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This study aimed to compare nurses' perceptions of career ladder systems, job satisfaction and turnover intention in small- and medium-sized hospitals with and without a career ladder system.A cross-sectional, correlational, descriptive study was conducted.Data were collected using self-report surveys from 130-144 participants in small- and medium-sized hospitals with and without a career ladder system, respectively. The data were collected from July 1, 2019-July 31, 2019.The perception of the career ladder system was positively correlated with job satisfaction in hospitals with and without a career ladder system but negatively correlated with turnover intention in those with a career ladder system only. A positive perception of the system is associated with increased job satisfaction and lowered turnover intention. Hospitals should implement a career ladder system and improve nurses' perception by addressing the specific categories identified in this study.

Objective To compare pressure injury (PI) incidence based on repositioning intervals and support surfaces in acute care settings. Methods This pragmatic, quasi-experimental trial recruited a total of 251 critically ill patients who were at low or moderate risk for PI development. Participants were assigned to three interventions: a 2-hour repositioning interval using an air mattress, a 2-hour repositioning interval using a foam mattress, or a 3-hour repositioning interval using a foam mattress. Data were collected by nurses every shift over the course of 14 days. Pressure injury incidence was analyzed using a χ2 test. Results There were no statistically significant differences in PI incidence between the groups with a 2-hour repositioning interval. However, the PI incidence in the group using a foam mattress with a 3-hour repositioning interval was significantly lower than in the group using an air mattress with a 2-hour repositioning interval (odds ratio, 0.481; 95% confidence interval, 0.410-0.565). Conclusions The findings showed that PIs decreased when the repositioning interval was extended from every 2 hours to every 3 hours while using foam mattresses. This study suggests that a 3-hour repositioning interval using a foam mattress could be applied to reduce the risk of PI development for patients at low or moderate risk.

Workplace cyberbullying has emerged as a new issue. This study aimed to explore individual and organizational factors that affect nurses' workplace cyberbullying in hospital settings. A multicenter, cross-sectional study was conducted using a self-report questionnaire. Three tertiary and 18 general hospitals were selected from one city in Korea. A total of 270 nurses with 6 months to 10 years of experience in the current department were enrolled. Multiple regression analysis was conducted to identify the factors associated with cyberbullying. Workplace cyberbullying was affected by self-labeled victimization due to face-to-face bullying, subjective health level, years of experience as a nurse (β = 0.148, p = 0.009), and relation-oriented nursing organizational culture. Face-to-face bullying must be addressed to prevent workplace cyberbullying. It is important to assist nurses to maintain good health-considering that, new nurses with less than 1 year of experience are vulnerable to being victimized. Effective prevention strategies should be prepared to control workplace cyberbullying in clinical practice.

This study's aim was to discern the nursing organizational culture and job stress, induced by infection control nurses (ICNs)' working together, affects ICNs' turnover intentions. Job stress was the most significant factor affecting ICNs' turnover intention. To reduce ICNs' turnover intention, their task stress needs to be lowered and managed. In particular, efforts should be made to establish a relation-oriented organizational culture that values positive relationships while enhancing their community spirit at the organization level.

Aims The purpose of this study was to investigate the effect of workplace cyberbullying on nurses' symptom experience and turnover intention. Background While face-to-face workplace bullying occurs frequently in nursing organisations, workplace cyberbullying has rarely been studied. Method This is a cross-sectional descriptive study using self-reporting surveys of 249 nurses from 20 hospitals. Results The prevalence of workplace cyberbullying was 8%, and the mean was 1.11 ± 0.31. Factors influencing symptom experience were workplace cyberbullying and perceived organisational support, while factors influencing turnover intention were workplace cyberbullying, perceived organisational support and educational level. Conclusions Workplace cyberbullying and perceived organisational support are factors that significantly influenced both symptom experience and turnover intention in nurses working in hospital settings. Managing workplace cyberbullying can reduce the negative effects on nurses' symptom experience and turnover intention. This suggests that the management of workplace cyberbullying by a nursing organisation is essential. Implications for nursing management Nursing managers need to focus on the control and prevention of workplace cyberbullying as well as traditional forms of bullying. Managing workplace cyberbullying can reduce negative effects on nurses' symptom experience. Interest in and prevention of workplace cyberbullying would decrease turnover intention and stabilize the nursing organisation and the workforce.

