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BACKGROUND Globally, breast cancer has been identified as the most common cancer among women. The clinical efficacy of adjuvant oral antiestrogen therapy-including tamoxifen and aromatase inhibitors-has been proven to be clinically efficacious for breast cancer survivors. However, medication adherence for these therapies remains suboptimal among breast cancer survivors. OBJECTIVE The aim of this study was to evaluate the effect of a reminder intervention-a smart pill bottle paired with the Pillsy mobile application-on medication adherence, medication self-efficacy, and depression, among breast cancer survivors who were undergoing oral antiestrogen therapy. METHODS This study is a randomized controlled trial. Sixty-one women were allocated to an experimental group (n = 31) and the control group (n = 30). The experimental group received the reminder intervention of a smart pill bottle for 4 weeks. Study outcomes were identified as medication adherence, medication self-efficacy, and depression. RESULTS Fifty-seven women completed the follow-up measurement. Significant differences in favor of the experimental group were noted for medication adherence (P = .004) and medication self-efficacy (P = .004). There was no statistically significant difference between the 2 groups with regard to depression (P = .057). CONCLUSIONS Reminder intervention using smart pill bottles was effective in improving medication adherence and medication self-efficacy among breast cancer survivors undergoing oral antiestrogen therapy. IMPLICATIONS FOR PRACTICE A smart pill bottle method of intervention can be a useful reminder strategy to improve medication adherence among breast cancer survivors.

Aim Nurses are pivotal in caring for patients infected with COVID‐19. Little is known about experiences of nurses in maternity care during the pandemic. Therefore, this study aimed to describe nurses’ experiences of caring for perinatal women and newborns during the pandemic. Design A descriptive qualitative study was conducted. Methods Data were collected from August–November 2020 using focus group and in‐depth interviews. A total of 24 nurses working in maternity and newborn care units participated in the study. Content analysis method was used for data analysis. Results The participants’ clinical experience ranged from 6 months–26 years. Three major themes emerged as follows: “making every effort to prevent COVID‐19 infection,” “caring for perinatal women and newborns with COVID‐19 infection or suspected infection” and “job stress and professional growth during the pandemic.” Participants reported that they needed more support in terms of staffing and mental health.

The present study investigated the concomitants of menopause-specific quality of life among premenopausal and postmenopausal women. Based on the Wilson and Cleary model of quality of life, this cross-sectional study recruited 329 women of age 40-65 years following operational convenience. The study was conducted in the office of the Korea Population, Health and Welfare Association (KPHWA) in Incheon, South Korea. Data collected on sociodemographic characteristics, social support, biological/physiological characteristics, the Pittsburgh Sleep Quality Index (PSQI-K), and self-rated health. Menopause-specific quality of life questionnaire (MENQOL) was used in this study. Hierarchical multiple linear regression analysis was performed. The study found that social support and self-rated health were negatively correlated with MENQOL in premenopausal women, while the income level and self-rated health were negatively associated with MENQOL in postmenopausal women. Sleep quality was positively correlated with MENQOL in both premenopausal and postmenopausal women. The study results indicate the need for tailored approaches based on menopausal status. Especially, social support may help improve the MENQOL of premenopausal women, while in postmenopausal women, improved sleep quality may enhance their menopause-specific quality of life.

Aim To examine a hypothetical model of physical activity and health outcomes (cardiovascular risk and quality of life) based on the information–motivation–behavioural skills model in adults. Design A cross‐sectional survey. Methods A total of 165 adults with osteoarthritis at risk for metabolic syndrome were recruited between October 2016 and September 2017 from the outpatient clinic in South Korea. Data were collected on the model constructs such as cognitive function, social support, depressive symptoms, barriers to self‐efficacy, physical activity and quality of life. A hypothetical model was tested using the AMOS 25.0 program. Results Cognitive function and barriers to self‐efficacy had a direct effect on physical activity. Physical activity had a direct effect on cardiovascular risk, while social support and depressive symptoms had a direct effect on quality of life. Conclusions The information–motivation–behavioural skills model can predict physical activity and, in turn, cardiovascular risk and quality of life in adults with osteoarthritis at risk for metabolic syndrome.

Aim This study examined the effects of a 12‐week school‐based “We Fit” weight control programme. Design A nonequivalent control group was used, with a non‐synchronized pretest–posttest design. Methods In total, 109 Korean high school adolescents participated. The programme comprised exergaming, diet diary and counselling, health education, and social networking service‐based group discussions. Anthropometric factors, physiological factors and physical activity (daily steps and sitting time) were measured in the intervention and the control groups before and after the intervention. Programme satisfaction was assessed post‐intervention. Data were analysed using descriptive statistics; the chi‐square, Mann–Whitney U and t tests; and generalized estimating equations. Results The intervention group showed a significantly decreased waist circumference, increased skeletal muscle mass, increased high‐density lipoprotein cholesterol, decreased low‐density lipoprotein cholesterol and reduced weekend sitting time. Conclusion This study adds to the evidence for the applicability and effectiveness of healthy weight control programmes using exergames for adolescents in school settings.

