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

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

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

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

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

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

Accessible Summary: What is known on the subject?: The importance of and interest in nurses' attitudes towards and subjective experience with workplace violence in clinical settings is increasing.The prevalence of patient‐perpetrated violence against Korean nurses in hospital settings is highly prevalent.Only few instruments are available to measure the nurses' perception of patient aggression in Korea. What the paper adds to existing knowledge?: This is the first study to assess the linguistic and psychometric reliability and validity of an instrument that evaluates the attitude of Korean nursing staff towards patient‐perpetrated workplace violence. What are the implications for practice?: This valid and reliable instrument could be used to assess and monitor the nurses' attitudes towards aggressive tendencies in the workplace.The results could contribute to the development of relevant interventions for coping with violence by patients towards nursing staff and the implementation of practical training to cultivate healthy perceptions towards patients to foster therapeutic nurse–patient relationships. Introduction: Despite the high prevalence of patient‐perpetrated violence against Korean nurses globally, reliable and valid measures of patient aggression are lacking in Korean. Aim: We translated the 12‐item Perception of Aggression Scale (POAS) into Korean and psychometrically assessed its utility in measuring nurses' attitudes towards aggression. Methods: The 12‐item Korean POAS was obtained through forward–backward translation and cognitive debriefing. It was administered online to 319 nurses (mean age = 32.64 years; females = 96.2%), of which 206 completed it again after two weeks. Confirmatory factor analysis validated the 3‐factor structure as hypothesized in the original version. The intra‐class correlation coefficient was used to assess the test–retest reliability. Results: The originally hypothesized 3‐factor structure showed a good fit. The 3 dimensions: aggression as a dysfunctional or undesirable phenomenon, aggression as a functional or comprehensible phenomenon, and aggression as a protective measure had internal consistencies of 0.74, 0.86 and 0.90 and corresponding ICCs of 0.70, 0.86 and 0.90, respectively. Discussion: The 12‐item Korean POAS is a valid and reliable scale that might aid investigating nurses' attitudes towards patient aggression. Implications for practice: The 12‐item Korean POAS can help Korean nurses adopt protective behaviours and develop interventions to cope with aggression. [ABSTRACT FROM AUTHOR]

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

Aims and objectives: To identify the experience of breast cancer survivors regarding cancer‐related fatigue, exercise and exercise adherence. Background: Cancer‐related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer‐related fatigue, relatively few research studies on the experience of cancer‐related fatigue and exercise adherence have been conducted. Design: This was a qualitative study to identify breast cancer survivors' experience of cancer‐related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. Methods: Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer‐related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. Results: Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer‐related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. Conclusions: Participants' experience of moderate or greater cancer‐related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self‐image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. Relevance to clinical practice: The insights shared by breast cancer survivors experiencing cancer‐related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients., What this paper add to existing knowledge? In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment., What are the implications for practice? Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone., For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general., Abstract Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations by correcting these cognitive distortions by controlling negative thoughts and panic attacks. Aims This study verified whether group CBT is more effective than treatment as usual (TAU) in South Korean patients with panic disorder. Methods The study participants consisted of 76 panic disorder patients. Patients in the therapy condition attended sessions once a week for a total of 12 sessions in addition to drug treatment. Results In the therapy condition, there were significant decreases in panic-related bodily sensations and ranking and belief scores for catastrophic misinterpretation of external events. Discussion Group CBT, in comparison to TAU, decreases panic and agoraphobia symptom severity in South Korean patients with panic disorder. Our study provides evidence for the effectiveness of a panic disorder management programme that integrates group CBT and traditional pharmacotherapeutic treatment for patients with panic disorder. Implications for Practice The cognitive behavioural approach is needed to reduce panic and agoraphobia symptoms for hospitalized patients with panic disorder more than activity therapies, medications and supportive counselling by doctors and nurses. [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]

