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Purpose: This retrospective study was conducted to identify factors associated with repeated suicide attempts by analyzing the electronic medical records of suicide attempters who visited emergency medical centers due to drug intoxication. Methods: Data from January 1, 2020 to December 31, 2021 were collected for this study and analyzed using SPSS/WIN 25.0. Results: In this study, the factors affecting repeated suicide attempts among individuals who visited the emergency medical center due to acute drug intoxication were the presence or absence of psychiatric diseases, the season of drug intoxication, and age. In order to identify the factors affecting repeated suicide attempts in those who presented with acute drug intoxication, logistic regression analysis was performed by inputting psychiatric diseases, season of drug intoxication, and age, all of which exhibited significant differences between those who did and did not attempt suicide again. The presence of psychiatric diseases (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.04~3.80), intoxication occurring in the fall (vs. spring; OR = 3.35, 95% CI = 1.28~8.75), and age ≥ 65 (vs. those under the age of 18; OR = 12.96, 95% CI = 2.02~83.17). The regression model was found to be statistically significant (F = 30.01, p < .001), and the coefficient of determination of Cox and Snell, which represents the explanatory power of the model, was 12.0%. Conclusion: This study suggests that to prevent repeated suicide attempts, it is necessary to develop a tool to evaluate the risk of suicide, use it to evaluate the risk of suicide, and then manage individuals accordingly. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify factors influencing oncofertility and to explore the oncofertility experiences of patients with gynecological cancer using quantitative and qualitative methods, respectively. Methods: An explanatory sequential mixed-methods study was conducted. The quantitative study involved 222 patients with gynecological cancer recruited from online cafes and hospitals. Data were analyzed using IBM SPSS Statistics 28. For qualitative research, eight patients with gynecological cancer were interviewed. Data were analyzed using theme analysis method. Results: Oncofertility performance was quantitatively assessed in 40 patients (18.0%). Factors that significantly affected oncofertility were fertility preservation awareness (odds ratio [OR] = 14.97, 95% confidence interval [CI]: 4.22???53.08), number of children planned before cancer diagnosis (OR = 6.08, 95% CI: 1.89~19.62; OR = 5.04, 95% CI: 1.56~16.29), monthly income (OR = 3.29, 95% CI: 1.23~8.86), social support (OR = 1.08, 95% CI: 1.01~1.17), and anxiety (OR = 0.79, 95% CI: 0.66~0.95). Qualitative results showed three theme clusters and eight themes: (1) themes for determinant factors affecting oncofertility selection: 'desire to have children' and 'special meaning of the uterus and ovaries;' (2) themes for obstructive factors affecting oncofertility selection: 'fertility preservation fall behind priorities,' 'confusion caused by inaccurate information,' and 'my choice was not supported;' (3) themes for support factors affecting oncofertility selection: 'provide accurate and reasonable information about oncofertility,' 'addressing the healthcare gap,' and 'need financial support for oncofertility.' Conclusion: Financial support, sufficient information, social support, and anxiety-relief interventions are required for oncofertility in patients with gynecological cancer. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to identify the double mediating effect of effect of diversity sensitivity orientation and positive nursing organizational culture between diversity management and organizational commitment. Methods: Participants were 245 nurses working in six tertiary hospitals located in 3 different regions. Data collection was conducted from February 13, 2023 to March 6, 2023 through online self-reported questionnaire. The data were analyzed by IBM SPSS Statistics 27 and SPSS PROCESS Macro 4.2 program. Results: The direct effect of diversity management on organizational commitment was significant (β = .21, p < .001). The indirect effect of diversity management on organization commitment was .34 (95% confidence interval [CI] = .23~.47). The double mediating effect of diversity sensitivity orientation and positive nursing organizational culture in the relationship between diversity management and organizational commitment was .02 (95% CI = .00~.05). Conclusion: Diversity sensitivity orientation and positive nursing organizational culture show double mediating effect on the relationship between diversity management and organizational commitment. Education program and human resource management strategy for enhancing diversity management, diversity sensitivity orientation and positive nursing organizational culture should be provided to improve organizational commitment, and which are needed active support of the association and nursing organization. [ABSTRACT FROM AUTHOR]

Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690). [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the validity of the PRE-DELIRIC model and E-PRE-DELIRIC model. Methods: Patients who underwent cardiac surgery at a tertiary hospital between January 2019 and December 2022 were included. The presence or absence of delirium was determined based on risk groups, and the sensitivity, specificity, positive predictive power, and negative predictive power were verified using the Youden index. Receiver operating characteristic curves were derived for the PRE-DELIRIC model and E-PRE-DELIRIC model, the area under the curve was calculated, and the 95% confidence interval (CI) was presented. Results: The incidence of delirium was 28.8%. The average scores of the PRE-DELIRIC model and E-PRE-DELIRIC model were 49.72±29.91 and 18.14±0.41, respectively. In the PRE-DELIRIC model, for which a cut-off point of 14.05 was established using the Youden index, the sensitivity, specificity, positive predictive power, and negative predictive power were 64.8%, 83.2%, 61.0%, and 85.4%, respectively. In the E-PRE-DELIRIC model, with a cut-off point of 64.01, the corresponding indicators were 73.1%, 51.5%, 37.8%, and 82.6%, respectively. The areas under the curve for the PRE-DELIRIC model and the E-PRE-DELIRIC model were 0.77 (95% CI, 0.74-0.82) and 0.65 (95% CI, 0.61-0.69), respectively. Conclusion: It may be helpful to use both the E-PRE-DELIRIC and PRE-DELIRIC models. The two prediction models are expected to help improve the quality of nursing for the early detection and prevention of delirium, enabling intensive observations and interventions for patients at high risk of delirium. [ABSTRACT FROM AUTHOR]