Purpose The purpose of this study was to identify human papillomavirus (HPV) vaccination research trends by visualizing a keyword network. Methods Articles about HPV vaccination were retrieved from the PubMed and Web of Science databases. A total of 1,448 articles published in 2006~2016 were selected. Keywords from the abstracts of these articles were extracted using the text mining program WordStat and standardized for analysis. Sixty-four keywords out of 287 were finally chosen after pruning. Social network analysis using NetMiner was applied to analyze the whole keyword network and the betweenness centrality of the network. Results According to the results of the social network analysis, the central keywords with high betweenness centrality included “health education”, “health personnel”, “parents”, “uptake”, “knowledge”, and “health promotion”. Conclusion To increase the uptake of HPV vaccination, health personnel should provide health education and vaccine promotion for parents and adolescents. Using social media, governmental organizations can offer accurate information that is easily accessible. School-based education will also be helpful.

Purpose This study aimed to examine engagement and satisfaction with a mobile web-based education program (HiChart) among pregnant women. Methods A cross-sectional descriptive study was conducted of 97 pregnant women hospitalized for obstetric care. Data were collected from October 1 to November 30, 2016, and were analyzed with descriptive statistics. Results Among participants, 16.5% engaged fully with HiChart, while 43.3% engaged partially. The overall satisfaction with HiChart was high. Some main reasons for not engaging with the education were participants’ unawareness of the text messages, lack of time, and poor internet connection. The participants suggested that more educational content needed to be covered, such as coping with infant emergencies and information about the neonatal intensive care unit. Conclusion To increase pregnant women’s engagement with mobile web-based education, efforts are needed to strengthen the system of sending text messages as part of mobile web-based education to all patients, to inform pregnant women that an educational web link was sent, and to encourage them to engage with mobile web-based education. Furthermore, it is essential to improve the HiChart service by providing educational content corresponding to users’ needs.

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: ‘postpartum hemorrhage and shock,’ ‘cardiopulmonary resuscitation (CPR) for neonate,’ ‘CPR during pregnancy,’ ‘disseminated intravascular coagulation,’ ‘sepsis,’ and ‘mechanical ventilation during pregnancy.’ CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

As misbehaviors online in higher education have been widely addressed in recent research, the discourse on cyberincivility has become a contemporary issue in health professions education. However, studies regarding cybercivility, particularly from an interprofessional education standpoint, are few. This study assessed the knowledge, experience, and perceptions about cyberincivility among students in 4 health care disciplines. Their preferred means of learning about cybercivility and the perceived benefits of such education are also discussed.

Problem It has been reported that some adolescents and young women who started taking human papillomavirus (HPV) vaccination are not completing all three doses. The aim of this study was to systematically review intervention studies on HPV vaccination completion. Eligibility Criteria Intervention studies with a comparison group that assessed HPV vaccination completion rate as the primary outcome variable in adolescents and adults younger than 26 years of age, and published in English from 2006 to 2016, were eligible for review. Sample Five studies from a literature search of CINAHL, EMBASE, PsycARTICLES, PubMed, SCOPUS, and Web of Science databases were included in this review. Results The overall quality of the reviewed studies was moderate, and the studies have mainly been conducted in a high-income country. Intervention strategies were DVD-based education on HPV and reminders that were delivered via either electronic or non-electronic methods. Some studies used fixed type of electronic reminders. Others chose preference-based electronic reminders, allowing participants to select one or two delivery options from e-mail, text message, automated telephone message, or Facebook message. Non-electronic reminders were letters sent by standard mail. Conclusions The rates of HPV vaccination completeness increased with the interventions. However, the completeness rate of HPV vaccination remained unsatisfactory and lower than its initiation rate. Implications Educational and reminder interventions for HPV vaccination could contribute to HPV vaccination completion. However, this review highlights the need for more high-quality studies to identify the best way to promote vaccination completion.

This study paid attention to the elderly space considering Aging in Place in pubic rental apartment housing corresponding to the population aging. Along with general population aging, deep consideration on elderly space in public rental apartments is inevitable in that tenant qualification assume elderly over 65 years as preferential tenant and that in general the mentioned elderly tenants continue to reside over 8 years. Thus, the troublesome problems of public rental apartments with social exclusion and alienation has been made point of contention and the role of the elderly space in the community facilities has been reconsidered. This study aimed at suggesting elderly space planning scheme cultivating a sense of community by activating the community and activating the local community as a base for Healthcare of Community Facilities in 2030. This study has perceived the limit of existing community facilities through literature review of the theoretical survey and case analysis and performs quantitative analysis on connectivity between the Space size of the community facilities as interviewing with residents, managers, and analyzing drawings. This allows the residents in the complex, from local residents as well as aging facilities as necessary and not isolated from the local community through communication and communities responding to. Community facilities for elderly boost aging in place through space.

The aim of this study was to describe interventions for PARO, as well as the outcomes evaluated and found following use of PARO, and to identify outcome measures in PARO intervention studies for older adults with dementia. Multiple databases (Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane, and Scopus) were searched and eight studies were included in the systematic review. The review demonstrated that interventions using PARO can be beneficial for improving QOL, affect, social interaction, and reducing NPS and psychotropic or pain medication use. This study identified three domains of outcome measures used to assess the effects of interventions using the PARO robot: quality of life, biological and physiological conditions, and medical treatment.

