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Aim: This paper was designed to extend the extant research regarding factors related to nurses' turnover intentions. Methods: This survey‐based study was based on a path analysis designed to verify a hypothesized causal model involving nurses' role stress, organizational commitment, turnover intentions, and burnout. This study distributed 500 questionnaires to nurses in general hospitals with more than 500 beds located in Seoul, Korea, during 16–30 April 2012. Results: Role conflict, an underlying factor in role stress, had no significant effect on role stress, but the results showed that role ambiguity reduced organizational commitment. On the other hand, role conflict and role ambiguity increased the level of burnout. Organizational commitment reduced turnover intentions, and burnout increased turnover intentions. Role conflict and role ambiguity had no direct effect on turnover intentions, but they had indirect effects on organizational commitment and burnout. Conclusion: To reduce nurses' turnover rate, this study recommends developing plans to improve their organizational commitment because it mediates role stress and turnover intention. [ABSTRACT FROM AUTHOR]

Background: Since the start of the COVID‐19 pandemic, virtual reality simulation, including web‐based simulation, has increased in nursing education. This study explored nursing students' self‐directed problem‐solving in web‐based virtual simulation experiences. Method: Convenience sampling yielded 16 Korean senior nursing students who had experienced clinical practice in the last semester. Data were collected from August 2020 to January 2021 through in‐depth Zoom video interviews and organized using NVivo version 12.0. Thematic analysis was applied to analyze the data. Results: The following four themes were identified from nursing students' learning experiences during the web‐based virtual simulations: "self‐awareness of a lack of nursing competency in virtual reality," "applying new learning strategies learned from failure," "voluntary learning behavior," and "cognitive shift toward a holistic understanding." Web‐based virtual simulations activated various cognitive and metacognitive factors of self‐directed learning, and the system's prompt feedback and students' reflections facilitated learning effects. Nursing students corrected their cognitive errors while learning from their failures and mistakes and gained a holistic view of nursing practice. Conclusion: In this study, web‐based self‐directed learning activated the metacognition of nursing students in a virtuous cycle. The virtual environment with no actual harm to the patient has become a space for learners to experience a sense of confidence, achievement, and satisfaction. Web‐based virtual simulation can be an effective teaching method to improve nursing students' self‐directed learning abilities and nursing competency. [ABSTRACT FROM AUTHOR]

Aim: This study was carried out to analyze nursing care provided to patients on high and low fall‐risk days and to evaluate the effectiveness of nursing care in terms of preventing falls. Methods: A retrospective review of medical records was conducted for patients admitted to a tertiary hospital in Korea. General and clinical information, fall occurrences, Hendrich II Fall Risk Model (HFRM II) fall‐risk assessment scores, nursing care related to fall prevention, and medications administered were extracted. Results: Data from 43,267 days of records for 11,718 patients were analyzed. Nursing assessment, intervention, and administration of medication were provided more frequently on high fall‐risk days than on low fall‐risk days. Analysis performed on the entire cohort days showed fall occurrence was significantly associated with infrequent mobility assessment and greater usage of anti‐anxiety agents. On high fall‐risk days, fall occurrence was related to less restraint assessment and greater usage of vessel dilatators. Conclusions: The implementation of risk‐targeted interventions for fall prevention based on fall‐risk assessment is needed. For general fall prevention, assessment of patients' mobility should be strengthened. For high fall‐risk patients, it may be more effective for nurses to focus on assessing restraints, evaluating medication records, and withdrawing medications related to falls. [ABSTRACT FROM AUTHOR]

Aim: This study is aimed to develop and test the measurement of environmental health perceptions and behavior concerning female adolescents' reproductive health. Methods: The scales constructed through literature review, in ‐depth interview, and factor analysis based on the protection motivation theory. The sample comprised 384 female adolescents for exploratory factor analysis, aged 18‐22 years, and recruited in September‐November 2019 in South Korea. The construct was validated using factor analysis, convergent validity, and known‐group comparisons. Reliability was examined using Cronbach's alpha for internal consistency and half‐split reliability. Results: The environmental health perception for female adolescents (EHP‐FA) comprises "Sensitivity," "Susceptibility," "Response efficacy," and "Self‐efficacy." The environmental health behavior for female adolescents (EHB‐FA), based on principal component analysis, yielded 19 items with five factors, including "Chemical reduction," "Electromagnetic reduction," "Food selection," "Cosmetic selection," "Dust & Gas reduction," and explained 62.6% of the variance (Cronbach's α =.93). Conclusion: The utility of EHP‐FA and EHB‐FA recommend assessment of female youth's environmental attention and health behavior in the community. Nursing professionals can use the scales to promote female adolescents' reproductive health. [ABSTRACT FROM AUTHOR]