Purpose : This study aimed to determine the mortality rate among elderly patients admitted to the intensive care unit (ICU) for acute drug intoxication resulting from suicide attempts. It also compared the characteristics of survivors and decedents to identify factors associated with mortality. Methods : This retrospective descriptive study included 150 patients aged 65 years or older who were admitted to the ICU of a tertiary university hospital in Gwangju due to acute drug intoxication, with the period spanning January 1, 2018 to December 31, 2020. The collected data were analyzed using descriptive statistics, independent t-tests, Chi-squared tests, Fisher's exact test, and multiple logistic regression analysis. Results : The mortality rate among elderly individuals admitted to the ICU for acute drug intoxication was 19.3%. The likelihood of death was significantly higher in patients with an acute physiology and chronic health examination (APACHE) III score of 70 or above (OR=23.75, 95% CI= 3.78-149.46, p < .001) and those with metabolic acidosis on initial acid-base results (OR=3.73, 95% CI=1.12- 12.43, p=.032). Conclusion : These findings underscore the need for developing and implementing systematic education and targeted nursing interventions for ICU nurses caring for acutely drug-intoxicated elderly adults, particularly considering the APACHE III score and the presence of metabolic acidosis. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the effects of resilience and nursing managers' empowering leadership on turnover intention among new nurses, as well as the mediating role of transition shock. Methods: This was a descriptive, cross-sectional study. Data were collected from 167 new nurses working in tertiary hospitals in Korea between July 1st and July 13, 2022. The relationships among the variables were analyzed using Pearson's correlation coefficients, and the factors affecting turnover intention were identified using PROCESS macro analysis. Results: Resilience (direct effect=-0.02, p=.781) and nursing managers' empowering leadership (direct effect=-0.00, p=.992) did not directly affect new nurses' turnover intention. Transition shock had mediating role in the relationship between resilience and turnover intention (indirect effect=-0.12, 95% Boot confidence interval=-0.23~-0.04) and between nursing managers' empowering leadership and turnover intention (indirect effect=-0.14, 95% Boot confidence interval=-0.23~-0.06). Conclusion: Resilience and nursing managers' empowering leadership indirectly influence turnover intention through transition shock among new nurses. To reduce turnover intention among new nurses, programs for preventing or mitigating their transition shock should be provided. In addition, improving the resilience of new nurses and nursing managers' empowering leadership may contribute to reducing turnover intention among new nurses by mitigating their transition shock. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the impact of health literacy on adherence of medication among older adults living alone and to determine the mediating effect of e-health literacy in the relationship between the two variables. Methods: A total of 91 older people living alone who visited a general hospital and welfare center participated, and data collection was conducted from July 20, 2023 to August 30, 2023. Descriptive statistics, t-test, ANOVA, Pearson’s correlations, Model 4 of PROCESS macro were used for data analysis. Results: Health literacy of older adults living alone was found to have a significant effect on adherence of medication (β=.33, p<.001) and e-health literacy (β=.34, p<.001). E-health literacy was found not to mediate the relationship between health literacy and adherence of medication (Indirect effect: β=-.02, 95% confidence interval -.08~.02). Health literacy was significantly different depending on age (F=6.86, p=.002), education background (F=10.36, p<.001), and monthly income (F=7.98, p<.001). There was a significant difference in adherence of medication based on age (F=4.38, p=.015). Also, e-health literacy had significant differences in age (F=10.05, p<.001), education background (F=7.91, p<.001), and monthly income (F=7.38, p<.001). Conclusion: When providing education to older adults living alone to improve adherence of medication, medical staff and nurses should identify health literacy, provide repetitive medication education tailored to the level of health literacy of each elderly living alone, and critically receive indiscriminate health information from the Internet. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine the effect of group education reflecting unmet needs led by Nurse Practitioners (NPs) on essential knowledge regarding chemotherapy for cancer patients and their families undergoing chemotherapy. Methods: Conducted at a tertiary general hospital in Seoul from December 30, 2020, to April 30, 2022, this study, which is based on a one group pre-post design, involved 104 cancer patients and their families. It assessed differences in knowledge regarding chemotherapy and satisfaction levels by means of participation through video-based group education led by NPs. The data were analyzed with SAS version 9.4 using paired t-tests and multiple logistic regression analysis. Results: The average score of knowledge regarding chemotherapy increased from 80.0 to 89.8 (p<.001). In multivariable logistic regression analysis, being less than 50 years old (adjusted Odds Ratio [aOR]=13.56, 95% Confidence Interval [CI]: 1.76~10.20) and having a college degree or higher (aOR=3.99, 95% CI: 1.15~13.82) were associated with an increase in knowledge regarding chemotherapy. Satisfaction with participation in the group education program was also reported to be high. Conclusion: This study aimed to develop and implement a group education program for cancer patients and their families undergoing chemotherapy, assess changes in knowledge levels, and investigate satisfaction with the program. As a result of the study, the average score of patients who received the group education program increased; thus, it is an effective method for improving the degree of knowledge about the daily life of cancer patients and the management of side effects. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated whether patient activation and nurse trust mediate the relationship between a person-centered climate and patient satisfaction in cancer patients. Methods: A total of 179 participants, who were admitted in a tertiary hospital of J city, were surveyed in a cross-sectional study. Data were collected from March 1 to June 10, 2023. The descriptive statistics and mediating effects were analyzed using SPSS/WIN 25.0 and PROCESS macro program. Results: A person-centered climate directly affected patient satisfaction (direct effect=0.21, p<.001; direct effect=0.34, p<.001). Patient activation had a mediating effect between a person-centered climate and patient satisfaction (indirect effect=0.31, 95% Boot confidence interval=0.24~0.39). Nurse trust had a mediating effect between a person-centered climate and patient satisfaction (indirect effect=0.19, 95% Boot confidence interval= 0.10~0.27). Conclusion: This indicates the importance of developing a person-centered climate, patient activation and nurse trust to improve satisfaction for cancer patients. Therefore, it is necessary to assess the level of trust in nurses to improve and strengthen trust in them and to develop various program to focus on patient activation in cancer patients. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effectiveness of exercise in patients with hemophilia. Methods: We carried out a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. A literature search was conducted of published randomized controlled trials for exercise interventions from January 1, 2014 to March 15, 2023. To estimate the size of the effects of exercise, a meta-analysis was performed using the R package “meta.” Results: Five databases were searched to obtain articles published in Korean or English. Of 1,150 articles reviewed, 13 were included in the systematic review and 9 in the meta-analysis. The risk of bias was assessed using RoB 2.0. The overall effect sizes of exercise interventions, calculated as the standardized mean difference, were -0.11 (95% confidence interval [CI] = -1.41 to –1.20) for pain, -2.13 (95% CI = -3.33 to -0.93) for joint health, 9.96 (95% CI = 7.51 to 12.28) for physical activity, and 0.59 (95% CI = -0.39 to -1.56) for quality of life. Conclusion: These findings suggest that exercise is useful for improving the joint health and physical activity of patients with hemophilia. Thus, it is necessary to develop and apply exercise interventions for patients with hemophilia to reduce their pain and improve their quality of life. [ABSTRACT FROM AUTHOR]

