Search

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

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

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

Aims and Objectives: To evaluate the measured fall risk score that more accurately reflects the changeable conditions in acute care settings, and to efficiently evaluate the association between falls and fall risk score. Background: The Morse Fall Scale (MFS) is a well‐known easy‐to‐use tool, while the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) consists of items with high specificity. Evaluating suitable fall‐risk assessment tools to measure these changeable conditions may contribute to preventing falls in acute care settings. Design: Retrospective case–control study using the STROBE checklist. Methods: In an acute care setting (708‐bedded university hospital with a regional emergency medical centre), the non‐fall group was adjusted to fall group using propensity score matching. According to the fall rate of 3–5%, non‐fall groups for each tool were selected (1386 and 1947) from the before adjusted data, and the fall groups included 42 and 59. The applied covariates were individual characteristics that ordinarily changed such as age, gender, diagnostic department and hospitalisation period. The adjusted data were analysed using generalised estimating equations and mixed effect model. Results: After adjustment, the fall group measured using the JHFRAT had a significantly higher difference between the initial and re‐measured total score than the non‐fall group. The JHFRAT, especially with the re‐measured score, had a higher AUC value for predicting falls than the MFS. MFS's sensitivity was 85.7%, and specificity was 58.8% at 50 points; for JHFRAT, these were 67.8% and 80.2% at 14 points, respectively. These cut‐off points were used to evaluate validity during tool development and are commonly used as reference scores. Conclusions: JHFRAT more accurately reflects acute changeable conditions related to fall risk measurements after admission. Relevance to clinical practice: JHFRAT may be useful for effective fall prevention activities in acute care settings. [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]

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 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 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 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: 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]

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 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]

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]

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

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

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

Aims and objectives: The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Background: Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. Design: A pre‐ and post‐test controlled quasi‐experimental design was used at public health centres. Methods: The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. Results: The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Conclusions: Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community‐based nutritional education and counselling programmes. Relevance to clinical practice: Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional programme continuously. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate whether warming the feet with socks would prevent hypothermia among patients undergoing spinal surgery. Background: Perioperative hypothermia is a common health problem among spinal surgery patients. Research design: This study used a quasi‐experimental design. Methods: Seventy‐two patients were assigned to two groups. The control group (n = 36) received usual care without the warmed socks. The intervention group (n = 36) received usual care plus warmed socks during operation and recovery period. Data were collected during (180 min) and after the surgery (30 min) during the period of 7 February–10 April 2015. Core body temperature, shivering response and subjective thermal comfort of the two groups were compared over time using the repeated‐measures ANOVA. Results: The oesophageal temperature of the socks‐wearing group was maintained between 36.36–36.45°C during surgery (mean = 36.41 ± 0.03, 95% CI = 36.34–36.47), whereas that of the control was between 35.75–35.97°C (mean = 35.98 ± 0.03, 95% CI = 35.92–36.04). The tympanic temperature in the recovery room of the socks‐wearing group was between 36.28–36.38°C (mean = 36.37 ± 0.04, 95% CI = 36.29–36.45) and that of the control group was 35.90–36.04°C (mean = 35.95 ± 0.04, 95% CI = 35.88–36.05). Shivering response of the intervention group (mean = 0.04 ± 0.08, 95% CI = −0.13 to 0.21) was significantly lower than that of the control group (mean = 0.47 ± 0.08, 95% CI = 0.30–0.64) in the recovery room (F = 4.28, p < .001). As for subjective thermal comfort, the intervention group (mean = 4.86 ± 0.13, 95% CI = 4.62–5.13) was significantly lower than that of the control group (mean = 3.08 ± 0.13, 95% CI = 2.82–3.33) in the recovery room (F = 98.13, p < .001). As for the frequency of pethidine medication, the intervention group was significantly lower than that of the control (χ2 = 5.14, p = .023). Conclusion: The use of perioperative warmed socks for spinal surgery patients was effective in maintaining perioperative core temperature, preventing shivering and maintaining subjective thermal comfort. Relevance to clinical practice: Considering cost‐effectiveness of warmed socks, it might be worth trying option for the maintenance of core temperature in spinal surgery patients. [ABSTRACT FROM AUTHOR]

