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Background: In light of the rising incidence of mild cognitive impairment in women, an appropriate cognitive reserve enhancement program is urgently needed for women experiencing climacteric symptoms., Purpose: The purpose of this study was to develop a cognitive reserve enhancement program for climacteric women based on cognitive reserve theory (CRT) and to verify its effectiveness., Methods: A nonequivalence control group, pre- and post-quasi-experimental design was used. The 58 climacteric women with subjective memory deterioration enrolled as participants were divided into the experimental group (28 women), which received a 24-session CRT-based cognitive reserve enhance program, and the control group (30 women), the members of which received the cognitive training via a mobile application after completion of the study. Valid data from 24 experimental and 26 control participants were available for analysis. Objective cognitive functions, including overall cognitive, memory, attention, and language, were measured pretest and posttest using the following tools: Everyday Cognition Scale (subjective cognitive function), Center for Epidemiologic Studies Depression Scale (depression), and World Health Organization Quality of Life-Brief Version (quality of life)., Results: The experimental group showed a statistically significant increase in overall cognitive function (t = 3.82, p = .001), memory (t = 2.63, p = .012), attention: number of correct answers (t = 2.12, p = .040), language high-frequency response speed (Z = -2.49, p = .013), and language low-frequency response speed (Z = -2.77, p = .006) in objective cognitive function after 8 weeks in comparison to the control group., Conclusions/implications for Practice: The intervention program tested in this study to enhance cognitive reserve in climacteric women includes cognitive training, emotional and social support, and group physical activity components was found to be effective in enhancing cognitive function., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Purpose: The purpose of this study was to explore the experience of living with mothers with schizophrenia from childhood to the present from the perspective of their now-adult child., Methods: Individual interviews were conducted with 10 adult children of mothers with schizophrenia. The data were collected in South Korea from July 2017 to March 2018 and thematic analysis was employed. Purposive sampling was used., Results: Four themes were identified: (1) Navigating Childhood Confusion and Isolation Due to Maternal Schizophrenia, (2) Journey Through Loneliness, Resentment, and Emerging Responsibility, (3) Facing real-life difficulties as an adult child with vulnerability, and (4) Satisfaction in well-grown self., Conclusions: Notwithstanding the real-life difficulties due to the unstable life with their mothers with schizophrenia, the children still had faith and confidence in themselves as well-grown thus far. Reflection on memories with their mothers served as a basis for continued maternal-child relationship and for taking on the role of guardians despite the negative experiences of their mothers' psychotic symptoms. Mental health nurses and school health professionals should pay attention to the children of mothers with schizophrenia and their difficulties in providing appropriate mental health services., Competing Interests: Conflict of interest The authors declared no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Clinical nurse educators (CNEs), responsible for nursing education, have begun to address unresolved issues in nursing education overlooked by preceptorship. However, research on this topic is lacking in South Korea, despite the government's 2019 launch of the CNE support project. This study explored the role experience of CNE in South Korea, focusing on their role challenges and the process of overcoming them. Fifteen CNEs from tertiary or secondary general hospitals in South Korea participated in semi-structured, in-depth interviews conducted between August and December 2023. Interviews were recorded and transcribed for conventional content analysis. Four categories emerged: challenges in the role of CNE, personal strategies for growth as a CNE, external support systems for growth as a CNE, and role evolution and emerging challenges for CNEs. This study demonstrates previously unexplored CNE role experiences in South Korea and provides valuable recommendations for enhancing CNE support projects., (© 2024 John Wiley & Sons Australia, Ltd.)