Aim: To examine the resilience of breast cancer patients by investigating the validity and reliability of a Korean version of the breast cancer survivors resilience scale (BCRS) and to provide basic data for developing interventions that can be used by healthcare professionals to enhance the resilience of breast cancer patients. Methods: Data were obtained from 280 breast cancer survivors receiving treatment at the outpatient clinic of Kosin University Hospital located in Busan City, Korea, and the collected data were used to confirm content validity, construct validity, criterion validity, and internal consistency reliability. Results: The Korean version of the BCRS comprised two subdomains and a total of 16 items, and the internal consistency reliability estimated by Cronbachʼs alpha was.87~.89. Conclusion: This study found that the Korean version BCRS has high validity and reliability. In future studies, it will be necessary to conduct research that identifies the resilience levels of patients with breast cancer, using the Korean version BCRS, and seeks interventions in agreement with the results. [ABSTRACT FROM AUTHOR]

Background: Breast self‐examination is a convenient and effective way to detect breast abnormalities. Based on Dale's Cone of Experience theory, we hypothesized that the combination of a smartphone application with hands‐on practice would have a greater impact than using a smartphone application alone. The purpose of this study was to compare the effects of different educational methods on (a) knowledge, (b) attitudes, (c) skills, and (d) students' satisfaction with the learning methods. Methods: We conducted a pre‐ and post‐test quasi‐experimental design and developed a smartphone application using a video clip. One experimental group received smartphone‐based education, another group received smartphone‐based education combined with hands‐on practice, and the control group received a one‐time classroom lecture. We administered a pre‐test, provided intervention, and conducted a post‐test. Results: Among the three groups, the knowledge and attitude of the experimental groups were significantly higher than that of the control group. In addition, the group using the combination of the smartphone application and hands‐on practice showed the highest score changes in skills and satisfaction with the learning methods. Conclusions: Smartphone application use combined with hands‐on practice could be an effective education method for breast self‐examination. [ABSTRACT FROM AUTHOR]

Aim: This is a descriptive longitudinal study conducted to identify the effects of the perception of child value by parents on parenting stress, controlling parenting attitudes, and children's self‐esteem. Methods: The present study targeted parents aged 19 years or older and their children who participated in the fourth through to the eighth Panel Study on Korean Children. The study examined the longitudinal relationship of the effect of parental factors on self‐esteem in children, and applied an actor‐partner interdependent model to analyze the effect of interactions with parents. Results: The paternal instrumental value had a partner effect on the rate of change in maternal parenting stress, while the maternal instrumental value of children had an actor effect on the rate of change in maternal parenting stress. The baseline value of parenting stress had an actor effect on the baseline value of controlling parenting attitudes, while the rate of change in maternal parenting stress had a partner effect on paternal controlling parenting attitudes and an actor effect on the rate of change in maternal controlling parenting attitudes. The baseline value and rate of change in controlling parenting attitudes were found to influence self‐esteem in children. Conclusion: Reducing parenting stress by increasing the parents' positive perception of the value of children can be helpful in maintaining a consistent parenting attitude by parents, which can have a positive effect on self‐esteem in children. It is important to provide intervention and management of variables related to self‐esteem in children using a long‐term and multidimensional approach. [ABSTRACT FROM AUTHOR]