Purpose: This cross-sectional study aimed to identify factors influencing the intention for continual fertility treatments among women undergoing assisted reproductive technology (ART). Methods: A total of 197 women were recruited through convenience sample from fertility hospitals in Gyeonggi-do and Busan, South Korea. Data were collected using a self-report questionnaire incorporating measures of uncertainty; Depression Anxiety Stress Scales; Fatigue Severity Scale; Coping Scale for Infertility-Women; spousal support; treatment environment; and intention for continual fertility treatment. Descriptive statistics, chi-square tests, t-tests, and logistic regression analysis were conducted using IBM SPSS 26.0. Results: As many as 70.6% of the participants expressed an intention for continual fertility treatments. Logistic regression analysis revealed that factors such as uncertainty (odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20-0.95), active coping (OR = 4.04, 95% CI 1.11-14.71), treatment environment (OR = 2.77, 95% CI 1.26-6.07), and the duration of marriage (OR = 2.61, 95% CI 1.24-5.49) were significantly related with this intention. Conclusion: These findings underscore the significance of uncertainty management, having proactive coping strategies, having supportive treatment environments, and considering the duration of marriage concerning women's intention for continual fertility treatment in the context of ART. The implications of these results extend to the development of nursing intervention programs aimed at providing crucial support for women undergoing ART and seeking to continue their infertility treatment. [ABSTRACT FROM AUTHOR]

Purpose: Globally, the issue of palliative and end-of-life care (PEOLC) in nursing homes is a common concern, and the need to measure the preparedness of nursing staff for end-of-life care is increasing. This study aimed to verify the validity and reliability of the Korean version of the self-reported scale for the Staff Preparedness for PEOLC in long-term care homes. Methods: A total of 161 staff took part in the study; among them were nine nurses, 19 nursing assistants, 133 care workers at four nursing homes located in Wonju and Seongnam cities, South Korea. The scale was translated according to the guidelines of World Health Organization guidelines and Consensus-Based Standards for the Selection of Health Measurement Instruments, and its reliability and validity were evaluated through assessing its internal consistency, stability, and construct validity (confirmatory factor analysis, CFA). Results: CFA confirmed that the measurement tool had a good fit (comparative fit index=.96, Turker-Lewis index=.95, root mean-squared error of approximation=.07). The items’ internal consistencies of the items were found to be reliable with Cronbach’s alpha=.94; the Pearson’s correlation coefficient between test and retest of the tool was .86 (p<.001); and the intraclass correlation coefficient value was .91 (95% confidence interval: .85~.96). Conclusion: The Korean version of the Staff Preparedness for PEOLC in long-term care homes was confirmed to be a useful and reliable scale for measuring the preparedness of nursing staff in Korean long-term care facilities in Korea for PEOLC. [ABSTRACT FROM AUTHOR]

Purpose: Sarcopenia is a state of reduced muscle function that can lead to increased falls, fractures, and mortality in the older population. This study aimed to identify the prevalence of sarcopenia and its related risk factors in older adults in the community during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study investigated sarcopenia, muscle strength, physical performance, fear of COVID-19, distress, and depression in 103 community-dwelling older individuals over 65 years of age. Results: The prevalence of sarcopenia among older people in the community was 4.8% and 29.1% in men and women, respectively. Age (odds ratio [OR]=14.48, 95% confidence interval [CI]=1.48~141.40), gender (OR=6.69, 95% CI=1.11~40.06), physical performance (OR=7.41, 95% CI=1.55~35.21) and depression (OR=5.29, 95% CI=1.16~24.06) were significant risk factors for sarcopenia, but COVID-19-related factors were not significant (p>.05). Conclusion: Preventive measures for sarcopenia in older people are urgently required. Since depression and physical performance are the main factors influencing sarcopenia, it is suggested to develop an intervention to prevent sarcopenia in older people. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate factors influencing assessment results in the new Health Technology Assessment (nHTA) in Korea. Methods: We analyzed publicly available nHTA reports obtained from the program's website. A total of 258 reports, encompassing 305 technologies, were included. Reported details were categorized into three main areas: technical characteristics, evaluation methods, and publication types. To investigate differences in evidence level (high, medium, or low) and assessment results (pass or fail) according to these categories, we employed a chi-squared test. Univariate and multivariate logistic regression analyses were further conducted to identify factors associated with evidence level and assessment results. Results: nHTA reports employing meta-analysis and included randomized trials for evidence synthesis exhibited a higher likelihood of achieving high evidence level (odds ratio [OR], 5.008; 95% confidence interval [CI], 1.265-18.826 and OR, 27.052; 95% CI, 7.802-103.330, respectively). Increasing evidence level was significantly associated with a higher possibility of passing the assessment (OR 2.789; 95% CI, 1.284-6.057). However, in univariate analysis, neither performing meta-analysis nor including randomized trials, both of which were associated with evidence level, demonstrated a statistically significant association with assessment results. Conclusion: This study represents the first systematic analysis of factors influencing nHTA assessment results in Korea. While increased evidence level was associated with positive assessment outcomes, factors affecting the evidence level itself did not directly influence assessment results. This suggests the need for further efforts to effectively integrate high-level evidence into assessment decisions within the nHTA program. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the mediating effect of leader-member exchange (LMX) on the relationship between nursing unit managers'ethical leadership and nurses'turnover intentions. Methods: A cross-sectional nationwide survey was performed using structured questionnaires. A total of 225 clinical nurses working in general tertiary hospitals were recruited through proportional quota sampling; the quota used represented the location of working hospitals in South Korea. Data were collected through an online survey and snowball sampling from June to September 2022 and analyzed using the SPSS 25.0 program. A mediation analysis was performed using a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results: In bootstrapping, the indirect effect (X→M→Y) was statistically significant (B=-0.77, 95% CI:-1.02 to -0.50). LMX showed a mediating effect on the relationship between nursing unit managers'ethical leadership and clinical nurses' turnover intention. In this model, the total effect was B=-0.93 (p<.001). Conclusion: These findings suggest that LMX must be considered when making a strategy for nursing retention in the hospital setting. Nursing unit managers with ethical leadership could decrease nurses' turnover intention by improving the LMX. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses. Methods: Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program. Results: The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r = .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09-.59]) and job-esteem (B = 0.27 [.04-.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem. Conclusion: In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses' motivation for career development and recognition of the nursing profession through improvement of the nursing work environment. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the effects of job embeddedness and resilience on the relationship between job rotation stress and nursing work performance among clinical nurses. Methods: We conducted a nationwide online survey with 205 nurses employed at advanced general or general hospitals. Data were collected from August 17 to October 5, 2021. We analyzed the data using various descriptive statistics, independent t-tests, one-way analysis of variance, Scheffe test, Welch test, Games-Howell test, Pearson's correlation coefficients, multiple regression, and the PROCESS macro with a 95% bias-corrected bootstrap confidence interval. These analyses were conducted using SPSS Windows Software version 23.0 and SPSS PROCESS macro version 3.5.2. Results: Nurses' job embeddedness mediated the relationship between job rotation stress and nursing work performance (B=-0.02, p<.05). Furthermore, their resilience moderated this mediated relationship, also known as moderated mediation, with job embeddedness as the mediating factor (B=-0.02, p<.05). Conclusion: These findings imply that, when devising a strategy to improve the nursing work performance of nurses undergoing job rotation, their resilience levels should be considered. Reducing job rotation stress while concurrently enhancing job embeddedness is essential for enhancing the nursing work performance of nurses with high levels of resilience. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis aimed to examine the effects of auricular therapy on alleviating indicators of disease status in patients with type 2 diabetes. Methods: A comprehensive literature search was conducted in the PubMed, Scopus, and Cochrane Library databases using relevant search terms. The quality of the included studies was assessed using the Cochrane Risk of Bias tool for randomized controlled trials and the Risk of Bias tool for non-randomized studies of interventions. Results: Ten studies were included for the systematic review. Most of the studies were conducted in Asia, and randomized controlled trials were primarily chosen as the study design. The auricular therapy points most commonly used were related to the pancreas, which is associated with diabetes. A meta-analysis using a random-effects model to analyze glycated hemoglobin showed a Hedges' g value of -0.11 (95% CI: -0.53 to 0.32, p=.623), which was not statistically significant. However, the standardized mean difference for fasting blood sugar was -0.97 (95% CI=-1.22 to -0.72, p<.001), indicating a large and statistically significant effect size. Conclusion: The results of this study indicate that auricular therapy may have an impact on fasting blood sugar levels. However, the studies used in this analysis were limited and some publication bias was identified, requiring further research to determine the broader implications and effectiveness of auricular therapy [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the mediating effects of communication skills and pediatric nurse-parent partnership on the relationship between emotional intelligence and job satisfaction among pediatric nurses. Methods: A survey was administered to 205 pediatric nurses working in children's, general, and tertiary hospitals situated in Chungcheong province and Seoul. Data were collected in August and September 2022. The collected data were analyzed using SPSS Statistics version 26.0 along with the PROCESS macro program. Results: Emotional intelligence had a significant effect, and was a critical factor affecting the job satisfaction of pediatric nurses. Furthermore, communication skills and nurse-parent partnership had a serial double mediating effect. Conclusion: These findings underscore the significance of conducting job satisfaction improvement programs, including strategies for augmenting emotional intelligence, bolstering communication skills, and fostering nurse-parent partnership. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the relationship between digital literacy and depressive symptoms, as well as the mediating role of social support in this relationship, among older women (60 years and older) in Korea. Methods: This study analyzed data from the User Experience Evaluation Survey which was conducted by the Ewha Institute for Age Integration Research to improve the accessibility of digital information for older adults research from May to September 2020. Survey data on depressive symptoms, digital literacy and social support were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression. Results The factors influencing depressive symptoms among older women included work status (B=-.19, p=.01), social support (B=-.17, p<.001), self-rated health (B=-.13, p=.003), and digital literacy (B=-.10, p=.005), which had an explanatory power of 33%. In addition, social support played a mediating role in the relationship between digital literacy and depressive symptoms (B= -.05, SE=.02; 95% CI, -.09 to -.02). Conclusion The findings of this study support the need to develop and apply interventions that promote digital literacy among older women to mitigate depressive symptoms by increasing social support. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the mediating effect of patient participation culture in the relationship between ethical leadership and performance in patient-engaged nursing services. Methods: This study employed a cross-sectional descriptive online survey design. The sample comprised 104 nurses from small- and middle-sized Korean hospitals. Data were collected between May 10 and September 10, 2019 using the Smart Patient Engagement Assessment Checklist, Korean versions of the Patient Participation Culture Tool for healthcare workers, the Ethical Leadership Scale, and a questionnaire about nurses' demographic and work characteristics. A mediation analysis was conducted using multiple regression and a simple model applying the PROCESS macro using SPSS/WINdows software version 26.0. Results: Ethical leadership directly affected (c'=0.28, p<.001) performance in patient-engaged nursing services. Patient participation culture partially mediated the relationship between ethical leadership and performance in patient-engaged nursing services (a x b=0.51x0.20=0.10, 95% Boot CI=0.18-0.20). Conclusion: Optimizing the patient participation culture and adherence to ethical leadership among hospital administrators and managers can improve nurses' performance in patient-engaged nursing services. Nurse managers' ethical leadership should be strengthened, and patient participation culture should be encouraged at policy levels through systematic nurse education on patient safety and engagement to enhance performance-engaged nursing services. [ABSTRACT FROM AUTHOR]