Accessible summary What is known on the subject? Despite the increased interest in nursing students' happiness in South Korea, few studies have attempted to identify factors influencing their happiness. Therefore, nursing educators should consistently investigate the factors influencing happiness and develop strategies to improve happiness among Korean nursing students., What this paper adds to existing knowledge? This study confirmed that there were positive correlations between grateful disposition, social support and happiness. In addition, grateful disposition and support from intimate people were identified as predictors of happiness in Korean nursing students., What are the implications for practice? Development of intervention programmes to help nursing students increase grateful disposition and support from intimate people may be helpful for improving happiness. These programmes can include activity, such as writing a gratitude journal, and extracurricular programmes, such as mentoring programmes between seniors and juniors and/or professor and student., Abstract Introduction Happiness is very important in the training and development of nursing students as future nurses. However, nursing students experience a high level of stress and low level of happiness in South Korea. Aim This study aimed to investigate factors that affect happiness among nursing students in South Korea. Method Data were collected from a total of 241 nursing enrolled in two 4-year baccalaureate nursing programmes in South Korea, using a self-administrated questionnaire. To identify predictors of happiness, stepwise regression analysis was conducted. Results The results indicated that grateful disposition and support from intimate people significantly predict happiness among Korean nursing students. These two factors accounted for 38.0% of the variance in happiness. Discussion This study indicated grateful disposition and support from intimate people as factors promoting happiness in nursing students. The findings highlight grateful disposition and support from intimate people as important factors when developing effective interventions that foster nursing students' happiness. [ABSTRACT FROM AUTHOR]

Accessible summary Narrative therapy is a useful approach in the treatment of depression that allows that person to 're-author' his/her life stories by focusing on positive interpretations, and such focus on positive emotions is a crucial component of treatment for depression., This paper evaluates narrative therapy with an emotional approach (NTEA) as a therapeutic modality that could be used by nurses for persons with depression., A nurse-administered NTEA intervention for people with depression appears effective in increasing cognitive-emotional outcomes, such as hope, positive emotions and decreasing symptoms of depression. Thus, NTEA can be a useful nursing intervention strategy for people with depression., Abstract Narrative therapy, which allows a person to 're-author' his/her life stories by focusing on positive interpretations, and emotion-focused therapy, which enables the person to realize his/her emotions, are useful approaches in the treatment of depression. Narrative therapy with an emotional approach ( NTEA) aims to create new positive life narratives that focus on alternative stories instead of negative stories. The purpose of this study was to evaluate the effects of the NTEA programme on people with depression utilizing a quasi-experimental design. A total of 50 patients (experimental 24, control 26) participated in the study. The experimental group completed eight sessions of the NTEA programme. The effects of the programme were measured using a self-awareness scale, the Nowotny Hope Scale, the Positive Affect and Negative Affect Scale, and the Center for Epidemiological Studies-Depression Scale. The two groups were homogeneous. There were significant differences in hope, positive and negative emotions, and depression between the experimental and control group. The results established that NTEA can be a useful nursing intervention strategy for people with depression by focusing on positive experiences and by helping depressed patients develop a positive identity through authoring affirmative life stories. [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: This descriptive, exploratory, correlational analysis investigated patients with type 2 diabetes and their diabetes knowledge, depression, diabetes‐management self‐efficacy, and social support and sought to determine the effects of these factors on psychological insulin resistance among type 2 diabetes patients in South Korea. Methods: This descriptive cross‐sectional study included 136 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding demographic and disease‐related characteristics as well as scores on the Diabetes Knowledge Tests, Center for Epidemiologic Studies Depression Scale, Diabetes Management Self‐efficacy Scale, Social Support Scale, and Psychological Insulin Resistance Scale, between September and December 2017. Data were analysed using descriptive statistics, independent t‐tests, a one‐way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. Results: The total score for psychological insulin resistance was 60.92 ± 14.75 of a maximum of 90. Stepwise multiple regression showed that diabetes knowledge, diabetes‐management self‐efficacy, social support, absence of diabetes complications, and depression explained 38.6% of the variance in psychological insulin resistance. Conclusion: Diabetes knowledge was found to have the largest influence on psychological insulin resistance, followed by social support, absence of complications, depression, and diabetes‐management self‐efficacy. Development of interventions that consider all these factors is required, and the effects of such interventions should be tested through further research. SUMMARY STATEMENT: What is already known about this topic? Patients with diabetes in Korea have been reported to have relatively high levels of psychological resistance to insulin therapy compared with their counterparts in the West.Previous studies on factors associated with psychological insulin resistance have considered only a limited number of factors and have simply analysed the association between these factors. The full range of disease‐related factors that can affect psychological insulin resistance has not been considered.Research on the psychological insulin resistance of patients with type 2 diabetes, and the factors that affect it, is currently lacking in Korea. What this paper adds? The level of psychological insulin resistance of Korean patients with type 2 diabetes was found to be higher than that of patients from other countries.Diabetes knowledge was found to have the most significant influence on the psychological insulin resistance in Korean patients with type 2 diabetes, followed by social support, absence of diabetes complications, depression, and diabetes‐management self‐efficacy. The implications of this paper: Levels of psychological insulin resistance among patients with type 2 diabetes should be monitored, and nursing education programs should be developed that are tailored to patients' level of psychological insulin resistance.Diabetes knowledge, social support, diabetes complications, depression, and diabetes‐management self‐efficacy should be systematically monitored to reduce the level of psychological insulin resistance in patients with type 2 diabetes. Development of detailed interventions that consider these factors may be helpful, and their effectiveness should be tested through further research. [ABSTRACT FROM AUTHOR]