This study aims to evaluate the importance and performance level of knowledge about sanitary management among foodservice employees in childcare centers that were registered at Center for Children’s Food Service Management in Chungju city according to their work duration, type of childcare center, and number of enrolled children. The self-administered questionnaire was conducted to examine food safety attributes of sanitary management at 150 childcare centers without qualified dietitians registered at Center for Children’s Food Service Management of Chungju city. The questionnaire consisted of 15 questions about perceived importance and performance regarding sanitation management (personal hygiene, ingredient control, temperature control of food, facility, equipment, and utensils sanitation) using IPA (importance–performance analysis). The results show that overall mean scores of the importance and performance of sanitary knowledge were 4.71 and 4.67 out of 5, respectively. ‘Checking the center temperature at 75 °C for 1 min in the thickest part of meat (3 times or more check for each serving)’ (p = 0.047) and ‘Keeping preserved meals (at least 100 g of each menu) for 144 h. with −18 °C or less’ (p < 0.001) show significantly lower scores of performance than those of importance. The results of importance and performance for sanitary management according to work duration of foodservice employees show that those who have worked more than 10 years had the highest scores of importance and performance for overall sanitary management among them. For the types of childcare centers, the overall performance scores of national/public employees for sanitary management were lower than those of private or home type (p < 0.001). Additionally, the result showed that the overall importance (p < 0.001) and performance scores (p < 0.001) of employees for sanitary management in centers with

Background: The global COVID-19 pandemic has increased cyber communication, causing nursing students’ clinical practice to be held in cyberspace. Thus, it is essential to ensure that nursing students develop comprehensive cyber ethics awareness. Moreover, cyberbullying is becoming more widespread and is an increasingly relevant new concept. Objectives: This study aimed to assess the experiences of cyberbullying among nursing students during clinical practice and determine the effects of cyberbullying victimization and cyber environments on their cyber ethics awareness. Research design: Data for this descriptive cross-sectional study were collected in July 2020 using a self-reported questionnaire and analyzed using hierarchical regression. Participants and research context: The study included data from 291 nursing students with more than 6 months of clinical experience who were enrolled in two nursing universities in two cities in South Korea. Ethical considerations: This study was conducted after obtaining approval from the Institutional Review Board of G University. Written, informed consent was obtained from all participants. Results: Cyberbullying victimization experiences during clinical practice were few. The most common cyberbullies of work- and person-related cyberbullying were nurses and classmates, respectively. Discussion: Cyber ethics awareness was affected by cyber anonymity and the perceived seriousness of cyberbullying; cyberbullying related to clinical practices was a new factor that significantly affected cyber ethics awareness. Conclusions: Hospitals and nursing universities should develop a multi-dimensional, comprehensive, and effective nursing intervention education program to be integrated into the nursing curriculum to enhance cyber ethics awareness and reduce cyberbullying of nursing students.

Backgrounds: Zika virus infection may cause severe complications in women of childbearing age. Female nursing college students, in the role of future nurses and women of childbearing age, can be ef...

Vulvar self-examination (VSE) is an essential examination that all women should perform monthly, as it enables potential patients to discover vulvar cancer in early stage. In this study, a survey was conducted to identify the factors that affect Korean young women's willingness to conduct VSE. Willingness to conduct VSE was higher if the perceived benefit and the individual health motivation were higher. However, it was lower if the perceived barriers were higher. The systematic strategies should be included in VSE education programs to increase perceived benefits of, and health motivation for conducting VSE while reducing the perceived barriers to VSE.

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

This study was performed to investigate the association of knowledge, attitudes, and preventive practices for the prevention of Zika virus infection. The study sample consisted of 185 pregnant women in Korea. The Zika virus-related knowledge and attitude of pregnant women significantly affected preventive practices. The younger pregnant women and pregnant women who had not taken the influenza vaccine had lesser preventive practices of the Zika virus, thereby necessitating educating them and emphasizing good preventive practices. Our results suggest that systematic education and effective prevention programs for Zika virus will contribute to the prevention of infection.