Purpose: To identify factors influencing health-related quality of life for young single-person households, this study investigated physical and mental health status, health behavior, depression, resilience, and health-related quality of life. Methods: An online survey was administered to members of young single-person households from March 22 to 30, 2022. The data were analyzed using the chi-square test, independent t-test, one-way analysis of variance, Pearson correlation coefficients, multiple regression, and a simple mediation model applying the PROCESS macro model 4 with 95% bias-corrected bootstrapped confidence intervals. Results: The participants were 229 members of young single-person households. Health-related quality of life showed significant relationships with residence (t = 2.80, p = .006), monthly income (F = 3.70, p = .026), mental health status (F = 20.33, p < . 001), and high-intensity exercise (F = 7.35, p = .001) among general and health-related characteristics. Health-related quality of life had significant correlations with depression (r = -.72, p < .001) and resilience (r = .58, p < .001). Multiple regression analysis showed that depression (β = -.57, p < .001) and resilience (β = .21, p < .001) influenced health-related quality of life. Moreover, resilience had a mediating effect between depression and health-related quality of life (indirect effect = -0.002, 95% bias-corrected bootstrapped confidence interval = -0.003 to -0.001). Conclusion: Members of young single-person households tended to be more vulnerable to emergency situations, such as during the coronavirus disease 2019 pandemic, when lockdowns and quarantines were frequent. To improve health-related quality of life in young single-person households, people with high levels of depression or low levels of resilience need special attention and support to promote mental health. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop and test a structural equation model on social re-adjustment of individuals with stroke based on a literature review and Roy's adaptation model. Methods: This study involved 321 participants who had a stroke and visited the outpatient department after discharge. The hypothetical model was developed based on Roy's adaptation model and a comprehensive review of previous literature on the topic. The model comprised four exogenous variables (neurological damage, gender [man], age, and social support) and five endogenous variables (activities of daily living, acceptance of disability, depression, rehabilitation motivation, and social re-adjustment). The data were analyzed using SPSS Windows software version 22.0 and AMOS 23.0. Results: Out of 28 research hypotheses, 18 were supported, and they indicated approximately 64% probability of social re-adjustment. Social re-adjustment is directly and significantly affected by age, social support, activities of daily living, and depression. Social re-adjustment is indirectly affected by neurological impairment, gender (men), age, social support, and rehabilitation motivation. Conclusion: Continuous assistance and care should be provided for individuals with disabilities caused by sudden neurological damage to facilitate gradual improvement in their social re-adjustment. To enhance social re-adjustment, especially among older adults, newly developed interventions should focus on improving their activities of daily living, preventing depression, and enhancing support from family and healthcare personnel. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann--Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R², which indicates the difference between the model's R² with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to identify the factors influencing falls in the community-dwelling elderly using the raw data of the 2020 National Survey of Older People. Methods: The study included 9,920 community-dwelling seniors aged 65 years and older. The data were analyzed using a complex sampling design univariate logistic regression analysis. Results: Although the subjects of this study were 9,920 people, it can be generalized to 7,617,710 people because it is a probability sample using the stratified systematic sampling with cluster plots. As a result of this study, the fall rate of community-dwelling elderly was 6.4% and the weighted percentage was 7.1%. Satisfaction with economic status, number of chronic diseases, use of medical facilities, smoking, limitation of lower muscle strength, decreased visual acuity, limitation of daily living function, and housing type were identified as factors influencing falls in older people dwelling in the community. Conclusion: Based on the variables identified in this study, it is necessary for nurses to select high-risk groups for falls and to actively develop and implement nursing interventions to prevent falls. [ABSTRACT FROM AUTHOR]

Purpose: This descriptive correlational study aimed to investigate the mediating effects of self-efficacy and social support on the relationship between eHealth literacy and self-care competency in patients undergoing percutaneous coronary intervention. Methods: The participants of this study were 146 patients who underwent multiple percutaneous coronary interventions at the Department of Cardiology at Y General Hospital in Jeollabuk-do, South Korea. Data were collected between September 19, 2022 and February 3, 2023, and analyzed using a parallel multiple mediation model in SPSS/WIN 23.0 and Model 4 of the PROCESS Macro 3.5 program. To determine the statistical significance of the indirect effect, 10,000 bias-corrected bootstrapping with 95% confidence intervals was used. Results: The effect size of the indirect effect of eHealth literacy on self-care competency via self-efficacy was 0.07, which was statistically significant, and the effect size of the indirect effect of eHealth literacy on self-care competency via social support was statistically significant at 0.13. These results verified the mediating effects of self-efficacy and social support. Conclusion: This study is significant in that it confirmed the effects of self-efficacy and social support on the relationship between eHealth literacy and self-care competency. In order to improve self-care competency in patients undergoing percutaneous coronary interventions, it is necessary to provide customized education that can improve eHealth literacy. Furthermore, there is a need for self-efficacy enhancement programs and social support strengthening programs that use various educational and material support systems to help individuals accept and access health information easily. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the internal structure (structural validity, internal consistency, and measurement invariance) of the Health-Related Quality of Life Instrument with Eight Items (HINT-8), developed to measure Korean people's health-related quality of life. Methods: A secondary analysis was conducted using data from the Korea National Health and Nutrition Examination Survey, involving 6,167 adults aged over 18 years. The structural validity of the HINT-8 was assessed using exploratory graph analysis and confirmatory factor analysis. Internal consistency and measurement invariance were analyzed using McDonald's omega (ω) and multigroup confirmatory factor analysis, respectively. Results: The HINT-8 had a single dimension and good internal consistency (ω = .804). The one-dimension HINT-8 exhibited matric invariance but not scalar invariance across sociodemographic groups (sex, age, education, and marital status). Further, it exhibited scalar or partial scalar invariance across medical condition groups (hypertension, diabetes, depressive symptoms, and cancer). Conclusion: The study finds that the HINT-8 demonstrated satisfactory structural validity and internal consistency, indicating its suitability for practice and research. However, the HINT-8 scores cannot be compared across different groups regarding sex, age, education, and marital status, as the interpretation varies within each sociodemographic category. Conversely, interpretation of the HINT-8 is consistent for individuals with and without hypertension, diabetes, depressive symptom, and cancer. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to valuate the reliability and validity of the Korean version of the 5C Psychological Antecedents of Vaccination (K-5C) scale. Methods: The English version of the 5C scale was translated into Korean, following the World Health Organization guidelines. Data were collected from 316 community-dwelling adults. Content validity was evaluated using the content validity index, while construct validity was evaluated through confirmatory factor analysis. Convergent validity was examined by assessing the correlation with vaccination attitude, and concurrent validity was evaluated by examining the association with coronavirus disease 2019 (COVID-19) vaccination status. Internal consistency and test-retest reliability were also evaluated. Results: Content validity results indicated an item-level content validity index ranging from .83 to 1, and scale-level content validity index, averaging method was .95. Confirmatory factor analysis supported the fit of the measurement model, comprising a five-factor structure with a 15-item questionnaire (RMSEA = .05, SRMR = .05, CFI = .97, TLI = .96). Convergent validity was acceptable with a significant correlation between each sub-scale of the 5C scale and vaccination attitude. In concurrent validity evaluation, confidence, constraints, and collective responsibility of the 5C scale were significant independent predictors of the current COVID-19 vaccination status. Cronbach's alpha for each subscale ranged from .78 to .88, and the intraclass correlation coefficient for each subscale ranged from .67 to .89. Conclusion: The Korean version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of vaccination among Korean adults. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To determine predictors of fall events in hospitalized patients with cancer, and identification of fall risk. Methods: An analysis of medical records was conducted together with a review of standardized fall reports of 565 patients admitted between January 1 and December 31, 2020. The collected data were analyzed with the chi-squared test, Fisher exact test, independent t-test, and logistic regression analysis using STATA 17 program. Results: There was a statistically significant increased fall risk; accompanied by a guardian (OR=10.30 CI=2.66~39.94), number of attachment devices (OR=1.30, CI=0.46~0.64), medication (OR=0.17, CI=0.04~0.84), pain (OR=4.73, CI=1.59~14.0), walking problem (OR=29.85, CI=9.31~95.74), chemotherapy (OR=5.20, CI=1.81~14.89), and fall risk score (OR=1.83, CI=1.50~2.24). Conclusion: These findings can serve as academic evidence to support the role of nurses in assessing the risk of fall events/accidents with regard to cancer patients and the development of individually adjusted fall assessment tools. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method: A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results: Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion: These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to verify the effect of patient safety environment (PSE) and health literacy (HL) on patient safety participation (PSP) and the mediating effect of HL. Methods: We recruited patients who were hospitalized at a tertiary general hospital in "D" city. A total of 230 people responded to a questionnaire survey we conducted from March 15 to July 10, 2020. The collected data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffe test, Pearson's correlation coefficient analysis, and hierarchical regression using SPSS/WIN 26.0. Results: PSP was found to be significantly associated with PSE (r=.29, p<.001) and HL (r=.44, p<.001). PSE and HL were found to have a significant effect on PSP (power: 23%). HL was found to have a partial mediating effect (indirect effect: 0.09, 95% CI: 0.04~0.14) between PSE and PSP. Conclusion: The findings from this study can contribute to developing interventions for patient participation in the PSE and providing directions for offering safe and high-quality medical care to patients. [ABSTRACT FROM AUTHOR]

Purpose: Nursing colleges are continuously being expanded to solve the problem of imbalance among regions, but the outflow of the provincial brain-drain to metropolitan regions continues. Therefore, this study aimed to identify the influencing factors on the regional outflow intention of nursing students. Methods: This study employed a mixed- method design, and 214 nursing students in the Honam region filled out a self-administered questionnaire. Eight participants recruited through random sampling were interviewed in depth. Data were analyzed using a t-test, χ² test and logistic regression. Results: Among the total respondents, 161 students (75.2%) had intent to regional outflow. Influencing factors were significantly correlated with employment in tertiary general hospitals (OR=3.32, 95% CI=1.35~8.16), perception of job opportunities in the province (OR=0.52, 95% CI=0.31~0.87), intrinsic job values (OR=2.43, 95% CI=1.14~5.22), and voluntary employment preparation behaviors (OR=2.75, 95% CI=1.05~7.19). Through the interviews, themes related to regional outflow intentions were drawn into the following three categories: "recognition of working environment by region", "aspiration for professional growth", and "expectation for self-development and rich experience". Conclusion: This study's results are expected to be used as strategic data for establishing plans for nurturing regional human resources and improving the local nursing workforce in non-metropolitan areas. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to identify handwashing in older adults living in the community and to identify the factors affecting handwashing. Methods: A total of 73,492 older adults were selected and analyzed using the 2021 Community Health Survey. The Rao-Scott χ² test was conducted to evaluate the differences between demographic, health status, and fear of infection with COVID-19, and health literacy according to handwashing. Results: Sex (odds ratio [OR]=2.56, p<.001), age (OR=1.61, p<.001), education (OR=0.60, p<.001), region (OR=2.35, p<.001), monthly income (OR=1.21, p=.036), subjective health status (OR=1.95, p<.001), depression experiences (OR=1.38, p=. 006), fear of COVID-19 infection (OR=2.44, p<.001), and health literacy (OR=1.71, p<.001) were identified as significant influencing factors of older adult handwashing. Conclusion: Based on these research results, it is necessary to develop and implement an education program for proper handwashing for older male adults residing in rural areas and/or living in local communities with low levels of education and poor health [ABSTRACT FROM AUTHOR]