In this study, we developed and tested the psychometric properties of a translated and culturally adapted Korean version of the Incivility in Nursing Education-Revised (INE-R) survey. Using a cross-sectional design, the INE-R was administered to a convenience sample of 284 students enrolled in three Korean nursing colleges. Descriptive statistics were calculated for 24 student and 24 faculty incivility behavior items. Underlying factor structure was examined using exploratory and confirmatory factor analyses, and model fit was assessed using chi-square goodness-of-fit and other fit indices. For student incivility items, a four-factor model provided the best fit for the data, while a two-factor model provided the best fit for faculty incivility items. Overall reliability of the INE-R for student and faculty incivility behavior was estimated as α = 0.94 and 0.96, respectively. The Korean version of the INE-R is a reliable measure for assessing perceptions of student and faculty incivility among Korean nursing students.

The aim of this study was to explore the work experience of perioperative nurses involved in robotic surgery. A qualitative descriptive study was conducted. Participants were 15 nurses who had been on a robotic surgery team at one of five major university hospitals in Seoul, South Korea. Participants were one male and 14 female nurses (mean age, 31.33 [SD, 4.19] years; range, 25-41 years). Their experience as robotic surgery nurses ranged from 8 months to 6 years. Nurses' experiences with robotic surgery were categorized within four main themes: (1) constant checking on patients' safety and the robot's functions; (2) unexpected robotic machine errors or malfunctions; (3) feelings of burden in a robotic surgical team; and (4) need and desire for more information and education. This study showed that there are common concerns about patient safety and the possibility of emergencies related to robot system failure among nurses. Offering more support for nurses involved in robotic surgery should be a priority to empower them to play an extended role in robotic surgery.

Although incivility in higher education has been widely described, little evidence exists regarding incivility among health professions students in online environments. This study aims to integrate literature on cybercivility in health professions education. The extent to which health professions students and faculty experience cyberincivility, the direct and indirect effects and actions taken after cyberincivility, and themes that guide facilitation of cybercivility are discussed. Efforts to prevent cyberincivility can be achieved through focused education on cybercivility, development of clear policies related to its consequences, and formulation of guidelines for both student and faculty behavior online.

Background The Asian lifestyle requires deep hip flexion, which increases the risk of dislocation. Hence, Asian total hip arthroplasty (THA) patients may have problems postoperatively. This study aimed to 1) document quality of life (QoL), Asian lifestyle-related items (five postures that require deep hip flexion), and perceived satisfaction in patients who underwent THA in Japan versus Korea, 2) assess the differences in QoL and Asian lifestyle-related items by patient lifestyle, and 3) identify the factors predicting QoL. Methods This cross-sectional study included 222 THA patients. Korean patients completed the questionnaires. Japanese patients were then matched with Korean patients by age, sex, and post-THA period. Assessed parameters included QoL measured by the EuroQoL, Oxford hip score (OHS), Asian lifestyle (measured by the Asian lifestyle-related items), and perceived satisfaction (measured by the five items of postoperative satisfaction). Multiple regression analysis was used to determine the predictors of QoL. Results Compared with Korean patients, Japanese patients had better QoL, but more difficulty performing postures requiring deep hip flexion. Greater QoL was associated with greater satisfaction. The predictors of decreased QoL after THA were lower OHS in both countries, worse squatting ability in Japan, and worse leg-crossing ability in Korea. Conclusions In Japan and Korea, the OHS is an important predictor of QoL after THA.

Background: Incivility behaviors are negative social behaviors that can create conflict and disrespect among the persons involved. In a learning environment, incivility negatively affects learning by reducing academic motivation, lowering satisfaction with the education program, and interrupting the learning process. In addition, incivility causes those involved to feel negative emotions, such as anger, depression, and anxiety. Research question: What are the incivility experiences of nursing students during their nursing education? In what context do nursing students experience incivility during their education? Research design: This study used an exploratory qualitative methodology. Participants and research context: Participants (n = 34) were nursing students at three universities in South Korea. Data were collected during focus group interviews of 34 participants between 20 March and 26 June 2015 and were examined using a qualitative content analysis. Ethical consideration: The institutional review board approved this study. Findings: The analysis revealed four learning contexts in which participants experienced incivility: (a) in the classroom, (b) outside the classroom, (c) clinical settings, and (d) related to technology use. Five themes were identified: student non-adherence to classroom standards, faculty non-adherence to classroom standards, lack of helping-trusting relationships with peers, lack of dedication to teaching and learning in a clinical setting, and inappropriate use of technology. Conclusion: Nursing students experience incivility in a variety of situations and settings and expect a safer, more positive learning environment. The incivility experienced by nursing students during their education affects their goal of becoming professional nurses.

Background Online interventions have the advantages of being widely available, accessible, comfortable, cost effective, and they can provide tailored information and support. Despite these benefits, the effects of specifically devised online intervention programs for cancer patients’ sexual problems are somewhat unclear. The aim of this review is to describe online-based interventions and to assess their effects on sexual health among cancer survivors and/or their partners. Methods We investigated the effects of online sexual interventions among individuals with cancer or their partners. Among these, we considered 4 eligible articles. Results Despite the diversity of contents of the interventions, the identified modes of delivery among most of the interventions were as follows: education, interactive methods, cognitive behavior therapy, tailored information, and self-monitoring. Methods of monitoring the interventions, including the utilization of the web site and post-treatment program rating, were reported. All the online intervention programs incorporated a focus on physical, psychological, cognitive, and social aspects of sexual health. Significant effects on patient sexual function and interest and the psychological aspect of sexual problems were reported. Conclusion This study provides evidence that online-based interventions would be effective in improving the psycho-sexual problems of cancer survivors and their partners.