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

Aims and objectives: To identify the relationship between emergency nurses’ intention to leave the hospital and their coping methods following workplace violence. Background: Emergency departments report a high prevalence of workplace violence, with nurses being at particular risk of violence from patients and patients’ relatives. Violence negatively influences nurses’ personal and professional lives and increases their turnover. Design: This is a cross‐sectional, descriptive survey study. Methods: Participants were nurses (n = 214) with over one year of experience of working in an emergency department. We measured workplace violence, coping after workplace violence experiences and job satisfaction using scales validated through a preliminary survey. Questionnaires were distributed to all nurses who signed informed consent forms. Multiple logistic regression analysis was used to identify the relationships between nurses’ intention to leave the hospital and their coping methods after workplace violence. Results: Verbal abuse was the most frequent violence experience and more often originated from patients’ relatives than from patients. Of the nurses who experienced violence, 61.0% considered leaving the hospital. As for coping, nurses who employed problem‐focused coping most frequently sought to identify the problems that cause violence, while nurses who employed emotion‐focused coping primarily attempted to endure the situation. The multiple logistic regression analysis revealed that female sex, emotion‐focused coping and job satisfaction were significantly related to emergency nurses’ intention to leave. Conclusions: Emotion‐focused coping seems to have a stronger effect on intention to leave after experiencing violence than does job satisfaction. Relevance to clinical practice: Nurse managers should begin providing emergency nurses with useful information to guide their management of violence experiences. Nurse managers should also encourage nurses to report violent experiences to the administrative department rather than resorting to emotion‐focused coping. Nurses should be provided with the opportunity to communicate their feelings to their colleagues. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify factors influencing falls and the fear of falling among older adults with chronic diseases in Korea. Background The fear of falling and falls in older adults are significant health problems towards which healthcare providers should direct their attention. Further investigation is needed to improve nursing practice specifically decreasing risk of falls and the fear of falling in Korea. Design Descriptive, cross-sectional survey. Methods A convenience sample of 108 patients was recruited at the geriatric outpatient department of a tertiary hospital in Seoul, Korea. Demographic characteristics, comorbidities, medication use, fall history, level of physical activity, activities of daily living, mobility, muscle strength, and a fear of falling were investigated. Student's t tests, chi-square tests and multiple linear regressions were used in statistical analysis. Results Thirty-six participants (33.3%) among 108 subjects reported experiencing ≥1 falls in the past year. Marital status and the use of antipsychotics were associated with falls, while other factors were not significantly related to falls. Only benign prostatic hypertrophy and polypharmacy were significantly related to the fear of falling in the analysis of the relationships between chronic disease, medication use and fear of falling. In the regression model, the number of comorbidities, level of physical activity, activities of daily living and mobility were predictors of a fear of falling. Medication use was marginally significant, in the model. Conclusion Increasing physical activity, functional fitness and physical independence is important to decrease the fear of falling, and to encourage active and healthy lives in older adults. Relevance to clinical practice The findings from this study provide evidence for the development of nursing interventions for older adults. We recommend early screening for a fear of falling and nursing interventions to decrease the fear of falling through enhancing physical activity level and function. [ABSTRACT FROM AUTHOR]

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

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

Aims and objectives The aim of the study was to assess the prognostic factors of short-term sexual recovery in patients with acute myocardial infarction after phase II cardiac rehabilitation for six weeks. Background It is often observed that patients who have suffered acute myocardial infarction and have sufficient aerobic capacity for sexual activity do not recover sexual activity. Until now, few studies have investigated factors associated with recovery of sexual activity. Design Observational study. Methods Among 627 male patients with acute myocardial infarction who were referred for cardiac rehabilitation from October 2010-September 2014, 72 were finally analysed. Subjects who met all the following criteria were included: (1) completed a questionnaire about sexual activity before and after phase II cardiac rehabilitation; (2) showed usual sexual activity before onset of acute myocardial infarction and (3) revealed decreased sexual activity at baseline of cardiac rehabilitation compared to preacute myocardial infarction status despite ≥5 maximal metabolic equivalents. Information on sociodemographic characteristics and cardiopulmonary function obtained before cardiac rehabilitation was used for the analysis. Results (1) Twenty-five of the 72 subjects (34·7%) had improved sexual activity after six weeks of cardiac rehabilitation, but 47 (65·3%) continued the status of no-recovery sexual activity after cardiac rehabilitation. (2) Age, body mass index and use of statins were significantly different between subjects who recovered and those who did not. (3) No differences in other clinical characteristics and cardiopulmonary functions were detected between the two groups. (4) Age and body mass index were significant factors associated with recovery of sexual activity. Conclusions Age and body mass index were significant factors associated with recovery of sexual activity in acute myocardial infarction patients. Aerobic capacity at baseline of cardiac rehabilitation was not an independent factor to predict the recovery of sexual activity. Relevance to clinical practice These results should be considered when educating patients under phase II cardiac rehabilitation on their return to normal sexual activity. [ABSTRACT FROM AUTHOR]