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

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

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

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

Aims: To explore nurse's, physician's and family member's experiences of withholding or withdrawing life‐sustaining treatment in an intensive care unit. Background: In South Korea, withholding or withdrawing life‐sustaining treatment is legalised by the enforcement of the Hospice, Palliative Care and Life‐sustaining Treatment Decision‐making Act (2018). The Act (2018) is the first legal ground for making decisions regarding life‐sustaining treatment in South Korea. Design: Focused ethnography. The standards for reporting qualitative research checklist is used. Methods: Interview data are collected between August 2018 and January 2019 using semi‐structured interviews with 23 nurses, 10 physicians and four family members in a South Korean intensive care unit. The interview data are analysed following the thematic analysis of Braun and Clarke. Results: An overarching theme of 'constructing death' is identified from the experiences of nurses, physicians and family members regarding withholding or withdrawing life‐sustaining treatment in a South Korean intensive care unit. Family members had the strongest power in the withholding or withdrawing life‐sustaining treatment process whilst the process had to be based on medical consideration. All the research participants shared the purpose and motivation of withholding or withdrawing life‐sustaining treatment as the dying patient's dignity. Due to the South Korean national health insurance system, the relationships between medical staff and family members were driven by customer ideology. Conclusion: The impact and linkage of the context of familism culture and health insurance with the process of withholding or withdrawing life‐sustaining treatment in South Korea are shown in this research. The findings of this research inspire future studies to uncover the impact of the cultural context in the decision‐making process of a patient's death, to explore the dynamics of family members under cultural values and to explore the influence of the healthcare system and medical costs on the relationships between medical staff and family members. Relevance to Clinical Practice: By integrating the experiences of nurses, physicians and family members, the findings of this study inform the shared values in the context of familism culture and the health insurance system. In particular, understanding family dynamics when a patient's dying and death as a result of withholding or withdrawing life‐sustaining treatment informs nurses to provide quality of care in the intensive care setting. Therefore, the findings of this research contribute to distinguishing the priority in care when withholding or withdrawing life‐sustaining treatment, rapidly changing the aims of care from the patient's recovery to a dignified death. [ABSTRACT FROM AUTHOR]