Nurses, as healthcare professionals who frequently interact with older patients in clinical settings, play a crucial role in providing direct care and services to older patients. However, nurses caring for older patients often experience substantial physical and emotional exhaustion, which can trigger a loss of motivation, feelings of helplessness, and burnout. The current study, conducted in Korea, investigated the impact of ageism on burnout among clinical nurses. To determine whether ageism was a significant predictor of nurse burnout, a structured questionnaire was distributed to 332 nurses at two hospitals. Multiple regression analysis then showed that ageism (B = .066, p < .001), female sex (B = .530, p = .003), and lower preference for geriatric nursing (B = .357, p = .002) were significantly associated with burnout. Our findings confirmed that ageism was strongly associated with nurse burnout, suggesting the need to develop interventions or training programs that can change nurses' perception of older people and facilitate emotional change., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: This study aimed to analyze if a multi-foam core mattress with a laminated cover can reduce the incidence of pressure injuries, compared to an alternating air mattress overlay among critically ill patients in acute settings., Design: Prospective observational study., Participants: and setting: Patients with a Braden scale score ≤16 on intensive care unit admission at five general hospitals in Korea were included in this study between February 2022 and March 2022., Methods: One hundred and twenty patients in acute settings were enrolled and categorized into two groups: a multi-form core mattress with a laminated cover group (n = 60) and an alternating air mattress overlay group (n = 60). Data were collected for 7 days by wound care nurses., Results: Pressure injury developed at a significantly lower rate in the multi-form core mattress with a laminated cover group (n = 4/60, 6.7 %) than in the alternating air mattress overlay group (n = 25/60, 25.0 %) (P = 0.011). Using a multi-foam core mattress with a laminated cover demonstrated a protective effect against pressure injuries (odds ratio 0.123, 95 % confidence interval 0.024-0.620, P = 0.011)., Conclusions: A multi-foam core mattress with a laminated cover was significantly more effective than an alternating air mattress overlay in preventing pressure injury in critically ill patients., (Copyright © 2024 Tissue Viability Society / Society of Tissue Viability. Published by Elsevier Ltd. All rights reserved.)

Nursing students' negative perceptions of and reduced interest in individuals experiencing mental health challenges could lead to problems such as deteriorating quality of mental health nursing and lack of competent, qualified mental health nurses. Promoting changes and developments in mental health nursing education for greater effectiveness is pivotal. This study aimed to develop, introduce and validate a blended learning service user involvement programme for mental health nursing education-the first of its kind in South Korea. This study is reported according to TREND guidelines. The experimental group's scores for attitudes and empathy with individuals experiencing mental health challenges increased significantly after taking the 6-week service user involvement class. The experimental group achieved higher scores for knowledge of mental health nursing, satisfaction, and confidence in performance than the control group, which attended a traditional-style class. However, no significant difference was found between groups in changes in attitudes towards and empathy with individuals experiencing mental health challenges. The service user involvement class could improve some students' knowledge of mental health nursing and confidence, but providing the course in a single semester is not sufficient to improve students' attitudes towards and empathy with individuals experiencing mental health challenges. Therefore, an appropriate approach to more systematic long-term planning should be developed, and public perception should be improved. Additionally, long-term studies should evaluate the sustainability and progression of changes in attitudes and empathy over time. We recommend developing mental health nursing education programmes with diverse designs and structures., (© 2024 John Wiley & Sons Australia, Ltd.)