This study aimed to identify the risk factors of cognitive decline in older adults living alone in local communities and to find cognitive nursing methods by the area of residence. Methods: The participants were 164 people living alone for 12 years. The data were analyzed using a generalized estimating equations method. Results: The following factors were identified as statistically significant predictors that increased cognitive decline in older adults living alone: 1) rural areas: age (odds ratio [OR]=1.02, 95% confidence interval [CI]=1.01~1.02), low education (OR=1.53, 95% CI=1.13~2.07), number of diseases (OR=1.07, 95% CI=1.01~1.14), 2) urban areas: women (OR=1.27, 95% CI=1.09~1.49), age (OR=1.02, 95% CI=1.01~1.03), low education (OR=1.26, 95% CI=1.14~1.40), body mass index (OR=0.98, 95% CI=0.96~0.99), instrumental activities of daily living (OR=1.02, 95% CI=1.00~1.04), depressive symptom (OR=1.14, 95% CI=1.03~1.25). Conclusion: The older adults who lived alone had different risk factors for cognitive decline depending on their areas of residence. Preventive management for cognitive decline should be presented according to the areas of residence among older adults living alone. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive impairment and depressive symptoms often accompany one another, as depressive symptoms often worsen cognitive impairment. This study aimed to identify the risk factors for depressive symptoms in older adults with mild cognitive impairment in Korea. Methods: This study analyzed data from the eighth Korean Longitudinal Study of Aging 2020. A total of 1,023 participants aged 65 and older were selected as participants whose scores on the Korean Mini-Mental State Examination ranged from 18 to 23. For data analysis, descriptive statistics, the Rao-Scott χ² test, and logistic regression using complex samples were performed. Results: The prevalence of depressive symptoms among participants was 33.2%. According to the logistic regression analysis, the significant risk factors affecting depressive symptoms in older adults with mild cognitive impairment were having a high education level (odds ratio [OR]=1.98, 95% confidence interval [CI]= 1.23~3.16), low hand grip strength (OR=1.85, 95% CI=1.12~3.08), visual impairment (OR=3.31, 95% CI= 1.36~8.04), good oral health status (OR=0.97, 95% CI=0.95~0.99), and rarely having contact with one's neighbors (OR=2.52 95% CI=1.23~5.18). Among the different characteristics(demographic, health status, social, and economic), health status characteristics were identified as having the greatest influence on depressive symptoms in older adults with mild cognitive impairment. Conclusion: The results of this study suggest that a multidimensional nursing strategy including the regular management of health conditions is necessary to prevent depressive symptoms in older adults with mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Purpose: Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established. Methods: Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the alternative path model satisfied recommended levels χ2 = .11 (p = .741), normed χ2 (χ2/df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08-.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00-.03). The explanatory power of variables was 44.0%. Conclusion: Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate COVID-19 vaccination intentions in Korean parents for their children aged 5 to 11 years and the factors influencing them. Methods: A cross-sectional online survey of 363 parents of children aged 5 to 11 years was conducted in Korea in April 2022. Data were analyzed using independent t-test, χ2-test, Fisher's exact test, and hierarchical logistic regression analysis using SPSS/WIN 26.0 and MedCalc software version 20.113. Results: Of 363 Korean parents with children aged 5 to 11, 42.4% intended to vaccinate their children. Significant factors influencing vaccination intention were the second or third birth order of children (OR = 3.45, 95% CI = 1.45-8.21), vaccine hesitancy-confidence (OR = 2.00, 95% CI = 1.51-2.65), vaccine hesitancy-collective responsibility (OR = 1.57, 95% CI: 1.10-2.25), and COVID-19 anxiety-avoidance (OR = 1.55, 95% CI = 1.13-2.11). Conclusion: Findings suggest that COVID-19 vaccine campaigns based on reliable information and evidence from health authorities are needed to increase COVID-19 vaccination. Well-designed health communications for the target population may help to increase parental vaccine acceptance. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community. Methods: A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis. Results: A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was - 0.21 (95% CI = - 0.32 to - 0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = - 0.22; 95% CI = - 0.36 to - 0.09), web (SMD = - 0.41; 95% CI = - 0.82 to 0.01), virtual reality (SMD = - 0.33; 95% CI = - 0.56 to - 0.10), mobile (SMD = - 0.15; 95% CI = - 0.28 to - 0.03), intervention period of less than 3 months (SMD = - 0.23; 95% CI = - 0.35 to - 0.11), and non-treatment group (SMD = - 0.23; 95% CI = - 0.36 to - 0.11). Conclusion: These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the association between the low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol (LDL-C/HDL-C) ratio and the incidence of diabetes in a Korean community-based cohort. Methods: The participants were 7,653 adults aged 40-69 years without diabetes at baseline from Korean Genome and Epidemiology Study who were followed up for 16 years biennially. These participants were categorized into four groups (Q1-Q4) according to quartiles of LDL-C/HDL-C ratio at baseline. Significant differences in the probability of diabetes-free survival curve were identified using the log-rank test in Kaplan-Meier analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression analysis. Results: In total, 1,833 (24.0%) participants newly developed diabetes. The overall incidence of diabetes was 20.37 per 1,000 person-years (14.94, 17.12, 22.0, and 22.08 per 1,000 person-years for Q1, Q2, Q3, and Q4, respectively). The probability of diabetes-free survival was significantly different among the four groups (log-rank, χ²=117.88, p<.001). Covariates included age, sex, triglyceride, fasting plasma glucose, homeostatic model assessment for insulin resistance index, hypertension, body mass index, family history of diabetes mellitus, smoking status, and alcohol use. Multivariate Cox proportional hazards regression showed that people with the highest quartile of the LDL-C/HDL-C ratio had a 1.17 times higher (HR=1.17, 95% CI: 1.01~1.35, p=.038) risk of diabetes development than those in the lowest quartile after adjusting for covariates. Conclusion: The LDL-C/HDL-C ratio is an independent risk factor for diabetes development. Measuring and managing the LDL-C/HDL-C ratio is necessary for detecting individuals at high risk for developing diabetes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the intention to use life-sustaining treatment for older adults living in a local community, and the factors that influence the intention to use life-sustaining treatment. Methods: A total of 9,555 older adults were selected and analyzed using 2020 National Survey of Older Koreans data. A Rao-Scott test was conducted to evaluate the differences in sociodemographics, health status, death preparation education experience, and life satisfaction according to intention to use life-sustaining treatment. Results: Economic status (odds ratio [OR]=1.38, 95% confidence interval [CI]=1.00~1.90), social support (OR=4.78, 95% CI=1.16~19.74), and life satisfaction (OR=1.53, 95% CI=1.12~2.09) were identified as significant influencing factors in the older adults’ life-sustaining treatment intentions. In other words, when satisfaction with economic conditions is moderate or low, when there is social support, and when life satisfaction is moderate, life-sustaining treatment intention was high. Conclusion: Education programs for life-sustaining treatment should be provided for older adults living in this community. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the effect of debriefing interventions on clinical competence in nursing students. Methods: A systematic review with a meta-analysis was conducted. Korean and English studies were retrieved from eight databases: KERIS, KISS, KoreaMed, NDSL, CINAHL, Cochrane Library, EMbase, and PubMed through January 2022. Fifteen studies were selected for the meta-analysis based on the inclusion criteria and low risk of bias. The data was analyzed using RevMan 5.3. and R software 3.6.2. Results: Most studies had a low risk of bias. Debriefing intervention in simulation-based education were found to be significantly effective compared to the control groups on clinical competence(Hedges'g=1.06, 95% CI=0.73~1.39, p<.001). In addition, the length of the debriefing intervention influenced the heterogeneity in the meta-ANOVA. Conclusion: Debriefing intervention in simulation-based education help improve nursing students' clinical competence in nursing students. Futhermore, our findings suggest that nursing educators should consider the length of debriefing for nursing students to improve their clinical competence. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this systematic review and meta-analysis was to assess the effectiveness of music therapy for depression in stroke patients. Methods: 823 studies were retrieved from seven databases (PubMed, Embase, CINAHL, Cochrane Library, RISS, KISS, and NDSL). Articles published up to June 2022 were selected for this study. Eight studies that satisfied the inclusion and exclusion criteria were selected for meta-analysis. The data was analyzed using the R 4.0.2 program. Results: Most studies had a low risk of bias. The pooled effect size showed that music therapy was able to reduce depression(ES=-0.87, 95% Cl=-1.52~-0.22, p=.016). In addition, the effect sizes were evaluated for type, length per session, duration, and total sessions, but they did not show statistically significant differences between groups. Conclusion: Music therapy helps reduce depression after stroke. However, subgroup analyses did not show significant between-group differences related to the details of the implemented programs. Studies with larger samples and additional meta-analyses of music therapy are required. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses. Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers' leadership styles; the outcome assessed was nurses' turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used. Results: The total effect size r (ESr) was - 0.25 (95% confidence interval: - 0.29 to - 0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = - 0.34), transformational leadership (ESr = - 0.28), authentic leadership (ESr = - 0.23), transactional leadership (ESr = - 0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses. Conclusion: Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the moderating effect of organizational justice on the relationship between self-efficacy and nursing performance among clinical nurses. Methods: In January 2021, a cross-sectional survey was conducted with 224 clinical nurses recruited from a university-affiliated hospital in Suwon, South Korea. Participants completed online-based, self-report structured questionnaires. Collected data were analyzed using multiple regression and a simple model of PROCESS macro with a 95% bias-corrected bootstrap confidence interval. Results: Self-efficacy and organizational justice were found to be significant predictors of nursing performance. These two predictors explained the additional 34.8% variance of nursing performance in the hierarchical regression model, after adjusting the other covariates. In addition, organizational justice moderated the relationship between self-efficacy and nursing performance among the clinical nurses. In particular, at low self-efficacy level, participants with high organizational justice had higher nursing performance compared to those with low organizational justice. Conclusion: Enhancing organizational justice can be used as an organizational strategy for improving the organizational culture in terms of distribution, procedure, and interaction. Ultimately, these efforts will contribute to the improvement of nursing performance through a synergistic effect on organizational justice beyond nurses' individual competency and self-efficacy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to review the effectiveness of delirium education programs for nurses in acute hospitals. Methods: The inclusion criteria were studies on delirium education programs for nurses published in English and Korean from 2012 to 2022. A literature search was conducted in the RISS, KISS, DBpia, PubMed, CINAHL, PsycINFO, and Web of Science databases using the key words of "delirium", "nurse", and "education". Qualitative appraisal of studies was conducted using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool translated by National Evidence-based Healthcare Collaborating Agency (NECA). For meta-analysis, the effect size of the intervention was calculated as standardized mean difference. Results: Eighteen studies were selected for the systematic review. While the contents of the education programs were similar, the teaching methods were different. Interventions implemented included traditional learning, e-learning, and blended learning. Teaching methods of delirium education programs for nurses included lecture, discussion, practice, simulation, role-play, and coaching. The systematic review found that delirium education programs for nurses effectively increased post-intervention outcomes in 17 studies. Delirium education programs for nurses have benefits regarding delirium knowledge and performance. In four studies, delirium education program interventions improved delirium nursing performance (95% CI: 0.48~2.44, p=.003). Conclusion: These results demonstrate the need for a standardized delirium education program. It is recommended that further studies evaluating the patient outcome effects of delirium education programs should be conducted. [ABSTRACT FROM AUTHOR]

Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery. Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, χ²-test, Fisher's exact test, and logistic regression analysis with SPSS/WIN 27.0. Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO2 before extubation (OR= 0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09- 8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (χ²=33.74, p<.001), longer intensive care unit stay (Z=-7.81, p<.001), and longer hospital stay than the maintenance group (Z=-8.29, p<.001). Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation. [ABSTRACT FROM AUTHOR]

Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site. Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded. Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site. Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the mediating effects of depression amid the influence of fear and social distancing arising from Coronavirus disease 2019 (COVID-19) in Korean women's suicidal ideation. Methods: A descriptive correlation study was conducted. Study participants, recruited by Hankook Research from March 2 to March 5, 2021, included 300 women aged 19 to 49 living in South Korea, and 100 people were randomly allocated and enlisted for each age group out of 700,000 Hankook Research Panels recruited in advance from 17 cities and provinces nationwide. Data were collected through a self-reported questionnaire and analyzed using Pearson's correlation coefficient and Hayes' Process Macro Model 4 with 95% bias-corrected bootstrap confidence interval via SPSS statistics 27.0. Results: Suicidal ideation was significantly correlated with fear of COVID-19 (r = .16, p = .006) and depression (r = .65, p < .001). The mediation effect of depression in the relationship between the fear of COVID-19 and suicidal ideation was found to be significant (B = 0.40, boot 95% CI: 0.21~0.61). However, social distancing did not significantly affect suicidal ideation via depression (B = - 0.79, boot 95% CI: - 1.94~0.26). Conclusion: It is necessary to develop and apply interventions to prevent depression and suicidal behaviors by continuously observing and reducing the negative psychological responses caused by COVID-19. [ABSTRACT FROM AUTHOR]