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Purpose: This study aimed to determine the validity and reliability of the electronic Compassion Competence Scale (e-CCS). Methods: A cross-sectional, randomized, two-period crossover design was used. Nursing students from four South Korean universities were surveyed between June 2017 and April 2018. The participants were randomly assigned to one of three groups-paper/paper, electronic/electronic, and paper/electronic or electronic/paper-and a test-retest procedure was implemented. The reliability and validity of the e-CCS were evaluated using linear weighted kappa coefficients and intraclass correlation coefficients (ICCs). Internal consistency reliability was verified using linear weighted kappa coefficients and ICCs. Pearson's correlation coefficients between the initial test and retest scores were all statistically significant. Results: The newly developed e-CCS was found to have good reliability and validity. We suggest that future research should increase sample heterogeneity by recruiting diverse age groups, nurses working in different nursing fields, and students from multiple colleges. Conclusion: This electronic instrument will help determine the differences in the level of compassion competence and devise interventions to improve compassion competence in nurses and nursing students. Further studies on enhancing compassion competence among nurses and nursing students may rely on the use of this electronic format. [ABSTRACT FROM AUTHOR]

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

Aim: The aim of this study was to examine the relationships among patient safety competency, systems thinking and missed nursing care. Background: Patient safety competency and systems thinking are important nurse attributes that promote patient safety. Missed nursing care is known to negatively impact patient safety. However, how nurses' patient safety competency and systems thinking relate to missed nursing care is unknown. Methods: A cross‐sectional survey design was used to collect data from nurses practicing in two general hospitals in South Korea. Data were collected between 3 March and 17 April 2020. Questionnaires were distributed to nurses providing direct care in general and specialty units. Patient safety competency, systems thinking and missed nursing care were measured using reliable and valid instruments. A total of 432 complete sets of data were used in final analysis. Results: Higher patient safety competency of nurses was associated with lower missed nursing care. Systems thinking partially mediated the relationship between knowledge of patient safety competency and missed nursing care, and attitudes of patient safety competency and missed nursing care. Conclusions: The knowledge, skills and attitudes sub‐scales of patient safety competency showed somewhat different effects in the relationship between missed nursing care and systems thinking, suggesting that each attribute may tap into a separate aspect of patient safety. Summary statement: What is already known about this topic? Patient safety can be threatened when nurses are not competent to provide safe care to patients.Systems thinking is an essential nurse attribute that enhances patient safety competency.Greater missed nursing care has been associated with negative patient outcomes including adverse events such as medication error, fall with injury and patient mortality. What this paper adds? Higher patient safety competency of nurses was associated with less missed nursing care.Nurses' systems thinking had a mediating effect on the relationship between the patient safety knowledge and attitude competencies and missing nursing care.Nurses' systems thinking had the effect of reducing missed nursing care, but only when nurses exhibited patient safety knowledge and attitude competencies. The implications of this paper: By enhancing patient safety competency, missed nursing care can be reduced and negative patient outcomes may decrease accordingly.Strategies to increase systems thinking should be applied as a way to reduce missed care and increase patient safety. [ABSTRACT FROM AUTHOR]

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

Background: An association between health literacy and health outcomes has been widely reported in the literature. However, models exploring the links between health literacy and the outcomes of health literacy need further testing. The purpose of this study was to examine the pathways of health literacy on diabetes self‐care activities amongst patients with Type 2 diabetes. Methods: A cross‐sectional survey using secondary data analysis was conducted on 155 patients with Type 2 diabetes recruited from the diabetes clinics of two university hospitals in a metropolitan city in South Korea. Structural equation modelling analysis using bootstrapping was carried out using the AMOS software. Results: Health literacy had no significant direct effect on diabetes self‐care activities. Rather, health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. Conclusion: These findings indicate that interventions intended to improve self‐care activity amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care. SUMMARY STATEMENT: What is already known about this topic? Health literacy is known to be a factor influencing self‐management of patients with diabetes.Low level of health literacy is associated with adverse health outcomes of patients with chronic illness.It is important to understand the processes through which health literacy affects health outcomes. What is already known about this topic? Health literacy had a significant direct effect on knowledge and patient activation but not on diabetes self‐care activities.Health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation. The implications of this paper: Interventions intended to improve self‐care activities amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care.For patients with low health literacy, information processing should be used to facilitate the advancement of their knowledge and the subsequent influence of this knowledge on diabetes self‐care activities.Patient activation should be encouraged by nurses during interactions with patients with diabetes. [ABSTRACT FROM AUTHOR]