PURPOSE: The purpose of this study was to investigate factors that influence married female immigrants' perceived health status. METHODS: This study was a retrospective review of dataset from the 2012 National Multicultural Family Survey in Korea. Data were analyzed using descriptive statistics, t-tests, an analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression with the data of 3,014 married female immigrants. RESULTS: Multiple regression analysis showed that demographic factors (age, education level, nationality, period of residency in Korea, and residential area), socio-economical factors (monthly family income, employment, support from the government for basic living, and Medicaid), social support factors (marital conflict, satisfaction with family relationships, some one to talk about self or family matters, meeting with homeland friend, and participation in community meeting), and immigration factors (life satisfaction, experience of social discrimination, and difficulties with living and using medical care) were associated with perceived health status. CONCLUSION: It is important to pay closer attention to immigrant women who have low economic status, less social support, experience difficulties with living in Korea and using medical care. An effective support system for this population should be developed in order to help them successfully transition.

Purpose The purpose of this study was to assess risk of cardiovascular disease (CVD) by comparing the Framingham and United Kingdom Prospective Diabetes Study (UKPDS) risk equations in Korean adults with type 2 diabetes (T2DM) and metabolic syndrome. Methods The study was a cross-sectional survey enrolling a convenience sample of 110 Korean adults with T2DM and metabolic syndrome. The 10-year CVD risk scores were calculated using the Framingham risk equation and UKPDS risk engines. Results Overall participants had a moderate prevalence (average, 64.3%) of metabolic syndrome factors, with the most prevalent being abdominal obesity (86.4%) and elevated blood pressure (78.2%). A lower percentage of women were current smokers and consumed alcohol than men, whereas a higher percentage of men had their weight and stress controlled than women. The mean scores of 10-year CVD risk using the Framingham and UKPDS equations were 14.55% and 15.99%, respectively. However, there were no significant differences between results of the 2 equations. Regarding level of CVD risk, the percentage of high risk (>20%) was about 24% using both equations. Also, the area under the receiver operating characteristic curves using Framingham and UKPDS equations was similar: 0.707 and 0.696, respectively, which indicated moderate accuracy. Conclusions About one-fourth of adults with T2DM and metabolic syndrome had high level of CVD risk (>20%). In practice, people with diabetes and metabolic syndrome could be managed earlier and more intensively based on their risk estimated by the Framingham or UKPDS equations.

Purpose: The purpose of this study was to explore nursing students' competence in drawing an accurate family pedigree. Methods: Thirty nine Korean college senior nursing students (average age, 22.3 years; range, 21~30 years) participated in this study. Data were collected from September to November 2014. After obtaining permission from the participants, each participants constructed pedigree based on their own family history and they were interviewed about their competence in drawing a family pedigree as a group. Each session for group interview was audio-taped and transcribed. The pedigrees were evaluated for its accuracy. The responses of participants were analyzed using qualitative content analysis. Results: The main themes of the sessions were “unequal opportunities in learning about a family pedigree,” “feeling competent in drawing a family pedigree,” “having difficulty with drawing a family pedigree,” and “knowing the family history incompletely.” Although most of the participants perceived the importance of family pedigree positively, some of them stated that they are not comfortable drawing pedigree because they did not know the details and did not have a chance to practice it repeatedly. Moreover, participants hoped to learn more how to draw a family pedigree. Conclusion: The education on family pedigree should be reenforced to increase nursing students' competence in drawing an accurate pedigree for themselves and clients. In addition, the educators should consider individual differences.

Purpose: This study was conducted to explore the nursing needs and satisfaction of patients who are hospitalized at hospice palliative care institutions. Methods: This study included 80 hospice patients who were in-patients of the hospice department of two general hospitals in S city. The collected data were analyzed by descriptive statistics, t-test, one-way ANOVA, and Pearson’s correlation coefficients using the IBM SPSS 20.0 program. Results: The mean score of nursing needs and satisfaction were 3.58 (±0.31) and 3.25 (±0.20) respectively. Significant differences in hospice nursing needs and satisfaction were observed in term s of general characteristics including gender, education level, occupation, religion, support for medical expense and functional status. Significant positive correlation was found between the overall nursing needs and nursing satisfaction. Conclusion: Based on the results of this study, in order to improve the quality of hospice service, further study is necessary in a comprehensive manner to develop nursing intervention to meet physical, psychological/social, spiritual, and educational/referral nursing needs of hospice in-patients.

This study presents an integrative literature review on sexuality among elderly people with dementia living in nursing homes. Original research studies published from 1980 to 2012 were included in the review. Sexual expressions ranged from holding hands to sexual intercourse. These behaviours were sometimes directed towards caregivers while the latter were providing daily care. Sexual expressions were sometimes assessed and reported subjectively without context. Responses to sexual expressions varied from positive to negative. Some sexual expressions were dealt with inconsistently, and some were considered to be problematic due to a lack of policy or privacy. It is important to assess and report sexual expressions objectively, preferably with a standardized form, and to consider context in doing so. Effort is required to provide privacy for residents' sexual expressions and a safe environment for all residents and caregivers. It is important that a policy and guidelines for care be established regarding issues related to sexuality among elderly people with dementia.