Triage is the process of prioritizing patients in the emergency department (ED). This has a pivotal role in ensuring patient safety and that the ED operates smoothly; therefore, triage training education is an important aspect of triage nurses' preparedness in different emergency situations. This study employed a quasi-experimental research design using a non-equivalent control group pre-post-test design to verify the effect of the Korean Triage and Acuity Scale (KTAS) education using role-playing on the knowledge of triage, triage performance ability, and triage competency in nursing students. Participants were 78 fourth-year nursing students from Shinseong University in South Korea; 39 were assigned to the experimental group, and 39 to the control group. The intervention was conducted for three weeks, from January 31 to February 16, 2024. The experimental group received KTAS education through role-playing, whereas the control group received triage education through lectures. Triage knowledge (t = 2.94, p = .004) and triage performance ability (t = 3.11, p = .003) were significantly improved in the experimental group. However, there was no significant difference in triage competency between groups (t = 1.32, p = .192). The post-test score of triage record in the experimental group showed a significant improvement over time (t = 0.56, p < .001). This study demonstrated that KTAS education using role-playing was more effective in improving triage knowledge and performance ability than traditional lecture methods for nursing students. Triage education programs should be developed considering the effectiveness of various teaching methods., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Seo, Lim. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aimed to determine the possibility of COVID-19 transmission through in-flight contact during flights for many patients with confirmed COVID-19 during the COVID-19 pandemic and explore infection prevention and control (IPC) methods for overseas infectious diseases. A retrospective cohort study was conducted on flight with a large number of confirmed case among. Delhi- Incheon flights in 2020. This flight was selected to confirm transmission through close contact with the cabin, with a total of 14 confirmed cases out of 190 passengers (including 10 flight attendants). After confirming COVID-19 test results for those entering Korea, we conducted an epidemiological investigation on confirmed patients to determine their general characteristics and epidemiological relevance. We analyzed the epidemiological relevance, occupational information, incubation period, and COVID-19 variation and genotype among confirmed patients who were in close contact with confirmed cases, and analyzed the possibility of transmission according to the distance of close contact in the flight. One confirmed patient was found to be highly likely to be infected due to close contact with the cabin. However, it occurred within two rows, not within 1 meter. In addition, considering the aerodynamics in the cabin and local incidence rate, infection in an unspecified number of local people could not be excluded. It was analyzed that the reason for reducing infection from close contact on board for a long time in a flight with a large number of confirmed cases was the effective IPC method. In order to prevent overseas infectious diseases caused by flights, autonomous IPC management of airlines and passengers is necessary in addition to national quarantine management such as symptom screening before boarding, wearing passenger masks while boarding, food and beverage restrictions, disinfection of public spaces, distancing between passengers, close contact management after boarding, and self-quarantine., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Park, Yeom. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Health literacy plays a crucial role in promoting and maintaining the health of patients with chronic illnesses. Therefore, adequate assessments and the application of interventions based on people's health literacy strengths, needs, and preferences are required to improve health outcomes. This study aimed to evaluate the psychometrical properties of the Health Literacy Questionnaire (HLQ) in Koreans with chronic diseases. Data were collected from 278 patients (57.04±15.22 years) diagnosed with chronic disease, including kidney disease, hypertension, and diabetes, who visited the outpatient clinic of a university hospital from June to December 2020. For validity assessment, construct, convergent, and discriminant validities were evaluated, along with the HLQ reliability using Cronbach's α. One-way analysis of variance was used to evaluate mean differences in the HLQ scale scores based on patients' characteristics. The confirmatory factor analysis (CFA) indicated that all items were loaded on their respective factors. The model fit of a full nine-factor CFA model showed satisfactory or better fit compared with nine one-factor CFA model; χ2WLSMV (866) = 576.596 (p < .001), comparative normed fit index of 1.000 (reference: >0.950), Tucker-Lewis index of 0.981 (reference: >0.950), root mean square error of approximation of 0.066 (reference: <0.080), and standardized root mean square residual of 0.055 (reference: <0.080). All scales demonstrated good to excellent internal consistency (Cronbach's α ≥.757). Sociodemographic characteristic variables with significant score differences in HLQ scores were reported across nine scales, with the level of education and income showing significant score differences in 8 and 6 scales, respectively. This study revealed that the Korean version of the HLQ has many strong measurement properties among patients with chronic diseases. The validation indicated the HLQ as a robust tool that is used cross-culturally and is recommended for use in the Korean population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Seo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

For many years, attempts have been made to incorporate service users into psychiatric nursing education, particularly in European countries and Australia. In Asian countries, however, concrete examples of this are notably scarce, and the limited instances of implementation lack the necessary systematic organisation and long-term sustainability. This study systematically planned and implemented a psychiatric nursing curriculum that integrated service users in Korea. It explored the experiences of 14 nursing students and four service users (who participated as instructors) who participated in these classes. Content analysis was performed on the results of focus group interviews with the participants. Owing to the participation of service users in the programme, students focused more on the patients as human beings, with the contexts of their individual lives, rather than on their diseases. The process facilitated a deeper grasp of person-centred psychiatric nursing and heightened student engagement in the learning process. The service users' experiences as instructors breathed new meaning into their psychiatric distress as an opportunity for new possibilities and helped them view themselves in a positive light, as members of society with self-esteem. They made great efforts to perform well in their role as instructors. These findings provide substantial evidence to support the expanded and sustained implementation of service user participation in future psychiatric nursing education. Establishing a national consortium to foster and support service user instructors could greatly improve psychiatric nursing education and related outcomes., (© 2024 John Wiley & Sons Australia, Ltd.)