A virtual-reality-simulation-based nursing education program incorporating an information processing model helps nursing students develop their learned knowledge as nursing behavior and develop their ability to cope with complex clinical challenges. The purpose of this study is to develop a nursing education program using an immersive virtual reality simulation app for clinical situations based on an information processing model and identify the effects. A non-quantitative control group pretest–post-test design was employed. The programs were developed using the ADDIE model and an information processing model. In order to verify the effectiveness of the program, six adult nursing learning issues were taught to the experimental group over 6 weeks. The nursing education program in this study provides comprehensive experiential learning through advanced virtual simulation, significantly enhancing nursing students' performance confidence, critical-thinking abilities, and problem-solving skills across a wide range of clinical scenarios. By repeatedly engaging with diverse learning topics related to adult nursing, this program not only equips students with essential practical skills but also contributes to the overall improvement of patient safety and the quality of medical care. [ABSTRACT FROM AUTHOR]

Background: Bullying in nursing workplaces has been considered a serious problem that increases nurse turnover. Aim: To develop a cognitive rehearsal intervention for workplace bullying and examine its effects on nurses' bullying experiences and turnover intentions. Methods: We developed a smartphone application to cognitively train nurses to handle bullying situations in the workplace. This application included common bullying situations and appropriate non‐violent communication scenarios. A cluster quasi‐randomized trial was performed with 72 hospital nurses working in a university hospital in South Korea from November 2016 to January 2017. We measured workplace bullying experiences and turnover intention before intervention and 4 and 8 weeks after intervention in both intervention and control groups. Results: The cognitive rehearsal intervention developed in this study was effective for decreasing nurses' person‐related bullying, work‐related bullying experiences, and turnover intention. However, it had no effects on intimidation‐related bullying experiences. Conclusions: The smartphone application‐based cognitive rehearsal intervention can serve as a personal coping measure for person‐related and work‐related bullying among nurses. It is recommended that the intervention developed in this study be applied as a strategy to reduce nurse turnover. SUMMARY STATEMENT: What is already known about this topic? Bullying in the nursing workplace is prevalent and a major cause of turnover.Cognitive rehearsals that reproduce specific situations and train positive coping skills can serve as an intervention for workplace bullying. What does this paper add? Cognitive rehearsal using smartphone applications is effective in lowering workplace bullying and turnover intention.Unit‐based intervention for workplace bullying can be implemented effectively. The implications of this paper: Cognitive rehearsal application can be used as a personal training tool.Workplace bullying scenarios can be applied in simulated nursing education. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the relationship between nursing students' perceived parental child-rearing attitude, ego identity, and college adjustment in Korea and explore factors that influence college adjustment. Methods: This study surveyed 224 nursing students enrolled in universities located in two regions within South Korea. Data were collected from October 14 to November 31, 2019. Perceived parental child-rearing attitude (paternal emotional warmth, paternal rejection, paternal overprotection, maternal emotional warmth, maternal rejection, and maternal overprotection) and ego identity of nursing students were used as independent variables on college adjustment. Collected data were subjected to correlation analysis using SPSS version 26.0 for Windows. Further, regression analysis was performed on the influence of parental child-rearing attitude and ego identity on college adjustment. Results: Among the parental child-rearing attitudes, paternal emotional warmth (r =.30, p <.001), maternal emotional warmth (r =.38, p <.001), and ego identity (r =.71, p <.001) were positively correlated with nursing students' college adjustment, whereas maternal rejection was negatively correlated with ego identity (r = −.28, p <.001) and college adjustment (r = −.15, p =.025). Regression analysis of the effects of nursing students' perceived parental child-rearing attitude and ego identity on college adjustment, with grade as a control variable, revealed that ego identity (p <.001) had a significant effect on college adjustment, and the higher the ego identity (β = 0.712), the higher the college adjustment. Further, the explanatory power of explaining college adjustment was high at 49.9%. Conclusions: The nursing students' perceived paternal emotional warmth, maternal emotional warmth, and ego identity were positively correlated with college adjustment. Additionally, ego identity was found as the influencing factor in Korean nursing students' college adjustment. Therefore, programs to strengthen ego identity should be developed and implemented for college adjustment among nursing students. [ABSTRACT FROM AUTHOR]