Aims: To track changes in the haemodynamic and respiratory indicators of patients and evaluate families' caring experiences via the visitation programme in the intensive care unit (ICU). Background: Although most people recognise the importance of family care visitation programme in the ICU, objective research results on the effect on patients and caregivers are still insufficient. Design: Mixed methods. Methods: In this a quasi‐experimental investigation and qualitative study, after executing the programme with families of ICU patients in a general hospital in South Korea from June to July 2019, changes in haemodynamic and respiratory indicators for control (n = 28) and experimental groups (n = 28) were analysed; the experimental group families' experiences were analysed through in‐depth interviews; the qualitative study's reporting rigour was checked against the COREQ guidelines and TREND checklist for a quasi‐experimental study. Qualitative and quantitative data were examined using content analysis and repeated‐measures analysis of variance, respectively. Results: There was a significant change in systolic and diastolic blood pressure in the haemodynamic indicator, and the respiratory indicator in both groups increased slightly over time and then gradually stabilised; there were no significant differences or interactions between groups regarding time of systolic blood pressure. The respiratory rate significantly decreased only in the experimental group. There was a significant increase in oxygen saturation over time, as well as interactions between time and group and between groups. Four themes were extracted from families' experiences. Conclusion: The haemodynamic and respiratory indicators of the group using patient‐ and family‐centred care (PFCC) showed a stable effect on critically ill patients, which increased families' satisfaction. In future, interventions should encourage family participation in the ICU for successful PFCC. Relevance to clinical practice: The findings provided evidence for the importance of PFCC through changes in objective haemodynamic and respiratory indicators. [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]

Aims: To identify specific patterns of lifestyle behaviours among young adults and examine the relationships of the patterns to sociodemographic characteristics and health conditions (hypertension, diabetes and obesity). Design: Descriptive, correlational study. Methods: Data from a nationally representative sample of 4562 young adults aged 19–39, who participated in the 2016–2018 Korea National Health and Nutrition Examination Survey, were analysed. Latent class analysis was used to identify the patterns of lifestyle behaviours, including smoking, alcohol use, physical activity and vaccination. Generalized linear regression analysis was used to examine the relationships among lifestyle behaviour patterns, sociodemographic characteristics and health conditions. Results: Three patterns of lifestyle behaviours were identified: physically active (6.9%), high risk (21.5%) and passive (71.6%). The membership of these three patterns was significantly associated with sociodemographic characteristics (age, sex, education level, occupation and living arrangement). Among the three groups, young adults in the high‐risk group were found to be significantly associated with all three health conditions (hypertension, diabetes and obesity) while controlling for sociodemographic characteristics. Conclusion: These results indicate that young adults are likely to engage in unhealthy lifestyle behaviours that are related to individual socioeconomic conditions, which could negatively affect their health conditions. Impact This study provides insights into the lifestyle behaviours among young adults who have been recognized to be socially disadvantaged. This could help develop education and prevention programmes tailored to specific patterns of lifestyle behaviours for improving health while considering their socioeconomic contexts. No Patient or Public Contribution: This applies to this research as the focus was on young adults in South Korea only. [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: The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. Design: This study applied an exploratory, descriptive and cross‐sectional design. Methods: The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self‐report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. Results: The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. Conclusion: The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. Impact Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. Reporting Method: The reporting of this study (Observational, cross‐sectional study) conforms to the STROBE statement. Patient or Public Contribution: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. Implication for the Profession and/or Patients Care: Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide. [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]