Background: As the number of patients with Zika virus infection increases worldwide, nursing students who conduct clinical practice in hospitals tend to at risk of Zika virus infection. Therefore, this study was conducted to identify nursing students’ knowledge, attitudes, practices, and risk perceptions of infection prevention related to occupational exposure to Zika virus infection, and to identify correlations among the related variables. Methods: This cross-sectional study included 249 nursing students from 3 nursing colleges located in 3 Korean cities, with experience in hospital clinical practice. A questionnaire to assess the knowledge, attitudes, practices, and risk perceptions of Zika virus infection was developed through a literature review and was subjected to pilot testing and validation. Results: The level of infection-control knowledge for Zika virus was 54.5 of 100 points, and that of practice was 4.5 of 5 points. The infection-prevention attitude score was 4.4 of 5 points, and the risk-perception score was 2.3 of 5 points. Significant differences emerged in infection-prevention attitude toward Zika virus based on Zika virus vaccination intention. Additionally, practice and risk-perception scores differed significantly based on gender and Zika virus vaccination intention. Knowledge significantly correlated with attitude and attitude toward preventive behavior. Conclusion: Improvement in infection-control knowledge for Zika virus can help improve nurses’ related attitudes, which in turn could promote effective practice. Considering the characteristics of nursing students, it is necessary to develop and apply an effective and viable education program related to the prevention of Zika virus infection. Keywords: Zika, Nursing student, Knowledge, Attitude, Practice

Because of globalization and growing immigrant populations, nursing students need to possess a high level of cultural competence to provide nursing care to patients from various cultural backgrounds. However, it has been reported that the current cultural education in nursing curriculums is not sufficient to improve students' cultural competence. Little is known about how nursing students' personal experiences of other cultures may impact their cultural competence. This study was conducted to identify the ways in which cultural education and personal experiences with other cultures affect nursing students' cultural competence. A questionnaire-based descriptive cross-sectional study was conducted with 236 Korean nursing students from four universities in South Korea. The explanatory power of cultural experiences and cultural education for nursing students' cultural competence was 8.1% and 7.1%, respectively. The present study revealed that the explanatory power of the variable for nursing students' cultural competence increased when cultural experiences were added to cultural education. Among cultural experiences, contact with people from other cultural areas influenced nursing students' cultural competence the most. Therefore, it is recommended to encourage nursing students to engage in extracurricular activities with people from other countries, adding this to organized lectures on cultural education.

BACKGROUND We explored the relationship between body mass index-for-age percentile, body image distortion, and unnecessary weight loss efforts in Korean adolescent girls who are underweight and normal weight and examined the mediating effect of body image distortion on weight loss efforts. METHODS This study used data from the 2013 Korea Youth Risk Behavior Web-based Survey conducted by the Korea Centers for Disease Control and Prevention. The study sample comprised 29,633 Korean adolescent girls who are normal weight and underweight. Chi-square tests and correlations were used to assess bivariate relationships between the variables. To assess the mediating effect of body image distortion on the relationship between body mass index-for-age percentile and weight loss efforts, a 3-step regression analysis was used. RESULTS There was a significant correlation between body mass index-for-age percentiles and body image distortion, and both significantly correlated with weight loss efforts. In addition, a distorted perception of being overweight or obese was a significant mediating variable. CONCLUSIONS School-based health education and intervention programs are needed to promote the formation of a positive body image, not only for obese adolescents, but also for normal-weight and underweight adolescent girls.

The purpose of this study was to examine how nursing students' intention to comply with infection control practices (ICPs) is affected by their awareness of ICPs and by their observations of staff nurses' noncompliance with ICPs. The subjects were 350 nursing students from 8 universities in Korea. Hierarchical multiple linear regression analysis was used to determine the predictive factors of compliance intention with ICPs. We found that nursing students' awareness of ICPs was the most significant influencing factor affecting their compliance with ICPs. Students' observation of staff nurses' noncompliance with ICPs was the second most significant influencing factor.

This study examined female university students' menstrual-hygiene management and identified factors associated with genitourinary tract infections in this sample. This study was conducted as a descriptive survey. Participants were 383 female students from six universities in South Korea. Data were collected between April and June, 2017. Multiple logistic regression analysis was used to access the factors associated with genitourinary-tract infections. Multiple logistic regression revealed that genitourinary tract infections were significantly associated with low socioeconomic level, history of sexual intercourse, and vaginal douching during menstruation. We evaluated menstrual hygiene practices and their relation to genitourinary tract infections. Korean college students were relatively good at managing menstrual hygiene. However, some menstrual hygiene behaviors were improper. Therefore, school and community health agencies should provide education to maintain adequate menstrual hygiene and correct erroneous hygiene practices to prevent genitourinary tract infections.