Aim To conduct a best-evidence review of non-pharmacological interventions for resistance-to-care behaviours of nursing home residents with dementia in a personal-care context. Background Resistance to care is a major source of staff burnout in nursing homes and it is also a safety issue for the staff. Design Best-evidence review. Data Sources We searched for non-pharmacological intervention studies published from 1990–2012, written in English. Review Methods The search identified 19 intervention studies that examined the effects of interventions to reduce the resistance-to-care behaviours of nursing home residents with dementia in a personal-care context. These 19 papers met the quality assessment requirements of the critical appraisal criteria for experimental studies, which were published by the Joanna Briggs Institute. Results Only three studies were RCTs and the rest were quasi-experimental. The sample size ranged from 7–127. Nine music interventions, such as pre-recorded music played to a group or playing a resident's preferred music, during his or her personal care, resulted in significant reductions in resistance-to-care behaviours. Resistance-to-care behaviours also were significantly reduced in three of four bathing interventions that focused on person-centred care. In the ability-focused interventions, only two out of five studies reported significant reductions in resistance-to-care behaviours. Conclusion Non-pharmacological interventions are options to consider to reduce resistance-to-care behaviours in older people with dementia, even though the evidence level is low, given the lack of alternatives. More randomized controlled trials are recommended to confirm the effects of non-pharmacological interventions during personal care.

Purpose: Promoting the health-related quality of life (HRQOL) is an important aim of nursing care for immigrant women. The aim of this study was to evaluate the level of HRQOL and its relationships with social support, acculturative stress, and depression among Vietnamese immigrant women. Method: A total of 216 Vietnamese immigrant women residing in South Korea participated in the study. Participants completed a series of questionnaires, including measures of social support, acculturative stress, depression, and HRQOL. For statistical analyses, a path analysis was applied. Results: Social support, acculturative stress, depression, and HRQOL were interrelated. Acculturative stress and depression directly influenced the mental health component of HRQOL, whereas social support indirectly influenced HRQOL through acculturative stress and depression. Only depression directly influenced the physical health component of HRQOL. Conclusion: Results suggest that social support and acculturative stress are related factors in preventing depression and promoting HRQOL, especially mental health, among Vietnamese immigrant women.

This quasi-experimental study examined the effects of cognitive-behavioral therapy (CBT) to control depression, anger, and self-control in soldiers from South Korea. Using a pretest-posttest design, the sample was composed of an experimental group ( n = 16) and a control group ( n = 12). The experimental group participated in four sessions of CBT. No significant differences were found between the groups with regard to demographic characteristics. Changes in the variables after the intervention were analyzed using Wilcoxon’s signed-rank sum test. The depression scores decreased significantly after the intervention ( z = −3.05, p = 0.002); whereas, the scores of state-trait anger and self-control did not change. In the control group, none of the outcome variable scores changed significantly. The results indicate that the developed CBT program might be an effective modality to decrease the depression of soldiers who are in military service. [ Journal of Psychosocial Nursing and Mental Health Services, 52 (2), 22–28.]

Purpose: The purpose of this study was to determine the status of tuberculosis (TB) infection control in hospitals. Method: This study was a cross-sectional descriptive study in which self-administered questionnaires were used to survey 77 hospitals. Data were collected from August 12 to September 15, 2012. Results: Only 27 institutions (35.1%) were monitoring patients infected with or suspected of having TB. Most hospitals were conducting TB prevention education for patients` family and employees, and TB screening for employees along with follow-up examinations. However, private negative pressure rooms were more often available in wards and intensive care units than in outpatient departments, and in institutions with over 700 beds located in Seoul or GyeongGi Province. Most hospitals ensured that masks were placed on infected patients while transporting them. In addition, efforts to control TB infection such as placing respiratory etiquette posters in outpatient departments and airborne infection signs on the doors in the wards were also well established in most institutions. Conclusion: More efforts are needed to improve the status of TB infection control to ensure quality care, especially in terms of monitoring patients with TB infections and making private negative pressure rooms available in outpatient departments.

PURPOSE: The purpose of this study was to review the literature on intervention for breast cancer survivors and their partners. METHODS: The literature search was performed using MEDLINE, Pubmed, and Proquest to summarize the current state of knowledge regarding intervention for breast cancer survivors and their partners. Articles published between January 2000 and December 2011 were included. RESULTS: A total of 14 studies were identified. Couple-base d intervention was more effective than intervention for survivors alone. Intervention to partners had also effects on their wives. Most studies were conducted in USA with Caucasian women. Sample size of intervention studies was small with most being pilot studies. CONCLUSION: Providing couple-based intervention to breast cancer survivors could have positive impacts on physical, interpersonal, and social aspects in breast cancer survivors. Future studies with large sample and different ethnicity are needed to confirm the effects of couple-based interventions for breast cancer survivors.

