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

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

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

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

Aim and Objectives: This study aimed to identify the associations between longitudinal trajectories of self‐care behaviours and unplanned hospital readmissions in patients with heart failure. Background: Adherence to self‐care behaviours is crucial to prevent hospital readmissions; however, self‐care behaviours remain unsatisfactory among patients with heart failure. Studies of long‐term trajectories of self‐care behaviours and their influence on hospital readmissions are limited in this population. Design: A prospective, longitudinal observational study. Methods: Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1‐year follow‐up data to determine the association between 1‐year trajectories of self‐care behaviours and hospital readmissions using Kaplan–Meier analysis and multivariable Cox regression, adjusted for confounding variables. Results: Self‐care behaviour trajectories of heart failure patients were classified as 'high‐stable' (58.4%) or 'low‐sustained' (41.6%). The cumulative rate of readmissions for the low‐sustained class was higher than that of the high‐stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self‐care behaviours trajectories. The low‐sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high‐stable class. Conclusions: Longitudinal self‐care behaviours pattern trajectories of heart failure patients were stratified as high‐stable and low‐sustained. Routine follow‐up assessment of patients' self‐care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions. Relevance to clinical practice: Identification of trajectory patterns of self‐care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self‐care behavioural patterns in heart failure patients. Reporting Method: The study has been reported in accordance with the STROBE checklist (Appendix S1). Patient or Public Contribution: Patients have completed a self‐reported questionnaire after providing informed consent. [ABSTRACT FROM AUTHOR]

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

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

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]

Background: Although the optimal use of prescribed medications for stroke survivors is critical for preventing secondary stroke, longitudinal observations of the natural course of medication persistence and adherence in Korean stroke survivors are rare. Furthermore, studies are needed to identify strong predictors influencing medication adherence and to determine whether these predictors change over time. Aims and objectives: To evaluate the longitudinal medication persistence and adherence at 3 months and 1 year after discharge in all stroke patients and to identify predictors of long‐term medication adherence in patients who can self‐medicate. Design: A multicentre, prospective, longitudinal descriptive study. Methods: A total of 600 consecutive ischaemic stroke patients were recruited from three stroke centres across Korea, from 1 September, 2017 to 28 February, 2019. Various factors related to medication adherence suggested by the World Health Organisation were investigated through face‐to‐face interviews at each centre during hospitalisation. Medication persistence and adherence were assessed at 3 months and 1 year after discharge using the eight‐item Morisky Medication Adherence Scale through telephone interviews. Results: Of 537 survivors at 3 months, 526 (98.0%) were persistent and 472 (89.7%) were adherent. Of 493 survivors at 1 year, 477 (96.8%) were persistent and 392 (82.2%) were adherent. Medication belief, income and health literacy were statistically significant predictors of three‐month medication adherence, which predicted one‐year medication adherence with older age and low income. Conclusions: Among Korean stroke survivors, three‐month and one‐year medication persistence and adherence were relatively good. Medication beliefs and three‐month medication adherence were important and modifiable factors predicting three‐month adherence and one‐year adherence, respectively. Relevance to clinical practice: To increase long‐term adherence to medication, various strategies are needed to improve beliefs about medication, taking into account the patient's age and level of knowledge. These interventions need to be initiated during hospitalisation to form early medication habits after discharge. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to determine the effect of overtime on alertness at work among rotating‐shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. Background: Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. Design: A prospective observational study was employed. The study followed STROBE checklist for observational studies. Methods: Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real‐time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed‐effect models were employed to investigate the association between overtime and alertness. Results: A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous‐day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous‐day overtime hours and consecutive overtime days in all shifts. Conclusions: The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. Relevance to clinical practice: Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime. [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: To validate a hypothetical path model estimating the health status of patients with insulin‐treated type 2 diabetes and to verify the mediating effects of diabetes management self‐efficacy, diabetes self‐management behaviour and haemoglobin A1c using a multi‐mediation model. Background: Diabetes knowledge, personal and social motivations, diabetes management self‐efficacy and health behaviours may be interrelated and may directly or indirectly affect the objective and subjective health outcomes of patients with type 2 diabetes mellitus receiving insulin treatments. Design: Model testing correlational design. Methods: The participants were 193 outpatients with insulin‐treated type 2 diabetes. Data were collected between July and November 2019. The collected data were analysed using SPSS version 25.0® and AMOS 23.0. This study is based on STROBE guidelines. Results: The model's fit indices were adequate. Diabetes‐related knowledge, psychological insulin resistance, family support for diabetes management, diabetes self‐care activities and haemoglobin A1c had significant direct effects on subjective health status. Diabetes management self‐efficacy had significant indirect effects on subjective health status via diabetes self‐care activities and haemoglobin A1c, and mediated the path through which diabetes knowledge, psychological insulin resistance and family support for diabetes management indirectly affect subjective health status. These variables explained 55.0% of the total variance of subjective health status. Conclusion: Diabetes knowledge, psychological insulin resistance, diabetes management family support, diabetes management self‐efficacy and diabetes self‐care activities were found to be related to the subjective and objective health status. Relevance to clinical practice: The findings can help health professionals improve diabetes self‐care activities and haemoglobin A1c, which will influence subjective health status in patients with type 2 diabetes mellitus, receiving insulin treatments. [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: The objective of this study was to examine differences in personal characteristics, core practice competency and role stress according to levels of teaching efficacy among clinical nurse educators working in general hospitals. Background: In the clinical setting, successful adaptation to instruction among practicing clinical nurse educators is challenging. Design: Secondary analysis of data through a cross‐sectional study design was adopted. Methods: Originally, 565 nurses were recruited from general hospitals; 364 were included in this study. Participants were nurses with more than 1 year of experience in various settings from 16 general hospitals wherein nursing students trained for clinical practicum in five cities in South Korea. Self‐reported data were collected via the Teaching Efficacy, Core Practice Competency and Perceived Stress Scales assessing clinical education‐related teaching efficacy, core practice competency and role stress. In the analyses, comparison between nurses with high and low teaching efficacy was conducted. We have followed through the EQUATOR (e.g. STROBE) research checklist for the preparation of this manuscript. Results: According to univariate analysis, levels of teaching efficacy were shown to be higher with age, longer clinical careers, in those undergoing a doctoral course or with a doctorate, previous experience in providing clinical education and enrolment in continuing education for clinical education. In the multivariate analysis, enrolment in continuing education for clinical education, assessment and intervention skills, critical thinking skills, teaching skills and role ambiguity were associated with level of teaching efficacy among nurse educators. Conclusion: Based on the results of this study, we recommend that nursing administrators should foster the recognition of personal characteristics in potential clinical nurse educators or preceptors with high teaching efficacy. Relevance to clinical practice: Nurses should be supported by providing them with opportunities for professional development to enhance teaching efficacy. [ABSTRACT FROM AUTHOR]