Summary Purpose Emergency department (ED) nurses suffer from persistent stress after experiencing the traumatic event of exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), which can subsequently lead to burnout. This study aimed to assess ED nurses' burnout level during an outbreak of MERS-CoV and to identify influencing factors in order to provide basic information for lowering and preventing the level of burnout. Methods Study participants were ED nurses working in eight hospitals designated for treating MERS-CoV-infected patients in Korea. We performed multiple regression analysis to explore the factors influencing burnout. Results The ED nurses' burnout was affected by job stress (β = 0.59, p

Aims and objectives The aim of this study was to survey nursing students’ Middle East respiratory syndrome–related knowledge, preventive behaviours and risk perception to examine the correlations among the variables during a Middle East respiratory syndrome outbreak. Background Middle East respiratory syndrome is a new viral respiratory illness. Nursing students who engage in clinical practice at hospitals may have been exposed to Middle East respiratory syndrome infection during the Middle East respiratory syndrome outbreak. Design This study was a descriptive cross-sectional survey. Methods Participants (n = 249) were nursing students in their third or fourth year of the programme who were engaged in clinical practice for eight hours per day at the tertiary hospitals with Middle East respiratory syndrome patients. Knowledge, preventive behaviours and risk perception related to Middle East respiratory syndrome were measured using scales developed through a preliminary survey and validity testing. Results The subjects’ knowledge level of Middle East respiratory syndrome was 84·4%; their practice of preventive behaviours was rated at 44·5%; and their risk perception rating was 2·4 out of 5. Middle East respiratory syndrome–related risk perception was significantly different according to gender and Middle East respiratory syndrome education. Middle East respiratory syndrome–related knowledge was significantly correlated with preventive behaviours and risk perception. Conclusion Considering the low scores for items regarding knowledge and preventive behaviours, it is necessary to develop effective and systematic publicity and education programmes for nursing students. Enhancing Middle East respiratory syndrome–related knowledge by considering cooperation between hospitals and universities will sharpen nursing students’ risk perception of the disease and effectively increase their preventive behaviours. Relevance to clinical practice Similar to other emerging infectious diseases, Middle East respiratory syndrome outbreaks may occur in other countries. The results of this study can be used to develop and apply efficient and feasible Middle East respiratory syndrome education programmes for nursing students during Middle East respiratory syndrome outbreaks.

Background: Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. Objective: The objective of this study was to explore emergency nurses’ ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome–coronavirus in Korea. Design and sample: For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome–coronavirus patients in the capital area. Methods: Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. Results: The findings of this study suggest that during the Middle East respiratory syndrome–coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses’ ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. Conclusion: Through this study, we obtained information on emergency nurses’ ethical problems during the Middle East respiratory syndrome–coronavirus outbreak and identified the factors that influence them. As found in this study, nurses’ ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers.

Aims and objectives To investigate the current state of face-to-face bullying and cyberbullying among nurses in the workplace and to identify the effects of nursing organisational culture on face-to-face bullying and cyberbullying. Background It is important to accurately examine the current state of workplace bullying to acknowledge the gravity of the situation faced by nurses and devise prevention strategies. Electronic communication by computer or smartphone is widely used as a prompt and efficient means of facilitating nursing work; however, this leads to the possibility of cyberbullying as well as face-to-face bullying among nurses. Design Descriptive cross-sectional study. Methods A total of 226 staff nurses working in one of five upper tertiary hospitals in Korea with a career of 10 years or shorter were surveyed using a self-reported questionnaire. The collected data were evaluated using various statistical analyses, including hierarchical regression. Our study was applied to the STROBE checklist of items. Results The mean face-to-face bullying score was 1.32 ± 0.53 and the cyberbullying score was 1.14 ± 0.37 (possible range: 1-5); most were work-related negative experiences. The explanatory power of nursing organisational culture for face-to-face bullying was 6.3%, and relation-oriented culture and hierarchy-oriented culture were major factors affecting face-to-face bullying. The explanatory power of nursing organisational culture for cyberbullying was 4.3%, and relation-oriented culture was a major factor affecting cyberbullying. Conclusions Relation-oriented culture had a significant effect on both face-to-face bullying and cyberbullying. Therefore, organisations should strive to foster a relation-oriented nursing organisational culture in order to prevent and resolve workplace bullying among nurses. Relevance to clinical practice Cyberbullying should be addressed as an important type of workplace bullying in nursing, which occurs via various information and communication devices. To prevent workplace bullying among nurses, various strategies that promote relation-oriented nursing organisational cultures should be considered.