Objectives: Our aim in this study was to develop and evaluate a tailored intervention for improving diabetes self-care among people with visual impairment (TID-VI) in South Korea., Methods: The TID-VI program was designed around the barriers, resources, and perceptual factors to promote diabetes self-care in those with visual impairment (VI). A single-arm pilot study was conducted to evaluate the feasibility and preliminary effects of the intervention. Diabetes self-efficacy, self-care behaviours, depression, health-related quality of life, and clinical outcomes (fasting blood glucose, glycated hemoglobin [A1C], lipids, and blood pressure) were measured before and up to 2 months after the 12-week intervention., Results: All 14 participants completed TID-VI. Diabetes self-efficacy, diabetes self-care behaviours, depression, and health-related quality of life showed improvement from baseline that was sustained at 2 months. Although high- and low-density lipoprotein also improved, there were no differences in blood glucose, A1C, total cholesterol, or blood pressure at 2 months., Conclusions: A theory-driven, tailored intervention specific to the needs of adults with VI can produce substantial improvements in patient-reported quality of life and health status outcomes, although the benefits are yet to be confirmed in a controlled study., (Copyright © 2024 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

This study presents a deep learning model to predict phlebitis in patients with peripheral intravenous catheter (PIVC) insertions. Leveraging electronic health record data from 27,532 admissions and 70,293 PIVC events at a hospital in Seoul, South Korea, the study involved analyzing patient demographics, PIVC-specific features, and drug-related information. The developed deep learning model was benchmarked against various machine learning models, demonstrating superior performance with an accuracy of 0.93 and an AUC of 0.89. This highlights its potential as an effective tool for early detection of phlebitis, promising enhanced patient outcomes and healthcare efficiency.

Although the associations between a patient's body mass index (BMI) and metabolic diseases, as well as their breath test results, have been studied, the relationship between breath hydrogen/methane levels and metabolic diseases needs to be further clarified. We aimed to investigate how the composition of exhaled breath gases relates to metabolic disorders, such as diabetes mellitus, dyslipidemia, hypertension, and nonalcoholic fatty liver disease (NAFLD), and their key risk factors. An analysis was performed using the medical records, including the lactulose breath test (LBT) data of patients who visited the Ajou University Medical Center, Suwon, Republic of Korea, between January 2016 and December 2021. The patients were grouped according to four different criteria for LBT hydrogen and methane levels. Of 441 patients, 325 (72.1%) had positive results for methane only (hydrogen < 20 parts per million [ppm] and methane ⩾ 3 ppm). BMIs and NAFLD prevalence were higher in patients with only methane positivity than in patients with hydrogen and methane positivity (hydrogen ⩾ 20 ppm and methane ⩾ 3 ppm). According to a multivariate analysis, the odds ratio of only methane positivity was 2.002 (95% confidence interval [CI]: 1.244-3.221, P = 0.004) for NAFLD. Our results demonstrate that breath methane positivity is related to NAFLD and suggest that increased methane gas on the breath tests has the potential to be an easily measurable biomarker for NAFLD diagnosis., (© 2024 IOP Publishing Ltd.)

Improving teamwork among mental health practitioners is crucial. However, there have been few intervention studies on teamwork enhancement among community mental health practitioners in South Korea. We aimed to determine the effectiveness of the Team Building Circle program (TBC) based on the restorative justice paradigm, which sought to promote integration and cohesion. The TBC was developed to improve conflict interpretation mind-set, interpersonal skills, and teamwork among practitioners in community mental health centers. We conducted a quasi-experimental study using a pre and posttest design with a non-equivalent control group. The participants were 44 practitioners from four community mental health centers. Data were collected before the implementation TBC (pretest), just after (posttest), and 3 months after TBC (follow-up test). A generalized estimating equation model was used for analysis. Our findings indicate that the intervention group had improved scores in the ability to cope with interpersonal stress in a constructive way, interpersonal relationship skills, and teamwork compared to the control group. To improve teamwork among community mental health practitioners, managers are encouraged to consider providing TBC intervention.