Aim: It is important to focus on the early identification of factors that promote children's self‐esteem, to foster the healthy development of children with allergic rhinitis. This study aimed to identify the effects of parents' parenting stress, self‐esteem, and parent–child interaction on the self‐esteem of children with allergic rhinitis. Methods: Structural equation modeling was used to verify the conceptual model. This study was conducted on 656 children with symptoms of allergic rhinitis and their parents who participated in the 8th Panel Study on Korean Children (PSKC). Data collection involved a questionnaire on parents' parenting stress, self‐esteem, parent–child interaction and self‐esteem of children. Secondary data from the PSKC were analyzed using Actor‐partner Interdependence Model. Data were analyzed using SPSS‐WIN Version 20.0 and AMOS Version 20.0. Results: In the high self‐esteem group, the father's parenting stress had a partner effect on the mother's self‐esteem, while the mother's self‐esteem affected her parent–child interaction, which in turn affected the child's self‐esteem. In the low self‐esteem group, the father's parenting stress affected the mother's self‐esteem, the father's self‐esteem had a partner effect on the mother's parent–child interaction, and the mother's self‐esteem had an indirect effect on the child's self‐esteem. Conclusions: This study was conducted to provide basic data to help understand the interactions among variables related to the self‐esteem of children with allergic rhinitis. The findings indicate that the model has utility in developing effective nursing intervention to promote self‐esteem of children with allergic rhinitis. [ABSTRACT FROM AUTHOR]

Aim: To develop a competency assessment instrument for nurses who have completed an outcome‐based educational program based on national standards and to assess the content‐, construct‐, and criterion‐related validity of that instrument. Methods: In the development stage, the competencies of nurses with 1–3 years' clinical experience after the completion of nursing education and training programs, based on national standards, were identified. A systematic literature review was conducted to derive the competencies in addition to the 12 national standard competencies. In the evaluation stage, the content‐, construct‐, and criterion‐related validity of the developed tool were verified. For verification of the content validity at each stage, the participants were 10 nurse managers of general hospitals and 10 nurse professors. A factor analysis was conducted to assess the construct validity and the Cronbach's alpha coefficients and item‐total correlation were used to assess the reliability of the developed scale. For the factor analysis, the participants were 141 nurses with 1–3 years' clinical experience who were recruited from four general hospitals. In order to evaluate the construct‐ and criterion‐related validity, the correlations between a nursing performance measurement scale, a self‐leadership tool, and the developed scale were examined. Results: A competency assessment instrument, consisting of 19 items on a 4‐point scale, was developed and validated for assessing the competencies among nurses with 1–3 years' experience. Conclusions: Nursing research, policy awareness, and leadership competencies were required by the Korean Accreditation Board of Nursing Education for nursing college graduates, but were removed due to poor content validity, indicating a need for nursing professionals to bridge the gap between educational standards in nursing colleges and clinical settings. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To investigate the causal relationship between nurses’ emotional intelligence and their organizational citizenship behavior and the possible mediating effects of leader trust and value congruence. Methods: The participants were 348 nurses who were working in a general hospital in a metropolitan area. The data were collected from December 16, 2012 to February 20, 2013. The hypothetical model of emotional intelligence, organizational citizenship behavior, leader trust, and value congruence was fitted to the actual data via structural equation modeling. Result: The leaders’ emotional intelligence had a direct positive effect on leader trust and value congruence; however, the nurses’ own emotional intelligence had a negative effect on these two variables. Furthermore, leader trust had a direct positive effect on organizational citizenship behavior; value congruence had no such relationship. The nurses’ emotional intelligence had a partial, indirect effect on organizational citizenship behavior via leader trust. Conclusion: In a nursing organization, it is necessary to build a system, such as mentoring, to be able to exchange emotions actively among the members in order to enhance emotional intelligence and have the same values between leaders and members throughout open communication. Therefore, nurse managers can contribute greatly to the enhancement of organizational performance by promoting members’ organizational citizenship behavior through improving their relationships with them and gaining their trust, while concurrently making efforts to further develop their emotional intelligence. [ABSTRACT FROM AUTHOR]