This study was performed to investigate the factors associated with preventive behaviors in the overuse and misuse of antibiotics in Korean nursing students. Knowledge was found to be an important variable in eliciting preventive behaviors in antibiotic overuse and misuse; however, information in one's family or personal medical history negatively affected such behaviors. Preventive behaviors in the overuse and misuse of antibiotics are important for nursing students, as future health professionals.

PURPOSE The purpose of this study is to investigate the conditions and influencing factors behind infection prevention self-care behaviors performed at home by hematologic cancer patients with a central venous catheter inserted before hospital discharge, and to identify additional external factors influencing these self-care behaviors. METHODS This is a descriptive survey study conducted with 147 patients with hematologic cancer who were hospitalized and re-admitted to a university hospital in Korea. Infection prevention self-care behaviors, knowledge, and family support were measured using scales developed through a preliminary survey and validity testing. RESULTS The score for infection prevention self-care behaviors was 3.67 ± 0.81 (out of 5), knowledge was 68.8 ± 18.2 (out of 100), and family support was 4.21 ± 2.14 (out of 7). Infection prevention self-care knowledge (β = 0.443, p

The aim of this study was to evaluate the competency level of Korean infection control nurses (ICNs) by comparing the self-perceived competency level based on Benner's framework and the core competency proposed by the Certification Board of Infection Control. Study subjects included 90 ICNs working in Korean hospitals with more than 300 beds. A questionnaire was used to measure self-perceived competency level and core competency level. Using descriptive analysis, the core competency level of ICNs was found to differ significantly according to self-perceived competency level, and core competency level showed a significant increase with the increase of self-perceived competency level. Self-perceived competency level could be useful in classifying the competency level of nursing specialties. These results illustrate the competency levels of Korean ICNs and could serve as a reference to evaluate and expand the application of competency measurement not only for ICNs but also other groups of nurse specialists.

This study was conducted to investigate the level of knowledge about and practice of respiratory hygiene/cough etiquette among the general population of Korea and to identify the factors that may influence the practice of respiratory hygiene and cough etiquette. The mean correct answer rate for knowledge of respiratory hygiene/cough etiquette was 56.1%. Predictors of respiratory hygiene/cough etiquette practice were carrying a handkerchief or tissues, prior education on respiratory hygiene/cough etiquette, awareness level of respiratory hygiene/cough etiquette, daily frequency of handwashing, and knowledge level of respiratory hygiene/cough etiquette.

To identify the measles vaccination status of nurses, their knowledge and health beliefs about measles, and the associated factors that influence their measles vaccination status during a community measles outbreak in South Korea.The participants were 156 nurses from four hospitals in a region where a community measles outbreak occurred.The measles vaccination rate of the nurses was 73.7%. The nurses' health belief score about measles was 2.44 out of 4 and their knowledge score was 73.85 out of 100. The associated factors that influenced the nurses' measles vaccination status included their experience of caring for patients with measles and a low level of perceived barriers to vaccination.In order to encourage an increased measles vaccination rate in nurses, hospitals should screen susceptible nurses and offer vaccination. Effective measles vaccination campaigns and educational programs are also required in hospitals.

Background This study investigated the self-perceived infection control (IC) knowledge and practice levels of professional standards competency (PSC) among Korean infection control nurses (ICNs) to identify factors that may influence PSC. Methods Using a self-reporting questionnaire method, we collected data from a total of 104 ICNs. Results The average self-perceived IC knowledge level was 3.1 ± 0.8, with hand hygiene scoring the highest at 3.7 ± 0.8. The total proportion of responders who did not meet the expected standard in 4 future-oriented domains was 51.7%. Of the 4 domains, technology had the highest number of respondents meeting the desired standard (57%). There were significant differences in self-perceived levels of PSC in relation to ICN specialist certification and continuing education (eg, extra coursework, conference attendance) in the field. Self-perceived practice levels of PSC also were significantly correlated with age, years of total clinical experience, years of ICN experience, hospital bed count, and IC knowledge. Predictors of self-perceived practice levels of PSC were knowledge and years of ICN experience. Conclusion Educational programs are needed to promote knowledge and competency, the lack of which was recognized by the ICNs. Also, various efforts are needed to prevent turnover of ICNs with a high level of competency.