Background Oncology nurses should possess a high level of sensitivity while dealing with patients' sexual health needs. However, sexual health care is still inadequately addressed because of barriers such as conservative beliefs and incorrect assumptions regarding sexual issues. Most scales for measuring attitude toward sexual health care were insufficient to establish the instrument's validity and did not focus on oncology nurses. Aims and objective The purpose of this study was to develop a scale considering cultural contexts to investigate nurses' attitude toward sexual health care in patients suffering from cancer. Design This study was designed for scale development. Methods A preliminary version of the instrument was developed through a literature review and interviews with 10 oncology nurses; this version consisted of 42 items rated on a 3-point scale. Eight experts reviewed the questionnaire for content validity and consolidated 36 items. Data were collected from 342 oncology nurses in Korea. Exploratory factor analysis was performed, and reliability was assessed using Cronbach α values. Pearson correlation coefficients were used to test the concurrent validity. Results Exploratory factor analysis revealed 17 items (4 factors), which account for 70.49% of the total variance. The 4 factors were (1) discomfort in providing sexual health care (7 items), (2) feeling uncertain about patient's acceptance (4 items), (3) afraid of colleagues' negative response (3 items), and (4) lack of environmental support (3 items). Correlation of the sub-factors ranged from 0.35 to 0.63. The Cronbach α value was 0.92. Significant negative correlations were found between the attitude toward sexual health care and the Sexuality Attitudes and Belief Survey ( r =−0.57, p Conclusion The scale of attitude toward sexual health care showed validity and reliability in evaluating the attitude of oncology nurses toward sexual health care and can be used to identify attitudinal barriers in nurses as well as to develop and test educational interventions for the improvement of sexual health care.

Purpose: The purpose of this study is to investigate the impact of job stress, self-efficacy and empowerment of 119 Emergency medical technicians in Jeollanam-do. Methods: This study used the data collected from 346 respondents working for first aid in a fire station. To answer research questions, this study employed frequency analysis, reliability test, F (t)-test, ANOVA, Scheffe' post-hoc test, and multiple-regression analysis. Results: In terms of demographic characteristics, marital status and age had significant impact on job stress, but sex and education did not. In terms of job characteristics, first placement, rank, and tenure made significant difference on job stress, whereas certificate, department, and area did not. These results address that general characteristics, self-efficacy and job stress are critical variables on empowerment. Conclusion: From the research findings, it is concluded that fire fighters' job stress can be reduced if professional development programs are given to them, which is likely to provide better public services such as first aids and welfare, as well as to increase job satisfaction.

1Objectives: The purpose of this study was to explore the experience of women for the use of “KoEunMom Card,” which is a service for medical expense aid for pregnant women. Methods: Twenty-four Korean women (average age, 30.57 years; range, 27-36 years) participated in 8 focus groups. Data were collected from June to September 2010. After obtaining permission from the participants, each session of the focus group was audiotaped and transcribed. The responses were analyzed using qualitative content analysis. Results: The main themes of the sessions were “a huge lack of support for medical expenses for pregnancy-related conditions and delivery,” “a hope for a better coverage for medical expenses,” “improvement of the benefits for pregnant women,” “inconvenience caused by the use of the card because of the spending limits per use and the restricted expense coverage.” Although most of the participants positively perceived the benefits of “KoEunMom card” service, they stated that the service was not adequate, because it did not cover all medical expenses for prenatal care or delivery. Moreover, the service was unfeasible because of the complicated procedure involved in issuing of the card, the spending limit per use, and the restricted expense coverage. Conclusion: An increase and expansion of the range of benefits will lower the burden of medical expenses for pregnant women during pregnancy and around the time of delivery. In addition, the feasibility of the use of the card should be increased by simplifying the registration process and expanding the range of options to allow the users to claim their medical expenses.

The purpose of this study was to examine the levels of Internet addiction and interpersonal problems, explore the relationship between the two, and identify the relevant factors of Internet addiction in Korean middle school students. A cross-sectional survey design was used. The participants were 676 middle school students. A Korean version of the Internet addiction self-test scale and a Korean version of the Inventory of Interpersonal Problems were used. Among the participants, 547 (80.9%) were identified as general users, 108 (16%) were potential risk users, and 21 (3.1%) were high-risk users. There were statistically significant positive correlations between Internet addiction and interpersonal problems (r = 0.425, P = .000). There were significant positive correlations between Internet addiction and hours spent playing games. Internet-addicted adolescents also had more interpersonal problems. It is important to raise awareness about Internet addiction, and close attention must be paid not only to students at risk of Internet addiction but also to students at low risk to prevent students from becoming addicted to the Internet.