Aims and Objectives: 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 performance of the National Early Warning Score 2 and composite score for clinical worry in identifying patients at risk of clinical deterioration, and to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome at discharge. Background: The efficacy of early warning systems depends on patient population and care settings. Based on a theoretical framework on factors affecting clinical deterioration and patient outcomes, studies exploring the relationship between early warning systems and patient outcomes at discharge are sparse. Design: Retrospective observational study. Methods: A random sample of 732 medical records were reviewed. The area under the receiver operating characteristic curve was calculated to evaluate predictive abilities regarding the events of unanticipated in‐hospital mortality, unplanned intensive care unit/ higher dependency bed admission and cardiac arrest. Multiple logistic regression analyses were performed to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome. Reporting followed the STROBE checklist. Results: National Early Warning Score 2 and clinical worry score significantly predicted the events within 24 hr of the assessment. After controlling for other patient, treatment and organisational characteristics, National Early Warning Score 2 was a significant factor associated with patient outcome, but clinical worry score was not. Specifically, patients at high risk based on National Early Warning Score 2 were less likely to have improved outcome. Conclusions: National Early Warning Score 2 and clinical worry score performed well for predicting deteriorating condition of patients. National Early Warning Score 2 was significantly associated with patient outcome. It can be used for efficient patient management for safe, quality care. Relevance to clinical practice: National Early Warning Score 2 can be used for early assessment of not only clinical deterioration but also patient outcome and provide timely intervention, when coupled with clinical worry score. [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 current state of face‐to‐face bullying and cyberbullying among nurses in the workplace and to identify the effects of nursing organisational culture on face‐to‐face bullying and cyberbullying. Background: It is important to accurately examine the current state of workplace bullying to acknowledge the gravity of the situation faced by nurses and devise prevention strategies. Electronic communication by computer or smartphone is widely used as a prompt and efficient means of facilitating nursing work; however, this leads to the possibility of cyberbullying as well as face‐to‐face bullying among nurses. Design: Descriptive cross‐sectional study. Methods: A total of 226 staff nurses working in one of five upper tertiary hospitals in Korea with a career of 10 years or shorter were surveyed using a self‐reported questionnaire. The collected data were evaluated using various statistical analyses, including hierarchical regression. Our study was applied to the STROBE checklist of items. Results: The mean face‐to‐face bullying score was 1.32 ± 0.53 and the cyberbullying score was 1.14 ± 0.37 (possible range: 1–5); most were work‐related negative experiences. The explanatory power of nursing organisational culture for face‐to‐face bullying was 6.3%, and relation‐oriented culture and hierarchy‐oriented culture were major factors affecting face‐to‐face bullying. The explanatory power of nursing organisational culture for cyberbullying was 4.3%, and relation‐oriented culture was a major factor affecting cyberbullying. Conclusions: Relation‐oriented culture had a significant effect on both face‐to‐face bullying and cyberbullying. Therefore, organisations should strive to foster a relation‐oriented nursing organisational culture in order to prevent and resolve workplace bullying among nurses. Relevance to clinical practice: Cyberbullying should be addressed as an important type of workplace bullying in nursing, which occurs via various information and communication devices. To prevent workplace bullying among nurses, various strategies that promote relation‐oriented nursing organisational cultures should be considered. [ABSTRACT FROM AUTHOR]