Purpose The aim of this study was to assess the awareness and practice of wound disinfection among Korean wound care nurses. Subjects and setting The target sample comprised 100 members of the Korea Wound Ostomy Continence Nurse Association. Seventy-eight wound care nurses responded to the questionnaire, yielding a response rate of 78%. Methods Potential respondents were contacted via e-mail and asked to complete a questionnaire designed for this study. Results Pressure ulcers were the most common wound type managed by WOC nurses, followed by surgical wounds. The mean score of items measuring awareness of wound disinfection practice and reported wound disinfection practice were 3.38 on a scale of 0 to 4 scale, and 3.14 on a scale of 0 to 4, respectively. Scores among items that queried awareness and practice in various methods for disinfecting a chronic wound disinfection were highest (3.74 and 3.67 out of 4, respectively) and scores of items querying disinfection with sodium hypochlorite were lowest (2.80 and 2.05 out of 4, respectively). There were significant differences between all items of awareness and reported practice except for disinfection with alcohol. Awareness of wound disinfection significantly correlated with reported practice. Conclusions Developing an effective educational program to enhance awareness is necessary to improve practice of wound disinfection.

Although bed rest is recommended after spinal anesthesia to prevent the occurrence of post-dural puncture headache, current literature suggests that periods of bed rest did not prevent headache as well as increase the risk of other complications such as backache. However, information is scarce regarding an appropriate period of bed rest following a dural puncture.The aim of this study was to compare the incidence of post-dural puncture headache and backache after different periods of bed rest following spinal anesthesia.This study was a pragmatic, parallel-group, blinded, and randomized controlled trial (trial registration number KCT0001797). A total of 119 patients who underwent surgery under spinal anesthesia participated in this study from December 2013 to June 2014. The participants were randomly allocated to three groups: the immediate mobilization group (n = 45), 4-hour bed rest group (n = 40), and 6-hour bed rest group (n = 34). The severity of headache and backache was measured using the Dittmann scale and a visual analogue scale, respectively. Data were collected for 5 consecutive days postoperatively by one researcher blind to the group allocation.No significant difference in the incidence of headache among the three groups was detected. However, the incidence of backache in the 6-hour bed rest group was higher and was significantly more severe than the other groups.Bed rest after spinal anesthesia did not prevent the occurrence of headache and increased the incidence of patients experiencing a backache and, therefore, is not recommended. The findings provide information for establishing evidence-based nursing practices for patients after a dural puncture.

AIMS AND OBJECTIVES: The objective was to survey the current state of human papillomavirus (HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27). BACKGROUND: Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical anal and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore motivation to receive human papillomavirus vaccination is needed to protect infection. DESIGN: Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea. METHODS: Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge health beliefs demographic and sexual history information variables relating to intentions to vaccinate were assessed. RESULTS: The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination. CONCLUSIONS: To promote human papillomavirus vaccination educational programming targeting males should include health beliefs and knowledge emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases. RELEVANCE TO CLINICAL PRACTICE: Male high school students should be included as a major target population for school human papillomavirus education programmes as they are at the age of commencing sexual intercourse. In addition public health policies including human papillomavirus vaccination in the national immunisation programme are warranted. (c) 2016 John Wiley & Sons Ltd.

This study was conducted in order to examine the intention of mothers to vaccinate their teenaged children against human papillomavirus (HPV) infection, according to the children's sex. Based on the theory of planned behavior, the study identified the sex-specific predictors of mothers' intention to vaccinate their teenaged children against HPV.This was a descriptive survey study that included, as participants, 200 mothers whose teenaged children were not vaccinated against HPV.The mothers' experience with HPV vaccination was a significant predictor of their childrens' HPV vaccination status. For the mothers of sons, subjective norms, attitudes, and perceived behavioral control were found to be significant predictors of intention of HPV vaccination, with an explanatory power of 69.5%. For those with daughters, only attitudes and subjective norms were significant predictors, with an explanatory power of 79.6%.The application of the theory of planned behavior is an effective method to determine the predictors of children's HPV vaccination status. In order to improve the HPV vaccination rate of teenaged children, strategies for education and effective promotion that involve mothers should be developed.

Background Middle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging infectious disease introduced in South Korea in 2015, spreads quickly through hospitals, and Korea became one of the major areas affected by the disease after the Middle East region. To stop the spread of an emerging disease, it is important to practice prevention guidelines correctly. Objectives The purpose of this study was to investigate factors influencing preventive behavior against MERS-CoV among Korean nursing students. Methods This is a cross-sectional study using a questionnaire survey. Data were collected from 429 nursing students from three colleges of nursing in Korea from June 25 to July 3 in 2015. Results Preventive behavior against MERS-CoV was affected mostly by attitude (β = .243, p, Highlights • Middle East Respiratory Syndrome Coronavirus spreads quickly in Korea in 2015. • To stop the spread of an emerging disease, it is important to practice prevention. • Preventive behavior against an emerging disease was affected mostly by attitude. • It's crucial to educate nursing students recognize the importance of preventive behavior.