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

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

Aims and objectives Maintaining adequate ratios of sodium-to-potassium requires heart failure patients to be adherent to recommended dietary guidelines. A potential deterrent to adherence is poor cognitive functioning. The aims of this study were to (1) estimate dietary sodium and potassium intake and sodium-to-potassium ratios and (2) examine the associations between cognitive functioning and sodium-to-potassium ratios. Background Cognitive impairment may impact levels of adherence and subsequently sodium-to-potassium ratios; however, little is known about the relationship of cognitive functioning, adherence to dietary restrictions and sodium-to-potassium ratios. Design This study used a descriptive correlational design. Methods Face-to-face interviews were conducted with heart failure patients with preserved or reduced left ventricular ejection fraction. Standard cognitive measures were used and included neuropsychological tests of global cognition, immediate and delayed recall, and executive function. Further, patients were instructed to complete a three-day food diary as an indirect measure of sodium-to-potassium intake. Results Ninety-one Korean patients with heart failure participated in this study (age 57 years, women 33%, education 10 years). A major underlying cause for heart failure was dilated cardiomyopathy (40%), followed by ischaemic cause (24%); the mean heart failure duration was 37 months. Average sodium intake was 3982 mg/day, with men consuming a significantly higher amount than women (4207 vs. 3523 mg). Potassium intake was 2583 mg/day, with both men and women consuming similarly insufficient amounts. Sodium-to-potassium ratio was 1·60, with men having a significantly elevated ratio compared with women (1·68 vs. 1·44). Cognitive function by sodium-to-potassium quartile groups showed nonlinear associations. Conclusion Participants in the study consumed excessive sodium and insufficient potassium; correspondingly, elevated sodium-to-potassium ratios showed significant associations with cognitive function (memory). Relevance to clinical practice Dietary guidelines tailored to levels of cognitive function as well as Korean dining culture may be important in ensuring sodium-to-potassium balance in these heart failure patients. [ABSTRACT FROM AUTHOR]

Aims and objectives This study was conducted to develop a family relocation stress scale by modifying the Son's Relocation Stress Syndrome Scale, to examine its clinical validity and reliability and to confirm its suitability for measuring family relocation stress. Background The transfer of ICU patients to general wards is a significant anxiety-producing event for family members. However, no relocation stress scale has been developed specifically for families. Design A nonexperimental, correlation design was adopted. Methods The study subjects were 95 family members of 95 ICU patients at a university hospital located in Incheon, South Korea. Face and construct validities of the devised family relocation stress scale were examined. Construct validity was examined using factor analysis and by using a nomological validity test. Reliability was also examined. Results Face and content validity of the scale were verified by confirming that its items adequately measured family relocation stress. Factor analysis yielded four components, and the total variance explained by these four components was 63·0%, which is acceptable. Nomological validity was well supported by significant relationships between relocation stress and degree of preparation for relocation, patient self-care ability, family burden and satisfaction with the relocation process. The devised scale was also found to have good reliability. Conclusions The family relocation stress scale devised in this study was found to have good validity and reliability, and thus, is believed to offer a means of assessing family relocation stress. Relevance to clinical practice The findings of this study provide a reliable and valid assessment tool when nurses prepare families for patient transfer from an ICU to a ward setting, and may also provide useful information to those developing an intervention programme for family relocation stress management. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the degree of eating ability in people with dementia and identify what factors affect their eating ability. Background Appropriate food consumption is important to human life. Although eating difficulties are common among people with dementia, little is known about what factors might influence their eating ability. Design Descriptive, cross-sectional study. Methods A total of 149 people with dementia residing in nursing facilities in Seoul or the Gyeonggi area of Korea were evaluated using the Korean Mini-Mental State Examination, Korean Activities of Daily Living Scale and Eating Behaviour Scale. Data were analysed using descriptive statistics, one-way analysis of variance, Pearson correlation coefficient and multiple regression analysis. Results The participants showed a moderate level of dependency with respect to eating ability and were most dependent on the use of utensils. There were significant differences in eating ability according to general characteristics such as duration of residence, duration of illness, degree of visual impairment, eating place, and diet type. The eating ability of the participants was significantly correlated with cognitive function and physical function. Cognitive function, physical function, duration of illness, eating place (living room or dining room), and diet type (soft or liquid) significantly predicted eating ability in people with dementia. Conclusions The findings of this study suggest that it is necessary to thoroughly assess the eating ability of people with dementia and to develop appropriate training programs to maintain or improve their remaining eating ability. The creation of a pleasurable physical and social environment for eating might also be helpful. Relevance to clinical practice These findings would be able to serve a useful basis in the development of materials for nursing intervention programs for people with dementia during mealtimes by improving the techniques and care qualities of nursing caregivers. [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.