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

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

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

Aims and Objectives: To conduct a concept analysis of self‐stigma among patients with diabetes and introduce an operational definition of self‐stigma. Background: Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients' self‐care and socialisation. Design: A concept analysis was conducted using a three‐phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz‐Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). Methods: During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in‐depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. Results: In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self‐stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self‐esteem and self‐efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. Conclusions: Self‐stigma among patients with diabetes is defined as a state in which patients develop negative self‐feelings as they deal with the disease. This can cause diminished self‐esteem and self‐efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. Relevance to Clinical Practice: Based on this self‐stigma concept analysis, we clarified the attributes of diabetes self‐stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment. [ABSTRACT FROM AUTHOR]

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

Aims and objectives: To analyse the operation, anaesthesia and recovery‐related factors affecting the occurrence of delirium in the intensive care unit. Background: The occurrence rate of postoperative delirium is high in surgical patients. Postoperative delirium most frequently occurs usually within 3 days after an operation. Design: This study used a secondary data analysis based on a case–control study. Methods: This study analysed data extracted from the electronic health records at a university hospital from October 2009–July 2015. One hundred and eighty patients with delirium admitted to the intensive care unit through the recovery room after surgery, and 720 nondelirium controls were included. A total of 17 variables were selected, and hierarchical logistic regression was performed to identify operative and anaesthetic factors influencing on delirium. STROBE statement was applied for reporting this study. Results: The operation, anaesthesia and recovery‐related factors increasing the risk of delirium included Class II or higher in the classification system of American Society of Anesthesiologists physical status, continuous remifentanil infusion and lower than seven‐point postanaesthesia recovery score at the time of admission to the recovery room. Conclusion: The operative and anaesthetic factors influencing the occurrence of delirium should be assessed when a patient is admitted to the ICU following an operation even if a patient is conscious. Relevance to clinical practice: Identifying operative and anaesthetic risk factors for delirium can improve the prevention intervention and the patient outcome in the intensive care unit. [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: To examine the current state of radiation safety education and its influence on nurses’ compliance with safety procedures. Background: Use of radiation in therapy and diagnosis has prolonged and improved millions of lives, but it presents potential hazards for healthcare professionals. Design: A cross‐sectional design. Methods: Participants included 1,672 female nurses of childbearing age who had recently been exposed to radiation‐emitting generators or radiation. Quantitative data were taken from the Korea Nurses’ Health Study, the Korean version of the Nurses’ Health Study conducted in the USA. Confounding variables included sociodemographic factors, duration of employment in a department where work involved radiation, hospital's geographical location, bed size and hospital safety climate. Statistical analyses included descriptive statistics, Spearman's correlation coefficients and multivariable ordinal logistic regression. Results: Half (50.3%) of nurses received no safety training, whereas the other half received some safety training as follows: only once (14.4%), irregularly (10.2%) and regularly (25.1%). Of the six radioactive safety compliance questionnaires, 29.4%, 20.2%, 30.7% and 19.7% complied to none, one, two and more than three, respectively. After controlling for confounding variables, relative to that observed with no safety education, irregular education that occurred more than twice (OR = 1.597, CI = 1.177–2.164) and regular education (OR = 2.223, CI = 1.770–2.792) increased the likelihood that nurses would comply with safety procedures. Conclusions: Low levels of safety education and adherence raise critical concerns regarding nurses’ well‐being. As routine safety education increases safety adherence, healthcare managers and policymakers should emphasise regular safety education. Relevance to clinical practice: Radiation safety education for nurses and their compliance with safety procedures have seldom been discussed in South Korea. However, as nurses’ safety is directly related to the quality of patient care, additional safety education should be provided for hospital nurses to minimise their occupational exposure to harmful radioactive substances in clinical settings. [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 describe changes in cognitive function, as measured by the trail making test; to identify distinct patterns of change in cognitive function; and to examine predictors of change in cognitive function in people with severe chronic obstructive pulmonary disease. Background: How cognitive function changes in people with chronic obstructive pulmonary disease and what factors