Purpose: Artificial intelligence (AI) has had a profound impact on humanity; in particular, chatbots have been designed for interactivity and applied to many aspects of daily life. Chatbots are also regarded as an innovative modality in nursing education. This study aimed to identify nursing students' awareness of using chatbots and factors influencing their usage intention. Methods: This study, which employed a descriptive design using a self-reported questionnaire, was conducted at three university nursing schools located in Seoul, South Korea. The participants were 289 junior and senior nursing students. Data were collected using self-reported questionnaires, both online via a Naver Form and offline. Results: The total mean score of awareness of using chatbots was 3.49±0.61 points out of 5. The mean scores of the four dimensions of awareness of using chatbots were 3.37±0.60 for perceived value, 3.66±0.73 for perceived usefulness, 3.83±0.73 for perceived ease of use, and 3.36±0.87 for intention to use. Significant differences were observed in awareness of using chatbots according to satisfaction with nursing (p<.001), effectiveness of using various methods for nursing education (p<.001), and interest in chatbots (p<.001). The correlations among the four dimensions ranged from .52 to .80. In a hierarchical regression analysis, perceived value (β=.45) accounted for 60.2% of variance in intention to use. Conclusion: The results suggest that chatbots have the potential to be used in nursing education. Further research is needed to clarify the effectiveness of using chatbots in nursing education. [ABSTRACT FROM AUTHOR]