Objectives This study examined the intentions, knowledge, and attitudes of college students regarding the use of emergency contraceptive pills (ECPs) and condoms. Design and setting A cross-sectional descriptive study was conducted at 16 Korean colleges. Methods Data were collected from March 15 to June 10, 2006 from a convenience sample of 1046 college students using a survey questionnaire. The survey included measures of demographic variables, intention to use ECPs (one item) and condoms (one item), knowledge about ECPs (12 items), and attitudes toward using ECPs (12 items) and condoms (16 items). All items except knowledge were rated on a 5-point Likert-type response format, with higher scores indicating greater intentions, more positive attitudes, and greater knowledge. Results Of the 1046 participants, 76.3% had heard of ECPs and 13.2% of the sexually active participants ( n =190) had used them. Participants showed a general lack of knowledge about ECPs and misconceptions about their safety. The intentions of using ECPs and condoms were positively correlated with each other and with attitude such that the more positive the attitude, the greater their intention to use both ECPs and condoms. There were significant gender differences on many of the variables, in that female students had higher knowledge about ECPs, intention of using ECPs and condoms, and more positive attitude toward condoms than male students who had more positive attitudes toward ECPs. Females had more concerns about the safety of ECPs than males. Conclusions The findings suggest that college students must be better informed about ECPs, and reassured about their safety. Additionally, promoting ECPs would not negatively affect condom use. Efforts are needed to disseminate up-to-date information to the general public and to develop educational and awareness programs to empower young people to make informed decisions about the use of ECPs and condoms.

The positive and negative aspects of breast cancer screening were measured to gain insight into the barriers that prevent Korean women from participating in mammography screening. Breast cancer screening behaviors, attitudes, and barriers were identified from a convenience sample of 328 Korean women recruited in Seoul, Gyeonggi, and Jeju, South Korea. Pros, cons, and decisional balance constructs of the transtheoretical model of behavior change were used to identify stages of change in attitude related to mammography screening. There were significant differences in pros (F = 5.175, p = .001) and cons (F = 3.357, p = .012) across the five stages of change for mammography. Participants indicated that the major barriers to mammography screening were, in order of frequency, the belief that an absence of symptoms meant there was no need for a breast examination, the high cost of breast cancer screening, lack of time, lack of information, embarrassment, fear about x-rays and test results, reliance on breast self-examination (BSE), and discomfort or pain. The benefits of breast cancer screening should be emphasized among Korean women.

Following our study of attitudes, barriers, and intentions concerning the influenza vaccination among pregnant women in South Korea, we discovered that women displaying a more positive attitude toward the influenza vaccination were more likely to receive it during their pregnancy. We also found that attitudes toward vaccination were more positive among vaccinated pregnant women than among those who were unvaccinated. Furthermore, women showed a greater intention to get vaccinated if a clinician, rather than friends, recommended it. The major perceived barriers to receiving an influenza vaccination were being pregnant, fearing harm to the baby, feeling healthy, and thinking it is unnecessary.

Background: The purpose of this study was to examine the experiences of nursing students with exposure of influenza A (H1N1). Methods : A qualitative descriptive study design was used. A total of 24 nursing students participated in six focus groups. Results: The six themes that emerged from the data are as follows: (1) worrying about becoming infected; (2) protectingoneself and others; (3) relying on the nurses in the school health center; (4) being hurt by others’ negative reactions; (5)being ambivalent, and (6) being concerned over the high price. Conclusions: Nursing students who come in contact with patients in a clinical setting must also be considered as candidatesfor early vaccination. Healthcare professionals, as well as family and friends, should keep in mind that their verbal ornonverbal expressions can hurt others’ feelings at a time when special care and support are needed the most. Stigma couldbe serious barriers of people's access to health services and preventive behaviors. Therefore, education on stigma reductionassociated with pandemic infection is essential to enhance public health preparedness.

Background Despite increasing awareness related to sexual health for breast cancer survivors, health care providers are passive in addressing their sexual issues. Objective The aims were to develop and investigate the effect of a sexual life reframing program on marital intimacy, body image, and sexual function (interest, dysfunction, and satisfaction) among breast cancer survivors. Methods Breast cancer survivors participated in this quasi-experimental study. The sexual life reframing program focused on the physical, psychological, and relational aspects of sexual health elements, and it consisted of 6 weekly 2-hour sessions. Results The participants reported poor body image and sexual function. There were no statistically significant differences in marital intimacy, body image, sexual interest, and sexual dysfunction following the program, although all the variables in the intervention group were improved. The sexual life reframing program was effective in increasing sexual satisfaction among breast cancer survivors. Conclusion This study suggests that the quality of sexual life in breast cancer survivors could be improved with the sexual life reframing program provided as part of supportive group care. This program may be more effective if targeted at couples rather than survivors only and if delivered earlier and for a longer period. Implications for practice The sexual life reframing program offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for breast cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction.

kang h.s., shin h., hyun m.-s. & kim m.j. (2010) Human papilloma virus vaccination: perceptions of young Korean women. Journal of Advanced Nursing 66(9), 1946–1952. Abstract Aim. This paper is a report of a descriptive study of young Korean women’s perceptions of use of the human papilloma virus vaccine. Background. In Korea, cervical cancer is one of the leading cancers in women, and the rate of human papilloma virus infection is increasing. A national media campaign has recently begun to promote human papilloma virus vaccination. However, research addressing the acceptability of this vaccine to women in Korea has been limited. Method. Twenty-five Korean women, 21–30 years of age, participated in seven focus groups. The data were collected in 2007. Findings. Participants were concerned about the potential harmful effects of the human papilloma virus vaccine, a possible increase in unsafe sexual behaviours, and the high cost of the vaccine, which is not covered by health insurance. They suggested group vaccination at-cost or free of charge. They discussed ambivalence about the vaccination, the need for more information about the vaccine, and questions about its effectiveness. Most preferred to wait until more people have been vaccinated. Conclusion. There is a need for more aggressive dissemination of information about the safety and efficacy of the human papilloma virus vaccine. More reasonable cost, insurance coverage, or free vaccination using a group approach might increase young Korean women’s acceptance and use of the human papilloma virus vaccine.