influence those changes over time is not well known, despite the fact that it declines rapidly in this population and significantly impacts functional decline in healthy older adults. Design: A secondary analysis and longitudinal study with a follow‐up period of 3 years. Methods: A data set from the National Emphysema Treatment Trial provided participant data. Patients with severe chronic obstructive pulmonary disease (n = 307) were recruited at a clinical site. Several demographic and clinical measures were assessed at baseline. Trail making test scores were measured at baseline, 1, 2 and 3 years. Results: Cognitive function was stable for 3 years in people with chronic obstructive pulmonary disease. However, four distinct patterns of change in cognitive function were identified. Age, education, 6‐min walk distance and cognitive impairment scores at baseline on the trail making test Part B were significant predictors of worsening cognitive function and below‐average cognitive function over 3 years. Conclusions: These findings suggest that increasing exercise capacity improves cognitive function and delays deterioration of cognitive function in people with COPD. Relevance to clinical practice: Understanding the trajectories of change in cognitive function and predictors of change in cognitive function over 3 years may enable health care providers to identify patients at greatest risk of developing mental deterioration and those who might benefit from interventions to improve cognitive function. Health care providers should periodically assess and frequently screen people with COPD for cognitive function. [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 examine the roles of two modifiable factors—health‐promoting behaviours and perceived stress—in predicting aneurysmal rupture. Background: Unruptured intracranial aneurysm detection produces significant stress and anxiety in patients because of the risk of rupture. Compared to nonmodifiable risk factors for rupture such as age, gender and aneurysm size/location, less attention has been given to modifiable risk factors. Two modifiable factors, health‐promoting behaviours and perceived stress, have hardly been examined as potential predictors of rupture. Design: This study used a cross‐sectional design. Methods: We assessed 155 patients with intracranial aneurysms—that is, subarachnoid haemorrhage (n = 77) or unruptured intracranial aneurysm (n = 78)—to examine (i) baseline characteristics (patient and aneurysmal factors), (ii) health‐related factors (lifestyle habits and health‐promoting behaviour) and (iii) perceived stress levels (psychological stress and physical stress). Patient records provided medical histories and aneurysmal factors; other data were collected using a structured questionnaire addressing lifestyle habits, the Health‐Promoting Lifestyle Profile‐II to measure health‐promoting behaviour and the Perceived Stress Questionnaire to measure perceived‐psychological stress and perceived‐physical stress levels. Results: Bivariate analysis indicated that aneurysm rupture risk was associated with female gender, aneurysm size/location, defecation frequency, hyperlipidaemia, sedentary time, low Health‐Promoting Lifestyle Profile‐II mean scores and high perceived‐psychological stress scores. After adjusting for known risk factors, the mean Health‐Promoting Lifestyle Profile‐II and perceived‐psychological stress scores remained robust predictors of rupture. Furthermore, known risk factors combined with these scores had greater predictive power than known risk factors alone. Conclusion: Health‐promoting behaviour and psychological stress are promising modifiable factors for reducing risk of aneurysmal rupture. Relevance to clinical practice: Our findings may stimulate greater understanding of mechanisms underlying aneurysmal rupture and suggest practical strategies for nurses to employ in optimising conservative management of rupture risk by teaching patients how to modify their risk. Both health‐promoting behaviour and perceived stress should be addressed when designing preventive nursing interventions for patients with unruptured intracranial aneurysm. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore barriers to ethical nursing practice for older adults in long‐term care facilities from the perspectives of nurses in South Korea. Background: The number of older adults admitted to long‐term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long‐term care facilities have not been fully explored in previous literature. Design: A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long‐term care facilities in South Korea. Methods: Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long‐term care facilities in South Korea. Data were analysed using qualitative content analysis. Results: Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long‐term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. Conclusions: This study has identified methods that could be used to improve ethical nursing practices for older adults in long‐term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. Relevance for clinical practice: Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study. [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 develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Background Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. Design A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. Methods The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. Results This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Conclusions Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. Relevance to clinical practice The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers. [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]