This study aims to investigate the mediation effect of narcissism and the mediation effect moderated by gender in the effect of social anxiety on university students' SNS addiction. In this cross-sectional survey, university students, aged 19 to 29 were selected from two provinces in South Korea. The sample size was calculated using G*power 3.1., and a sample of 170 university students was used in the final analysis. To perform the analysis, descriptive statistics; independent t-test, one-way ANOVA, and Pearson's correlation were used. The data collected was statistically analyzed using SPSS Program 23.0 and SPSS PROCESS macro (version 4.0). The moderated mediation effect was significant in both male and female groups. The mediation effect of narcissism on the relationship between social anxiety and SNS addiction proneness was stronger in the female group than in the male group. The findings have the potential to provide substantial basic data for developing health promotion and education programs to reduce university students' social anxiety, narcissism, and SNS addiction., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jin Pyo Lee. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study investigated the relationship between self-determination, physical health status, and Health related Quality of Life (=HRQoL) among living kidney donors. A descriptive survey was conducted between 2019 and 2020 and included 111 kidney donors. Data were collected using a self-report questionnaire on general and donation-related characteristics, self-determination, and HRQoL. The data also included medical records reflecting the physical health status at the time of the survey. Data were analyzed using a multiple regression model. Factors associated with HRQoL were perceived health recovery after donation (β = 0.42, P < .001), up to 1 year since donation (β = 0.33, P = .008), more than 1 up to 5 years since donation (β = 0.52, P < .001), more than 5 up to 10 years since donation (β = 0.53, P < .001), and competence of self-determination (β = 0.23, P = .033). The explanatory power of these variables was 43.3%. HRQoL of living kidney donors can be affected by subjective and psychological factors. Therefore, health care providers should help living kidney donors have high self-determination during pre and post donation and concentrate on the subjective and psychological factors as well as objective health status., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Smoking ban policies (SBPs) are potent health interventions and offer the potential to influence antismoking behavior. The Korean government completely prohibited smoking in indoor sports facilities, including billiard halls, since the government revised the National Health Promotion Act in December 2017., Objective: This study aimed to examine the impact of the SBP on the economic outcomes of indoor sports facilities, particularly billiard halls., Methods: This study used credit card sales data from the largest card company in South Korea. Data are from January 2017 to December 2018. Monthly sales data were examined across 23 administrative neighborhoods in Seoul, the capital city of South Korea. We conducted the interrupted time series model using the fixed effects model and the linear regression with panel-corrected standard errors (PCSE)., Results: The sales and transactions of billiard halls were not significantly changed after the introduction of the SBP in the full PCSE models. The R2 of the full PCSE model was 0.967 for sales and 0.981 for transactions., Conclusions: The introduction of the SBP did not result in substantial economic gains or losses in the sales of billiard halls. In addition to existing price-based policies, the enhanced SBP in public-use facilities, such as billiard halls, can have a positive synergistic effect on reducing smoking prevalence and preventing secondhand smoke. Health policy makers can actively expand the application of SBPs and make an effort to enhance social awareness regarding the necessity and benefits of public SBPs for both smokers and the owners of hospitality facilities., (©Jin-Won Noh, Jooyoung Cheon, Hohyun Seong, Young Dae Kwon, Ki-Bong Yoo. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 17.04.2024.)