The purpose of this study was to identify factors predicting clinical nurses' willingness to care for Ebola virus disease (EVD)-infected patients. Data were collected from 179 nurses employed at 10 hospitals in Korea using self-reporting questionnaires. Only 26.8% of the participants were willing to care for EVD-infected patients. Factors predicting their willingness to provide care were their belief in public service, risk perception, and age. Nurses' willingness to provide care was high when their belief in public service was high, low when their risk perception was high, and low as their age increased. In order to strengthen nurses' willingness to care for EVD-infected patients, education that targets the enhancement of belief in public service should be included in nurse training. Efforts should be directed toward lowering EVD risk perception and developing systematic responses through government-led organized support.

To investigate the status of hepatitis A vaccination, knowledge, and health beliefs among university students in Korea and identify factors influencing their hepatitis A vaccination rate.A self-reporting survey was conducted with 367 university students in Korea via descriptive survey. Data were collected on demographics, status of hepatitis A vaccination, knowledge, and health beliefs.The hepatitis A vaccination rate was 23.4%. The hepatitis A vaccination rate was significantly higher in those who had a general awareness about the hepatitis A (odds ratio [OR] = 3.56, P = 0.003), those with some overseas travel experience (OR = 2.64, P = 0.025), those perceiving the benefits of hepatitis A vaccination (OR = 1.66, P = 0.023), and those perceiving barriers (inversed) to hepatitis A vaccination (OR = 1.95, P = 0.011).To promote hepatitis A vaccination among university students, information and education should be provided to improve their health beliefs. In addition, this demographic should be a major target population for hepatitis A vaccination. This study's results suggest that the development of national promotional campaigns and hepatitis A vaccination programs based on predictors of the vaccination rate are needed.

Background Job embeddedness indicates the degree to which an employee of an organization intends to remain in his or her position at that organization. This study examined how job embeddedness affects infection control nurses' turnover intention along with general characteristics, job satisfaction, and perceived job alternatives. Methods We collected data from a total of 133 infection control nurses using self-reporting questionnaire methods. All questions were answered on a 5-point Likert scale. Results The average turnover intention was 3.01 ± 0.72 (100-point conversion, 60.2%), and average job satisfaction was 3.48 ± 0.79 (100-point conversion, 69.6%). The average perceived availability of job alternatives was 3.02 ± 0.78 (100-point conversion, 60.4%), and average job embeddedness was 3.33 ± 0.57 (100-point conversion, 66.6%). Predictors of turnover intention were monthly income, perceived availability of job alternatives, and job embeddedness. Job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Conclusion Through this study we identified predictors of turnover intention and found that job embeddedness among predictors has high explanatory power as a predictor of infection control nurses' turnover intention. Strategies to enhance infection control nurses' job embeddedness are needed.

A Middle East respiratory coronavirus (MERS-CoV) outbreak occurred in Korea between June 20 and July 28, 2015. A total of 186 patients were confirmed as being infected with MERS-CoV, 36 of whom died. Infection control nurses referred to hospital guidelines to address the screening and isolation needs of patients and instigated a variety of infection control activities to prevent MERS-CoV transmission at the frontlines of patient care. Their concerted effort is believed to have been instrumental in ending the outbreak.

The purpose of the current study was to identify gender-specific factors influencing diabetes self-care behaviors and health-related quality of life among older adults with type 2 diabetes in South Korea. This is a secondary analysis using data from 278 older adults (77 women, 201 men) with type 2 diabetes. An independent t test and hierarchical multiple regression analyses were used to analyze the data. No significant mean differences in diabetes self-care behaviors and health-related quality of life were observed according to gender. Regarding predictors by gender, the number of diabetes-related complications was a unique predictor of diabetes self-care behaviors in older men, whereas duration of diabetes and barriers were unique predictors in older women. Depression was a significant common predictor of health-related quality of life in older men and women. Nurses should be aware of and consider gender specificity when developing intervention programs for promoting self-care behaviors and health-related quality of life. [Res Gerontol Nurs. 2015; 8(5):231–239.]