Aims. This study examined the influence of nurse staffing level, measured using various methods, on nurses' perceived adequacy of nurse staffing level, fatigue, and nursing care quality. Background. Although previous studies have recommended various methods of measuring nurse staffing level, there is a lack of research that compares different measurement methods or considers nurses' perceptions of staffing level on a daily basis. Methods. We conducted a cross-sectional study using work sampling and the questionnaire method in a general hospital in South Korea from July 18 to August 14, 2022. Results based on responses from 90 nurses and scores of 5,536 inpatients derived from the Korean Patient Classification System were included in the analysis. Results. The average nurse-to-patient ratio a day was 1 : 3.20, and the registered nursing hours per patient day was 2.35. Perceived insufficient nurse staffing and fatigue were higher on weekdays than on weekends (p < 0.001). All variables measuring the nurse staffing level affected the nurses' perceived inadequacy of nurse staffing level, fatigue, and nursing care quality, compared to other variables related to nurse staffing level, such as work intensity and demanding nursing hours per nurse (R2: 0.19–0.31), the nurse-to-patient ratio had the lowest explanatory power in explaining the nurses' perceptions (R2: 0.14–0.18). Conclusions. Nurse staffing level measurement should consider the acuity of inpatients and nursing care time. Further research is needed to utilize nurses' perceptions of the appropriate nurse staffing level. Implications for Nursing Management. Efforts are required to maintain an appropriate nurse staffing level through continuous monitoring of nurses' perceptions and acuity of inpatients to preserve nurses' alertness during work and improve nursing care quality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to define and clarify the concept of the family caregivers’ perceived value of caring for older patients. Methods: The hybrid model of Schwartz-Barcott and Kim was used to perform the concept analysis of perceived value of caring. Concept analysis was conducted in three phases: the theoretical phase, fieldwork phase, and final analysis phase. Results: The perceived value of caring was found to have four dimensions and nine attributes. The providing care dimension consisted of two attributes—care behavior and care attitude—and the goals and expectation dimension included three attributes—social norms, family norms, and personal norms. The other two dimensions consisted of two attributes each: a belief in usefulness and a belief in meaning in the building beliefs dimension and life expansion and insight into the future in the suffering sublimation dimension. Finally, perceived value of caring can be defined as the personal belief that behavior or attitude of providing physical, mental, and social services to those in need of care is usefulness and important based on one’s goals and criteria, and with the personal effort of sublimating suffering that arises from care. Conclusion: Based on the study findings, it is suggested that the use of the perceived value of caring should expand in nursing phenomena. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationships among nurse staffing, nurses prioritization of nursing activities, missed care, quality of nursing care, and nurse outcomes. Background: Inadequate staffing is associated with increased missed care, which threatens the quality of care and nurse outcomes. Methods: The study sample included 2114 staff nurses from 156 medical or surgical units of 49 general hospitals who had participated in a cross‐sectional survey conducted in 2015. Nurse staffing was measured using the patient‐to‐nurse ratio and perceived staffing adequacy. The Missed Nursing Care Survey was used to measure how frequently nurses had missed each of 24 activities. Multilevel regression analyses were employed to examine the relationships among variables. Results: The prevalence of missed care differed by nursing activity. Poorer staffing was associated with an increased number of missed activities. A higher number of missed activities and poorer staffing were associated with poorer patient safety, quality of nursing care and job satisfaction, and a higher intent to leave. Nurses gave the highest priority to focused patient reassessments, timely medications, and patient teaching, under hypothetical conditions of improved staffing. Conclusion: Adequate staffing is required to reduce missed care and to improve quality of care and nurse outcomes. SUMMARY STATEMENT: What is already known about this topic? Low nurse staffing is associated with a high prevalence of missed care, which has negative effects on patient and nurse outcomes.Nurses are known to prioritize their nursing tasks in the face of time scarcity. However, insufficient studies have investigated how nurses prioritize nursing care and, further, how their prioritization would be modified if nurse staffing were to improve. What is already known about this topic? Poorer perceptions of staffing adequacy and the patient‐to‐RN ratio had a significant association with a higher number of missed nursing activities.Nurses gave the highest priority to focused reassessments, timely medications, and patient teaching, which were less frequently missed than basic care (eg, mouth care, bathing, and ambulation), even under hypothetical conditions of improved staffing. The implications of this paper: Adequate staffing is required to meet patients needs and to improve patient and nurse outcomes.Nurses perceptions and reports of missed care appear to be influenced by their health care system and culture (eg, family caregiving). [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: This study aimed to investigate the differences in practices, policies, and perceptions of nurses regarding work‐related utilization of smartphones in acute‐care settings. Background: Mobile devices utilizing emerging technology are widely used in acute‐care settings; however, concerns such as potential distraction, improper use, and negative impact on the nursing image in clinical practice remain valid. Methods: Nurse managers (n = 8) and nurses (n = 181) were enrolled from eight academic tertiary hospitals that have comprehensive electronic medical record systems and mobile versions. Between October 2018 and February 2019, participants completed a questionnaire designed to explore their use of smartphones. The reporting guide for self‐administered surveys of clinicians was applied. Results: Approximately 80% of nurses carried personal smartphones while working, with 70% using their devices for work. The prevalence of work‐related smartphone use ranged from 3% to 43% by functionality, which was lower than that estimated by managers. Frequent uses included taking pictures/videos and internet browsing. Nurses were more positive than managers about the benefits of smartphone use and less burdened by related concerns. Novice and junior nurses were more optimistic than senior nurses. Only one hospital had a policy on nurses' use of personal devices at work. Conclusion: Two unmet needs in the current clinical information system were identified: information supporting task‐related knowledge at the bedside and security of data capture and communication. Implication for nursing policy: The unintended perception gaps between nurses and managers regarding work‐related smartphone use can be closed by nursing leadership. Unmet nursing informatics, particularly for information‐seeking purposes, can be addressed in the context of quality assurance. Nurse leaders can advocate secure and proper use of smartphones in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the methodological quality of nursing studies using structural equation modeling in Korea. Methods: Databases of KISS, DBPIA, and National Assembly Library up to March 2014 were searched using the MeSH terms 'nursing', 'structure', 'model'. A total of 152 studies were screened. After removal of duplicates and non-relevant titles, 61 papers were read in full. Results: Of the sixty-one articles retrieved, 14 studies were published between 1992 and 2000, 27, between 2001 and 2010, and 20, between 2011 and March 2014. The methodological quality of the review examined varied considerably. Conclusion: The findings of this study suggest that more rigorous research is necessary to address theoretical identification, two indicator rule, distribution of sample, treatment of missing values, mediator effect, discriminant validity, convergent validity, post hoc model modification, equivalent models issues, and alternative models issues should be undergone. Further research with robust consistent methodological study designs from model identification to model respecif ication is needed to improve the validity of the research. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease. Design: A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals. Methods: To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13–19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010–December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log‐likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two‐step method. Results: The physical symptoms experienced by adolescents with moyamoya disease were 'limb weakness' – the most common – followed by a 'headache,' 'difficulty in speech,' and 'nausea/vomiting.' A total of five symptom clusters were derived: cluster 1 was characterized by 'limb weakness'; cluster 2 participants were asymptomatic or experienced 'convulsions'; cluster 3 experienced 'difficulty in speech' and 'facial paralysis'; cluster 4 is prone to 'dizziness' and 'pins and needles'; and cluster 5 displays 'headaches' and 'nausea/vomiting'. Conclusion: This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents. Impact: These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents. [ABSTRACT FROM AUTHOR]