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

Aims and objectives To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Background Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. Design The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. Participants The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. Methods The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. Results The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. Conclusion The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Relevance to clinical practice Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. [ABSTRACT FROM AUTHOR]

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

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

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

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

Aims and objectives. The purpose of this study was to identify changes in blood pressure and pulse rate after a meal for elders living in a nursing home. Background. Postprandial hypotension is a major health issue for older persons, because it has been shown to cause increased incidence of falls, syncope, coronary disease, strokes and deterioration in the quality of life. However, there has been little systematic investigation into blood pressure changes after meals in older people. Design. A descriptive, cross-sectional design was used to identify postprandial blood pressure and pulse rate changes in residents of a nursing home. Method. Blood pressure and pulse rates of 121 people aged 65 and above were measured before and after a meal and at 15-minute intervals for six more measurements. Data were analysed with descriptive statistics, repeated measures anova and paired t-tests using SPSS (SPSS Inc., Chicago, IL, USA). Results. There were significant differences in systolic and diastolic pressure by time. The biggest drop in systolic and diastolic blood pressure occurred at 45 minutes after the meal. There was no significant change in pulse rates except for immediately after the meal. Conclusions. To prevent complications from drops in postprandial blood pressure, nurses should carefully monitor blood pressure of elders at least from 30-90 minutes after meals. Further study of drops in postprandial blood pressure should be conducted for various types and times of meals. Relevance to clinical practice. Nurses caring for older persons can identify drops in the postprandial blood pressure to manage the incidence of falls, syncope and stroke more effectively, especially in nursing homes. [ABSTRACT FROM AUTHOR]

Aims and objectives. To test a staged theoretical model designed to explain causal relationships affecting the quality of life (QOL) of middle-aged Korean women suffering from Hwa-Byung (HB). Background. The model contains three stages comprised of antecedents (stage 1), perception (stage 2) and outcome variable (stage 3). Stage 1 contains individual characteristic and emotional distress variables. In stage 2, the perception variable is depression (DEP). In stage 3, the outcome factor is QOL. Design. A cross-sectional, descriptive design was used. Methods. A convenience sample of 135 community dwelling middle-aged women was recruited over a five-month period in the neuropsychology outpatient clinic at an Oriental hospital in Korea. The instruments were the Korean version of WHO Quality of Life-BREF (WHOQOL-BREF), Korean version of State-Trait Anger Expression Inventory (STAXI-K), The Korean version of State-Trait Anxiety Inventory (STAI-K) and Korean version of Beck Depression Inventory (K-BDI). Results. Forty-five per cent of the variance in the QOL of women with HB was explained by the direct effect of depression (β = −0·356, p = 0·000) and trait anxiety (β = −0·324, p = 0·001). State anger (β = 0·429, p = 0·000) and spouse (β = −0·180, p = 0·021) explained 45·0% of the variance in (of) depression. Conclusion. The findings showed that depression mediates the relationship between the emotional distress and QOL as a negative outcome. Relevance to clinical practice. These relationships can guide researchers and psychiatric mental health nurses to understand depression as a mediating factor and to develop nursing interventions to improve QOL of HB women. [ABSTRACT FROM AUTHOR]