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

Background: It is necessary to examine the level of perception, knowledge and attitudes of the medical staff for advance medical directives, which are practical alternatives to good practice for end‐of‐life care in the actual medical field. Purpose: This study was conducted to determine the degree of perception, knowledge and attitude of cancer hospital medical staff about advance medical directives, and to confirm the relationship between them. It also explored their experiences with advance medical directives. Methods: This study used a convergent design to collect quantitative and qualitative data separately in the mixed methodology. This design adheres to the STROBE guidelines. Participants were a total of 140 subjects (70 doctors and 70 nurses) with more than 3 years and considered to have sufficient experience related to the study purpose. Focus group participants were a total 19 persons (9 doctors and 10 nurses). Results: Mean score for perception was 35.40, which indicates lower perception when compared to the median value (37.50 points). Perception of advance medical directives had significant, positive relations with attitude of advance medical directives (p =.032). The perception on attitude of advance medical directives factor was significantly influencing (p =.021). As a result of the analysis based on qualitative research questions, six subjects and 11 categories were created by deriving meaningful sentences from the statements. Conclusion: This study suggests that the perception of medical professionals about advance medical directives has a positive correlation with attitudes, as well as a causal relationship. Relevance to clinical practice: Based on the finding from this study, concrete strategies and interventions to improve the perception of advance medical directives among cancer hospital medical staff are needed. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study explored nursing home staff's barriers and needs in implementing person‐centred care for people with dementia. Background: Person‐centred care is an imperative international policy and the best‐practice standard for dementia care. However, a gap exists between policy and practice. Moreover, there is a lack of qualitative studies that explored nursing home staff's barriers and needs in implementing person‐centred care for people living with dementia. Design: A qualitative descriptive approach was adopted. Methods: Using convenience sampling method, a total of 24 staff members (nurses, nurse's aides, or care workers) were recruited from six nursing homes in Korea. Two in‐depth, face‐to‐face, one‐to‐one interviews were conducted with all participants (a total of 48 interviews). A semi‐structured interview guide was used and field notes were written after each interview. Data were collected until data saturation was reached. Qualitative content analysis was used. This study followed the COREQ guidelines. Results: Four themes emerged from data analysis: insufficient resources, lack of education, negative mindset and poor relationships. This study showed that nursing home staff experienced many barriers and unmet needs in implementing person‐centred care for people with dementia. Conclusion: The findings indicated that nursing home staff faced many barriers and needs in implementing person‐centred care for people with dementia. Nursing home staff need more legitimate, financial, educational and emotional support. Relevance to clinical practice: The study indicates more national and organisational support are needed for nursing home staff to successfully implement person‐centred care for people living with dementia. Nursing home leaders need to recognise the importance of their role in overcoming the barriers and provide effective support for staff in implementing person‐centred dementia care. [ABSTRACT FROM AUTHOR]

The artice presents research that examines the practical difficulties interfering the appropriate use of intermittent pneumatic compression and graduated compression stocking for critical patients. Topics discussed include the significant use of mechanical prophylaxis by nurses, systematic education based on information needs for improvement, and necessary Velcro loosening problems. The importance of additional knowledge on the problems encountered by nurses is also noted.