Aim: To develop and initially validate the Diabetes Self‐Stigma Scale for assessing self‐stigma in people with diabetes. Design: Scale development and evaluation. Methods: Participants were 399 patients with diabetes. In phase 1, initial items were generated based on the concept analysis of diabetes self‐stigma. Moreover, content validity was established by diabetes experts. Phase 2 evaluated structural validity through item analysis, exploratory factor analysis and confirmatory factor analysis. Reliability was evaluated by examining stability and internal consistency. Results: The findings revealed that the self‐stigma scale for patients with diabetes is a valid and reliable instrument. The Diabetes Self‐Stigma Scale was confirmed with 16 items. It consists of four domains: comparative inability, social withdrawal, self‐devaluation and apprehensive feeling. The scale developed in this study can measure self‐stigma in diabetes patients and can be used as an intervention to reduce self‐stigma. [ABSTRACT FROM AUTHOR]

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

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

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

Objectives: To investigate registered nurses' awareness and implementation of oral health care in patients who are hospitalized in general wards or intensive care units (ICUs) in South Korea. Methods: This research was performed as a descriptive survey of 149 nurses working in nine general hospitals with at least 100 beds in major Korean cities. Results: Approximately half (40.9%) of the survey respondents reported providing oral health care for hospitalized patients but that relevant protocols were not available at most hospitals or wards (89.5%). Nurses working in an ICU were significantly more likely to provide oral health care than those working in general wards (83.9% vs 15.1%; P < .001). Most respondents (83.2%) were aware of the importance of providing oral health care for hospitalized patients; however, the proportion considering that such care should be provided by dental hygienists was greater than that considering it should be provided by nurses (36.4% vs 26.0%; P < .001). Agreement that oral health care should be provided for hospitalized patients by dental hygienists was highest in nurses working in ICUs (53.3%; P < .001). Conclusions: According to this survey, oral healthcare provision is generally low in hospitalized patients and differs between ICUs and general wards. Most respondents considered that dental hygienists should provide oral health care for hospitalized patients. There is an opportunity for nurses and dental hygienists to work collaboratively towards development of an evidence‐based protocol for oral health care in hospitalized patients. [ABSTRACT FROM AUTHOR]