Aim The 25 item Cultural Competence Assessment assesses the cultural competence of multiple types of healthcare providers. This study aimed to examine the validity and reliability of the Korean version of the questionnaire ( KCCA) and to determine the need for changes to improve its validity and reliability. Methods Data from 161 hospital nurses were used for the item analysis and to assess the reliability and construct validity of the KCCA before and after the deletion of nine items. Results The KCCA did not demonstrate acceptable construct validity and subscale internal reliability. Nine items with high interitem correlations, high modification indices, and relatively lower factor loadings were deleted. The 16 item Modified KCCA showed improved construct validity, convergent and discriminant validity, and reliability. Conclusion While further psychometric evaluation of the Modified KCCA should be undertaken with larger samples and diverse professionals, the study's data provide evidence that the Modified KCCA might be a more suitable measure for use among Korean healthcare providers. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted in order to examine the intention of mothers to vaccinate their teenaged children against human papillomavirus (HPV) infection, according to the children's sex. Based on the theory of planned behavior, the study identified the sex-specific predictors of mothers' intention to vaccinate their teenaged children against HPV. Methods: This was a descriptive survey study that included, as participants, 200 mothers whose teenaged children were not vaccinated against HPV. Results: The mothers' experience with HPV vaccination was a significant predictor of their childrens' HPV vaccination status. For the mothers of sons, subjective norms, attitudes, and perceived behavioral control were found to be significant predictors of intention of HPV vaccination, with an explanatory power of 69.5%. For those with daughters, only attitudes and subjective norms were significant predictors, with an explanatory power of 79.6%. Conclusion: The application of the theory of planned behavior is an effective method to determine the predictors of children's HPV vaccination status. In order to improve the HPV vaccination rate of teenaged children, strategies for education and effective promotion that involve mothers should be developed. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to develop an educational program to promote healthy life behaviors and to evaluate its potential effects on the health practices of fifth grade elementary school children. Methods: The program, which consisted of six categories (daily life and health, disease prevention and management, prevention of drug misuse and overuse, sexuality and health, mental health, and injury prevention and first aid), was developed based on the ADDIE model. A pretest–post‐test, one‐group, quasi‐experimental design was used with 85 elementary school students who voluntarily participated in the program. Results: A school‐based educational program, called the “Six Kid Keys,” referring to the six categories of healthy life behaviors, was developed. Significant pre–post differences in two of the six healthy life behavior categories (disease prevention and management, injury prevention and first aid) were found. Conclusion: A school‐based intervention that was aimed at changing habits related to healthy life behaviors could be effective for elementary school children. [ABSTRACT FROM AUTHOR]