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

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

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

Aims and objectives: To investigate the incidence of urinary tract infection and analyse its risk factors among hospitalised patients with spinal cord injury. Background: While the incidence of urinary tract infection varies widely according to the healthcare setting and patients' clinical characteristics, formal reports are limited in quantity. There has been no consensus regarding the risk factors for urinary tract infection. Design: A retrospective descriptive study. Methods: Electronic medical records of 964 subjects between 2010–2017 were reviewed. Urinary tract infection status was examined to identify newly occurred cases. Data included demographic and clinical characteristics, hydration status and length of hospitalisation. The reporting of the study followed the EQUATOR Network's STROBE checklist. Results: Of the sample, 31.7% had urinary tract infection (95% confidence interval: 1.288 to 1.347, p <.001). Sex, completeness of injury, type of bladder emptying, detrusor function and urethral pressure were significant factors affecting urinary tract infection. Patients who were male and those with injury classifications A, B and C had higher risk of urinary tract infection. Patients with urinary or suprapubic indwelling catheters, as well as those with areflexic detrusor combined with normotonic urethral pressure or overactive detrusor combined with normotonic urethral pressure, showed higher risk. Length of hospitalisation in patients with urinary tract infection was greater than that in uninfected patients, which implies the importance of prevention of urinary tract infection. Conclusions: Nurses should carefully assess risk factors to prevent urinary tract infection in patients with spinal cord injury in the acute and sub‐acute stages of the disease trajectory and provide individualised nursing care. Relevance to clinical practice: This study contributes evidence for up‐to‐date clinical nursing practice for the comprehensive management of urinary tract infection. This can lead to improvements in nursing care quality and patient outcomes, including length of hospitalisation. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to compare anxiety, resilience, and depression between COVID‐19 unit (confirmed patients and suspected patients) and non‐COVID‐19 unit nurses and assess their effects on depression. Background: Nurses working during the global pandemic are known to be physically and psychologically exhausted, and experience severe anxiety and depression. However, there is a lack of studies comparing anxiety and depression between COVID‐19 and non‐COVID‐19 unit nurses. Design: Descriptive research study. Methods: This study was conducted on 64 nurses who directly worked for more than a month in a COVID‐19 unit of a general hospital with nationally designated negative‐pressure isolation beds and 64 nurses working in a non‐COVID‐19 unit. Data were collected through questionnaires and were analysed using SPSS 25.0. Reporting of this research adheres to the STROBE guidelines. Results: Anxiety and depression were significantly higher in nurses working with patients suspected to have COVID‐19 rather than nurses working with confirmed COVID‐19 patients and non‐COVID‐19 patients. Resilience was significantly lower in suspected patient unit nurses than in COVID‐19 unit nurses. Anxiety was the major factor predicting depression in both COVID‐19 unit (confirmed patients and suspected patients) and non‐COVID‐19 unit nurses with 76.6%, 80.7%, and 63.6% explanatory power, respectively. Conclusions: Among nurses working in COVID‐19 units, suspected patients unit nurses had higher depression than confirmed patients unit nurses due to an unsafe facility environment, insufficient personal protective equipment, and unknown conditions of the patients. Thus, interventions which have a high impact on depression need to be provided to relieve anxiety. Relevance to clinical practice: The nursing organisation must provide comprehensive support including coordinated shifts, internal motivation, incentives, up‐to‐date information, and clear infection prevention guidelines to relieve anxiety caused by exhaustive workload, uncertainty of infectious diseases, and lack of human and material resources. [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: The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease. Design: A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals. Methods: To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13–19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010–December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log‐likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two‐step method. Results: The physical symptoms experienced by adolescents with moyamoya disease were 'limb weakness' – the most common – followed by a 'headache,' 'difficulty in speech,' and 'nausea/vomiting.' A total of five symptom clusters were derived: cluster 1 was characterized by 'limb weakness'; cluster 2 participants were asymptomatic or experienced 'convulsions'; cluster 3 experienced 'difficulty in speech' and 'facial paralysis'; cluster 4 is prone to 'dizziness' and 'pins and needles'; and cluster 5 displays 'headaches' and 'nausea/vomiting'. Conclusion: This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents. Impact: These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents. [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 understand hospice palliative care nurses' (HPCNs) perceptions towards spiritual care and their competence to provide spiritual care. Background: Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients' spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited. Design: A mixed‐methods research design was used. Methods: Quantitative data were collected from 282 nurses in forty hospice palliative care (HPC) institutions in South Korea and analysed using descriptive statistics, independent t‐test, one‐way ANOVA with Bonferroni test and multiple regression. Qualitative data collection involved two stages: first, an open‐ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative data sets were analysed separately using content analysis. This study followed the GRAMMS guidelines. Results: Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in 'attitude towards the patient's spirituality' and 'communication', whereas the 'assessment and implementation of spiritual care' and 'professionalisation and improving the quality of spiritual care' had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardised terminology, and the opportunity to reflect on nurses' own spirituality. Conclusions: Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance. Relevance to clinical practice: The results of this study provide a useful resource to develop educational programmes for strengthening the SCC of nurses and the entire HPC team. [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]