Purpose: To encourage the enactment of laws about mandatory nurse staffing in nursing homes, researchers should provide evidence of concrete nurse hours per resident day (HPRD). This article estimates optimal nurse staffing HPRD to achieve increased quality‐of‐care outcomes for nursing home residents. Design: Secondary analysis of longitudinal data. Methods: This study used secondary analysis of longitudinal nursing home survey data. Nurse staffing HPRD and quality‐of‐care survey data accrued from nursing homes operating under long‐term‐care insurance in Korea. The collected data include a total of six quarterly base measurements on nurse staffing HPRD and 15 quality indicators from 2014 to 2017. The proposed optimization model emerged to most appropriately combine nurse staffing HPRD to increase quality‐of‐care outcomes for nursing home residents by 3% to 8%. Optimal outcome measures were fixed as best outcomes and compiled from 15 nursing‐sensitive quality indicators. Findings: Constrained nonlinear optimization was used for analysis. A 12% increase in registered nurse (RN) HPRD (from 0.168 HPRD [10 min 5 s] to 0.177 [10 min 38 s]) aligned with a 3% improvement in quality‐of‐care outcomes. A 20% RN HPRD increase aligned with a commensurate 5% to 8% increase in compiled quality‐of‐care outcomes (from 0.168 HPRD [10 min 5 s] to 0.202 HPRD [12 min 6 s]) without increasing certified nurse aide HPRD. About a 30% RN HPRD increase aligned with a commensurate 5% to 8% increase in compiled quality‐of‐care outcomes (from 0.168 HPRD [10 min 5 s] to 0.218 HPRD [13 min 6 s]) without increasing certified nurse aide HPRD. Conclusions: It is urgent to institute mandatory nurse HPRD for nursing homes in Korea by law. This research provides evidence that increasing nursing HPRD improved residents' outcomes in nursing homes. Clinical Relevance: Findings from the optimization model implied that stable care by RNs in nursing homes is a key factor in achieving acceptable quality of care for residents. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors affecting nurses' patient safety competency under the new nursing care delivery model. Background: In Korea, a new model was introduced in 2013 to ensure that nursing personnel provided inpatients with care without relying on guardians. After the launch of this service, there continue to be nurse‐related patient safety incidents. Methods: This is a descriptive study. Data from 132 general hospital nurses were collected during 15–24 February 2017 and analysed using hierarchical multiple regression. Results: Participants' mean patient safety competency score was 3.82 (range 1–5). Clinical career (Pratt index = 47.3%), critical thinking disposition (30.4%), teamwork (24.1%) and critical thinking training experience (7.3%) were found to affect nurses' patient safety competency. Conclusion: Under the new model, new nurses showed a low level of patient safety competency. Clinical career most influenced patient safety competency. Enhanced critical thinking and teamwork training are needed to improve patient safety competency among nurses. Implications for nursing management: Nursing leaders must consider qualitative staffing mix involving appropriate placement of experienced nurses as well as quantitative staffing level to provide patients with high‐quality, safe care and to implement the new model successfully. Regular training on critical thinking and teamwork should be carried out. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in integrated nursing care services. Background: Korea is expected to be a super‐aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced “integrated nursing care services”; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. Design: The study applied a cross‐sectional survey. Methods: In 2016, we conducted a multicentre survey involving 302 Registered Nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Results: Trial centre nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top‐three desired primary roles for care robots were “measuring/monitoring”, “mobility/activity” and “safety care”. “Reduction in workload”, especially in terms of “other nursing services” which were categorized as nonvalue‐added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Conclusion: Care robots are expected to be effective in integrated nursing care services, particularly in “measuring/monitoring”. Such robots should decrease nurses’ workload and minimize nonvalue‐added nursing activities efficiently. No matter how excellent care robots are, they must cooperate with and be controlled by nurses. [ABSTRACT FROM AUTHOR]