Aim: Urinary incontinence is a major health problem among middle‐aged women. Pelvic muscle exercise is one of the primary interventions, but difficulty performing this exercise has led researchers to seek alternative or conjunctive exercise. This study aimed to examine the effect of a combined pelvic muscle exercise and yoga intervention program on urinary incontinence. Methods: A single group pre‐/post‐test design was used. Subjects were recruited from a community health center in Seoul, Korea, and a questionnaire survey was conducted. Fifty‐five women participated in the first day of the program, 34 of whom completed the 8 week, twice weekly intervention program. Urinary incontinence was measured by five domains of urinary tract symptoms: filling factor, voiding factor, incontinence factor, sexual function, and quality of life. Also measured were attitude toward pelvic muscle exercise and pelvic muscle strength. Results: Significant improvements were found in attitude toward pelvic muscle exercise, pelvic muscle strength, and incontinence factor. Daily performance of pelvic muscle exercise was positively correlated with improved incontinence factor and with quality of life related to urinary tract symptoms. Conclusion: A combined pelvic muscle exercise and yoga program was effective for improving overall urinary incontinence in community health center attendees in Korea. Further study is needed with a control group, different populations, and a longer intervention period. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to verify the validity and reliability of an instrument and to identify nurses' attitudes toward obese patients. Methods: Basic questions were developed after a preliminary published work review, and content validity was verified by a group of experts. Principle components analysis was applied to the verified questions as a factor analysis, and a confirmatory factor analysis was used to verify whether each question qualified for a specific factor and construct reliability. Average variances were extracted and checked to appraise the reliability of each factor. Results: The first 74 questions composed with reference to the published work to identify nurses' attitudes toward obese patients were tested for construct validity and modified via factor analysis to 32 questions. Then, the questions were again modified to 29 questions with four factors after a confirmatory factor analysis. Construct reliability and the average variance extracted for the factors were verified to demonstrate that this tool was highly reliable to explain the 29 factors under the four categories. Conclusion: These results show nurses' attitudes toward obese patients. Further research using various subject groups and appropriate measures is needed. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to develop an assessment tool for the hospital nursing work environment in Korea. Methods The participants were 564 clinical nurses who worked in 13 hospitals in seven provinces in regions throughout South Korea; they worked in medical-surgical nursing, pediatric and maternal nursing, intensive care unit, and other areas. The data analysis relied on descriptive analysis and exploratory factor analysis, including varimax rotation, and reliability was determined using SPSS software. Results The final assessment tool, the Korean Work Environment Scales for Clinical Nurses ( KWES-CN) was composed of 39 items divided into nine factors: (i) manager leadership; (ii) supporting environment for nursing work; (iii) patient care environment and professional activities; (iv) violence within ward; (v) sufficient inventory and supply; (vi) hospital's support for working environment; (vii) recognition and respect; (viii) satisfaction with work schedule; and (ix) computer problems. The total variance for validity described by the nine factors was 58.7% and the reliability of the tool was a Cronbach's alpha of 0.87. Conclusion This final assessment tool will be used to improve nursing work. Further research must be conducted to verify the reliability and validity of this tool, and evaluations of nursing quality and patient results related to the nursing environment. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to investigate the degree and influencing factors of musculoskeletal disease symptoms among care workers in long-term care facilities in South Korea. Methods Participants in this cross-sectional study were 265 care workers in 15 long-term care facilities. Data were collected between 1 and 27 August 2011, using the Korea Occupational Safety and Health Agency ( KOSHA) code H-30-2003 and analyzed using logistic regression with SPSS ver. 18.0. Results Of the care workers, 88.7% had pain in at least one of the six body parts. The highest prevalence of musculoskeletal disease symptoms was in the lower back and legs. Among the organizational factors, there were significant differences in neck pain by work shift and patient grade. Neck pain was more severe in the 8 h shift group than 12-24 h shift group. Care workers caring for patients who were classified in the first patient grade of long-term care insurance had 4.73 times more complaints of musculoskeletal symptoms in the neck, 9.54 times (95% confidence interval [ CI] = 3.37-27.02) in the hand and wrist, 4.37 times (95% CI = 1.59-12.03) in the lower back, and 2.96 times (95% CI: 1.17-7.51) in the leg and foot. Conclusion To prevent and manage musculoskeletal disease symptoms, activities and the intensity of work should be arranged systematically and planned, and the improvement of organizational factors such as appropriate assignment by patients' severity is considered. [ABSTRACT FROM AUTHOR]

Aim To assess the effects of a visiting nurse-driven community-based case management program for low-income adults with hypertension. Methods This single group pretest-post-test study included 22 newly registered low-income adult patients with hypertension in a public health center in Seoul. Visiting nurses delivered a case management program for 2-8 months. Pretest and post-test measurements of blood pressure ( BP), knowledge level, and self-management level in terms of diet, lifestyle, physical activity, and medication were obtained. Results The visiting nurse-driven case management was effective in reducing the BP level and improving the knowledge and self-management level of the low-income adults with hypertension in the community. Conclusion This study serves as a baseline for visiting nurse-driven case management for low-income patients with hypertension. Its findings suggest that visiting nurse-driven case management targeting the self management of BP can foster improved BP control for newly diagnosed hypertensive patients in low-income populations. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to identify the prevalence and factors associated with age‐related macular degeneration (AMD) in Korean elderly. Methods: The study population of this cross‐sectional survey was the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2012, the fifth population‐based study. Results: Analysis of 2,767 elderly (above age 65) from 23,376 participants showed the prevalence of any AMD to be 17.6% in the Korean elderly. Factors that were significantly positively associated with AMD included age, sex, occupation, low socioeconomic status, liver cirrhosis and physical activity (p <.01). Significantly negatively associated with AMD were cardiovascular disease, obesity, and beta‐carotene intake (p <.05). Conclusions: This study estimated the prevalence rate and assessed factors associated with AMD in the elderly. This can be used to build a strategy for elderly eye health, and provides valuable information for screening for putative risks in the elderly. [ABSTRACT FROM AUTHOR]