suicidal ideation (OR = 1.33–3.19, 95% CI = 1.25–1.42 to 2.25–4.51) were more likely to engage in multiple HRBs. Discussion: A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self‐reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice: Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs. [ABSTRACT FROM AUTHOR]