Purpose Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. Design A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). Methods Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unit-based consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. Findings Repeated measures analysis of variance showed significant differences between groups in knowledge ( p < .001), perceptions ( p < .001), and attitudes ( p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. Conclusions The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. Clinical Relevance These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of critical thinking in clinical and educational settings, little is known about its role in evidence-based practice (EBP). Aim: This study examined whether critical thinking disposition (CTD) mediates the relationship between perceived barriers to research use and EBP in clinical nurses (N = 409). Methods/design: A path diagram using structural equation modeling was used to estimate the direct and indirect effects of perceived barriers to research use on EBP, controlling for CTD as a mediator. Results: CTD partially mediated the relationship between perceived barriers to research use and EBP. Furthermore, the hypothesized mediation model demonstrated an appropriate fit to the data. Conclusions: Individual and organizational efforts are needed to help nurses further improve their critical thinking skills. CTD is important as research barriers to engage effectively in EBP. Without the skills to evaluate evidence carefully, research utilization may be compromised. [ABSTRACT FROM AUTHOR]

In this study, nursing interventions used by hospice nurses in Korea were identified and compared with core interventions selected by US end-of-life care nurses in order to determine similarities and differences between the two nations regarding such care. Data were collected from the electronic medical records of 353 hospice patients admitted to a tertiary hospital in Korea over a period of two years. First, extracted narrative interventions were mapped onto the Nursing Interventions Classification for comparison with interventions selected by nurses in the USA. A total of 56,712 intervention statements were mapped onto 147 Nursing Interventions Classification interventions. Hospice nurses in Korea performed more nursing interventions in the physiological basic domain, compared to nurses in the USA. The most frequently-used interventions in Korea were related to patient pain management. Among 47 core Nursing Interventions Classification interventions used in the USA, only 18 were used by Korean nurses in this study. This study highlights cultural differences in hospice care nursing interventions between the two countries. [ABSTRACT FROM AUTHOR]

Aim To determine the factors affecting the prevalence of metabolic syndrome in younger and older Koreans. Background Metabolic syndrome, in combination with other, interrelated predisposing factors, is a risk factor for cardiovascular disease. In Korea, the prevalence of this syndrome, like those of other chronic diseases, has increased continually in recent years. Design This is an analytic, descriptive cross-sectional study. Methods This survey targeted 690,283 examinees that had undergone a medical examination on a life transition period performed by the National Health Insurance Corporation from January- December 2008. For the purpose of this study, the diagnosis of metabolic syndrome was based on the criteria of the American Heart Association and the Heart, Lung, and Blood Institute. The relationship between the risk factors and prevalence rate was shown using a multiple logistic regression model. Results The prevalence of metabolic syndrome was 24·8% in the 40 year olds and 40·8% in the 66 year olds. Among the younger adults, the prevalence in women was only 0·57 times that in men. A multiple logistic regression analysis demonstrated that heavy obesity and family history of cardiovascular disease are the strongest independent predictors of metabolic syndrome among younger and older Koreans. Conclusion As a management strategy, a nursing intervention strategy for the improvement of lifestyle factors including self-care through proper diet and exercise should be developed and implemented. [ABSTRACT FROM AUTHOR]

Aim. To report a correlational study of the relation of body mass index to children's perceptions of physical appearance and global self-worth and depression, as mediated by their perceptions of parental teasing. Background. The relation between depression and self-perception in children with obesity has been reported. Recently, parental factors were found to be related to childhood obesity. Little is known about the effects of perceived parental teasing on depression and self-perception in children. Design. A descriptive correlational research design was used. Methods. Data were collected from 455 children in the fifth and sixth grades in four provinces of South Korea using self-report questionnaires for measuring self-perception of physical appearance and global self-worth, depression and perceived parental teasing between October-December in 2009. The children's weight and height information from school health records was used. Multiple regression analysis and the Sobel test were used to identify the mediating effect of perceived parental teasing. Results. Among the children, 20% were overweight or obese. Although children with obesity did not differ in the level of depression from their normal weight counterparts, they demonstrated lower perceived physical appearance and higher perceived parental teasing. The mediating effects of perceived parental teasing were found for the relations between body mass index and self-perception of physical appearance and global self-worth, and body mass index and depression, respectively. Conclusion. Obese children at risk of parental teasing should be identified to prevent their psychological problems. A well-designed intervention study is necessary to examine the effects of psycho-emotional interventions for obese children. [ABSTRACT FROM AUTHOR]