Purpose: The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. Methods: A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. Results: Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. Conclusion: More educational opportunities in physical assessment should be provided including education programs based on the nurses’ skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.

Han Ju Lee,1 Linda Moneyham,2 Hee Sun Kang,3 Kyung Sun Kim41Department of Nursing, Sangmyung University, Cheonan-si, Chungcheongnam-do, South Korea; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea; 4Gyeonggi Branch, Korean Alliance to Defeat AIDS, Anyang, Gyeonggi-do, South KoreaPurpose: This study's purpose was to explore the experiences of peer supporters regarding their work in a home visit program for people with HIV infection.Patients and methods: A qualitative descriptive study was conducted using focus groups. Participants were 12 HIV-positive peer supporters conducting home visits with people living with HIV/AIDS in South Korea. Thematic analysis was used to analyze the data.Results: Six major themes emerged: feeling a sense of belonging; concern about financial support; facing HIV-related stigma and fear of disclosure; reaching out and acting as a bridge of hope; feeling burnout; and need for quality education. The study findings indicate that although peer supporters experience several positive aspects in the role, such as feelings of belonging, they also experience issues that make it difficult to be successful in the role, including the position's instability, work-related stress, and concerns about the quality of their continuing education.Conclusion: The findings suggest that to maintain a stable and effective peer supporter program, such positions require financial support, training in how to prevent and manage stress associated with the role, and a well-developed program of education and training.Keywords: human immunodeficiency virus, qualitative research, workplace experience

Although the documented incidence and prevalence of HIV/AIDS in South Korea are relatively low in comparison with other counties, rates are steadily rising. It is believed that many cases have not been diagnosed because of the extreme stigma associated with HIV/AIDS in South Korea that serves as a barrier to voluntary counseling and testing (VCT). Little is currently known about individuals who present for counseling and testing. The purpose of this study was to explore the characteristics of individuals who sought VCT at the Korean Alliance to Defeat AIDS (KADA). Data were collected from 264 individuals who presented for VCT between October 1 and December 30, 2005, using self-administered questionnaires. More men than women (218 and 46, respectively) participated in this study. A large majority (85.3%) reported never using condoms and/or inconsistent condom use. The major reasons given for seeking HIV testing were unprotected sexual intercourse with commercial sex workers, premarital sex, and extramarital sex. Although none of the participants were HIV-positive, most were engaged in high risk sexual behaviors. Additionally, participants sought HIV testing at KADA because the results were rapidly available and their anonymity was ensured. The results suggest the need for interventions focused on safer sex practices and the importance of rapid HIV testing and assurance of anonymity to those in need of testing.

PURPOSE Nursing research is recognized as an essential basis for the continuous development of the scientific nursing knowledge and practice. An understanding of the barriers and attitudes to research among nurses is important to improve clinical nursing research activities. METHOD Data were collected from nurses at a general hospital, located in D city, using a self-reported questionnaire, from March 15th to April 4th, 2003, and 133 questionnaires were used for the analyses. A 5 point scale instrument was used to measure barriers and attitudes towards nursing research, with a Cronbach's alpha of .85 and .89, respectively. RESULTS Nurses had limited experience in research and were not well prepared to conduct it. Lack of experience, training and time were the major barriers for conducting research. However, the nurses had positive attitudes toward research. There was a difference in barriers (t=2.68, p=.02) and research attitudes (t=-2.74, p=.00) according to the nurses' position. Also, the nurses' research experience influenced research attitudes (t=-3.27, p=.00). The degree of research preparation (F=6.98, p=.00) had an effect on the attitudes toward nursing research but not on the barriers. CONCLUSION There is an urgent need to promote both the ability and environment for clinical nurses to actively participate in research. As the majority of nurses had little experience and low confidence in research and perceived many barriers, this promotion can be accomplished by enhancing their confidence in research through continuing education and by gradually eliminating the barriers to research.

With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse.Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion.The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients' reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse.Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.

We found an title error in our published article.

Purpose: The purpose of this study was to investigate the health care utilization in Korean women with cervical cancer and cervical intraepithelial neoplasia (CIN). Methods: This is a retrospective study. Data were collected using the insurance coverage data-base of Health Insurance Review and Assessment Service (HIRA) from January 1, 2006 to December 31, 2010. Women who were treated for cervical cancer and cervical intraepithelial were included in this study. The data were analyzed using descriptive statistics. Results: In 2006, women treated for cervical cancer and CIN were 27,109 and 18,794, respectively. The number constantly increased from 2006 to 2010. In particular, the prevalence among women with cervical cancer aged 80 years or over was found to increase. Claims for health care services increased. Conclusion: Even though new cases of cervical cancer in Korea is decreasing, the number of women being treated and the costs are constantly increasing. Cervical cancer patients are at an increased risk of negative health outcomes. Therefore, screening for cervical cancer should be enforced to promptly treat women with abnormal Pap tests and thus minimize the risks. Every effort should be made to increase awareness about the importance of Human Papilloma Vaccination and regular screening on a personal as well as community and governmental levels.