Aim and objectives: To explore the experiences of Korean nurses who had directly cared for patients with Middle East respiratory syndrome (MERS) and to derive the structure and meaning of these experiences. Background: In 2015, the MERS epidemic struck Korea, and ill‐prepared nurses had to care for patients with MERS. Nurses experienced conflict between their fear of the disease and their work and professional ethic. Design: We employed a phenomenological qualitative approach. Methods: Inductive, qualitative, in‐depth interviews were performed with 17 nurses. The study process followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: The qualitative inductive content analysis generated seven theme clusters and 18 themes. The theme clusters were "Fear of Uncertainty," "Beyond Hesitation," "A Scene Like a Battlefield," "Chaotic Nursing Identity," "Buttresses for Sustainability," "Lingering Trauma" and "Expanded Horizon of Nursing." The final analysis revealed that the core theme was "Beyond the fear of uncertainty." Conclusions: This study contrives a more in‐depth, holistic understanding by describing the experiences of nurses who directly cared for patients with MERS—the first large‐scale infectious disease in Korea. Although nurses saw themselves as vital caregivers, they were frightened of the disease, had to work in a harsh environment, experienced various internal conflicts and had to deal with varying forms of uncertainty. Relevance to clinical practice: This study sheds light on the nursing situation during crises involving serious infectious diseases; to combat these, more medical facilities are needed, and staff should be proactively guided on how to care for patients. It can serve as part of a good foundation for further study of medical staff during recurring epidemics. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the psychometric quality of two single‐item pain‐intensity measures: the Numeric Rating Scale (NRS) and the Verbal Rating Scale (VRS). Background: Measuring pain intensity is a vital step in initiating symptom management and evaluating the effectiveness of interventions with cancer patients. Single‐item pain‐intensity measures of the NRS and VRS format have been evaluated to be acceptable for use in clinical practice and research; however, evidence to choose one over the other, as a standardised pain‐assessment format, is insufficient. Design: Descriptive correlational study. The study was guided and reported following the STROBE guideline. Methods: Data accrued at two time points during cancer treatment with a total of 249 patients treated in a Korean University Hospital. Two single‐item measures were constructed to assess pain intensity over 1 week. The Brief Pain Inventory (BPI; pain intensity subscale and interference subscale) and the functional assessment of chronic illness therapy‐fatigue were the criterion. Convergent and concurrent validity were tested with Pearson's correlations. Results: In the convergent‐validity evaluation of the cross‐sectional association with the BPI, the NRS showed a much higher level of association than the VRS (0.81 versus 0.61). In convergent validity with a longitudinal association with the BPI, the NRS score change had a much higher level of association (0.61 versus 0.37). In concurrent‐validity evaluation, the NRS and VRS showed similar levels of associations with fatigue (−0.48 versus −0.49). Yet, the NRS showed statistically higher levels of correlation with functional limitations than the VRS (0.55 versus 0.42), comparable to the concurrent validity of the BPI. Conclusion: The NRS showed higher validity than VRS when assessing overall pain intensity over the past week. Relevance to Clinical Nursing: Pain assessment is a vital role of nurses in caring for patients with cancer. Current study findings support the use of the single‐item NRS pain measure to assess global pain intensity over the past week. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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: This study aimed at examining the construct validity and reliability of the Full Outline of UnResponsiveness score in patients with spontaneous subarachnoid haemorrhage caused by aneurysm rupture. Background: The Full Outline of UnResponsiveness score is known to be a valid and reliable consciousness assessment tool and provides comprehensive information not given by the Glasgow Coma Scale. However, the validity and reliability of this tool have not been tested in patients with spontaneous subarachnoid haemorrhage. Design: A nonexperimental, descriptive, correlational study design was adopted. Methods: The STROBE statement was used for reporting this study. The study participants were 72 patients with spontaneous subarachnoid haemorrhage caused by aneurysm rupture, admitted to an intensive care unit in a university hospital between August 2016–July 2017. Data on demographic characteristics, Hunt–Hess clinical stage scores, Fisher CT stage scores, disease‐related characteristics, Full Outline of UnResponsiveness scores and 1‐month Glasgow Outcome Scale scores were subjected to analysis. Results: Full Outline of UnResponsiveness scores were found to have significant correlations with scores on Hunt–Hess clinical or Fisher CT stage tool and adequately predict 1‐month recovery. This tool also exhibited excellent inter‐rater agreement and internal consistency. Conclusions: The Full Outline of UnResponsiveness score is valid and reliable for consciousness evaluation in spontaneous subarachnoid haemorrhage. It has been believed that use of this tool may help prevent negative consequences arising from impaired consciousness and improve the outcomes of patients with spontaneous aneurysmatic subarachnoid haemorrhage. Relevance to clinical practice: The Full Outline of UnResponsiveness score is a consciousness assessment tool that provides more neurological detail because it includes consideration of brainstem reflexes, visual tracking, breathing patterns and respiratory drive, and can be applied in cases of spontaneous subarachnoid haemorrhage and other types of brain injury, especially in patients with severe consciousness impairment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]