Purpose To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP). Methods Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated. Results In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695). Conclusion Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.

Background Costs of postexposure treatment of sharps injuries (SIs) in health care workers (HCWs) are an economic burden in many countries. This study analyzed the costs associated with SIs in HCWs in the Republic of Korea. Methods Between October 1, 2005, and February 28, 2006, general information on SIs among HCWs and the direct costs (eg, laboratory, pharmacy, medical and surgical treatments) and indirect costs eg, (loss of working days) were collected prospectively from 34 hospitals nationwide. Results A total of 700 SIs were documented, 505 of which (72.1%) generated costs. The average costs per SI were pharmacy, 123,091 won (US$129); laboratory tests, 66,958 won ($70); medical services, 26,332 won ($28); and medical treatments, 9,377 won ($10). The average costs of preventive measures were 160,274 won ($168) for hepatitis B virus (HBV), 127,858 won ($134) for hepatitis C virus (HCV), and 139,552 won ($146) for HIV. Of the laboratory tests, 32.9% were HBV-related, 29.4% were HCV-related, and 19.8% were HIV-related. Of postexposure prophylaxes, 34.9% were HB immunoglobulin and 31.4% were HBV vaccines. We estimated that 7,057.5 SIs generated costs, at a total annual cost of 844,587,577 won ($884,385). Conclusions The direct costs of managing SIs among HCWs constitute an economic burden in Korea. More aggressive and comprehensive preventive measures of SIs should be adopted.

Purpose: To develop a web-based program on blood-borne infection control and to examine the effect of the newly developed program on perceived threat of diseases, knowledge, preventive health behaviors for blood-borne infections, and incidence rates of accidental needle sticks and other sharp object injuries in nurses. Methods: The program was developed through the processes of analysis, design, development, implementation, and evaluation. The research design involved a nonequivalent control group for pretest and posttest experiments. The setting was a 745-bed general hospital located in Korea. Results: The program was designed and developed after consulting previous studies. After development of the program was completed, it was evaluated and revised by a panel of experts. The total score for perceived threat of diseases, knowledge, preventive health behaviors in the experimental group was significantly higher compared to the control group (p

Purpose: The purpose of this study was to compare 1% chlorhexidine-gluconate/61% ethanol (CHG/Ethanol) emollient and 7.5% povidone-iodine (PVI) scrub for antimicrobial,residual effect, and skin condition. Method: CHG/Ethanol emollient hand hygiene was performed waterless, and brushless by operating doctors and nurses (N=20). PVI hand washing was performed with water and a brush (N=20) for 5 min. The subjects were asked to press their left hand in hand-shaped agar before a surgical scrub, immediately after a surgical scrub and after the operation. The amount of isolated microorganisms were calculated by counting the number of divided areas(1×1 cm, 160 cell) which were culture positive in the hand culture plate. The skin condition was evaluated. Result: The antimicrobial count of CHG/Ethanol emollient and PVI immediately post surgical scrub was 0.0 vs. 4.1 (p>.05), and after the operation was 0.1 vs. 37.8 (p>.05)respectively. The Residual effect of CHG/Ethanol emollient immediately post surgical scrub and after the operation were 0.0 vs. 0.1 (p>.05), and PVI were 4.1 vs. 37.8 (p>.05)respectively. The skin condition and satisfaction of CHG/Ethanol emollient was higher than PVI (p

Summary Purpose The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. Methods In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. Results Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. Conclusions A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.

summary Purpose: This study was performed to analyze the characteristics and trends of published research papers related to infection control in Korean nursing journals. Methods: A total of 177 studies published between 1970 and 2011 were reviewed using analysis criteria. Subject articles were selected through KoreaMed and journal database searches on the website of subject academic societies using key words related to healthcare-associated infections. Results: Most reports were quantitative studies and the majority of them were descriptive studies. The most common subjects of research were infection control measures for pathogens, followed by disinfection and sterilization, and hand hygiene. Among them, the most descriptive studies were conducted on the knowledge, attitude, and performance of infection control. Theoretical framework, criteria for sample size and ethical consideration were rarely presented in quantitative studies. Conclusions: To enhance the quality of infection control studies and establish infection control studies as a nursing knowledge body, meta-analyses and systematic literature reviews as well as quantitative studies are needed. Moreover, studies employing behavioral science to identify factors influencing the level of knowledge and practice and to change infection control behaviors are also warranted.