Background: During the height of the COVID-19 pandemic, the Korean government temporarily allowed full scale telehealth care for safety and usability. However, limited studies have evaluated the impact of telehealth by analyzing the physical and/or mental health data of patients with COVID-19 diagnosis collected through telehealth targeting Korean population., Objective: This study aimed to identify subgroup of depressive symptom trajectories in patients with clinically mild COVID-19 using collected longitudinal data from a telehealth-based contactless clinical trial., Methods: A total of 199 patients with COVID-19 were accrued for contactless clinical trial using telehealth from March 23 to July 20, 2022. Depressive symptoms were measured using the patient health questionnaire-9 on the start day of quarantine, on the final day of quarantine, and 1 month after release from quarantine. Additionally, acute COVID-19 symptoms were assessed every day during quarantine. This study used a latent class mixed model to differentiate subgroups of depressive symptom trajectories and a logistic regression model with Firth's correction to identify associations between acute COVID-19 symptoms and the subgroups., Results: Two latent classes were identified: class 1 with declining linearity at a slow rate and class 2 with increasing linearity. Among COVID-19 symptoms, fever, chest pain, and brain fog 1 month after release from quarantine showed strong associations with class 2 (fever: OR, 19.43, 95% CI, 2.30-165.42; chest pain: OR, 6.55, 95% CI, 1.15-34.61; brain fog: OR, 7.03, 95% CI 2.57-20.95). Sleeping difficulty and gastrointestinal symptoms were also associated with class 2 (gastrointestinal symptoms: OR, 4.76, 95% CI, 1.71-14.21; sleeping difficulty: OR, 3.12, 95% CI, 1.71-14.21)., Conclusion: These findings emphasize the need for the early detection of depressive symptoms in patients in the acute phase of COVID-19 using telemedicine. Active intervention, including digital therapeutics, may help patients with aggravated depressive symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sung, Kim, Kim, Bae and Chie.)

Purpose: This study investigated the effects of prenatal education characteristics, pandemic-related pregnancy stress, and health behaviors during pregnancy on prenatal depression in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic., Methods: The participants were 180 pregnant Korean women, recruited from internet communities for pregnancy preparation, childbirth, and childcare, from July 5 to 15, 2022. The collected data were analyzed using the t-test, analysis of variance, the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple regression analysis., Results: The scores for pandemic-related pregnancy stress (24.50±6.37) and health behaviors during pregnancy (67.07±9.20) were high. Nearly half of the participants (n=89, 49.4%) presented with prenatal depression, with scores of 10 or greater. Prenatal depression had a positive correlation with gestational age (r=.18, p=.019) and pandemic-related pregnancy stress (r=.27, p<.001), and a negative correlation with health behaviors during pregnancy (r=-.42, p<.001). The factors associated with prenatal depression were pandemic-related pregnancy stress (t=4.70, p<.001), marital satisfaction (dissatisfied) (t=3.66, p<.001), pregnancy healthcare practice behaviors (t=-3.31, p=.001), family type (weekend couple) (t=2.84, p=.005), and gestational age (t=2.32, p=.022). The explanatory power of these variables was 38.2%., Conclusion: Since participants had a high level of prenatal depression during the pandemic, and infectious diseases such as COVID-19 may recur, strategies should be developed to improve pregnant women's mental health with consideration of the unique variables that are relevant in a pandemic. It is also necessary to develop efficient online prenatal education programs that can be implemented even in special circumstances such as social distancing, and to evaluate their effectiveness.

Background: Family health significantly affects society and the country. Health problems have been identified as the most important cause of family anxiety and conflict in South Korea. Because valid instruments to measure this concept are limited, using the Assessment of Strategies in Families-Effectiveness scale may provide precious insight into family health and nursing practice., Purpose: This study was designed to translate and validate the Korean version of the Assessment of Strategies in Families-Effectiveness (K-ASF-E) scale. This scale was developed based on the framework of systemic organization for assessment and intervention use in the context of family nursing in South Korea., Methods: A methodological approach was used to verify the validity and reliability of the K-ASF-E. To determine validity, we first invited four experts to evaluate content validity. Next, we collected data from 1,028 participants using stratified random sampling that considered the background of each participant in terms of region, age, and gender. On the basis of the collected data, we determined the construct validity of the scale using exploratory factor analysis and confirmatory factor analysis. Finally, we used Cronbach's alpha and intraclass correlation coefficient analyses to assess scale reliability., Results: The K-ASF-E showed item-level content validity index and scale-level content validity index values of 1.00, as assessed by four experts. Using the principal component analysis method with varimax rotation, the exploratory factor analysis verified the validity of a K-ASF-E scale comprising four dimensions and 20 items, including system maintenance (seven items), system change (four items), coherence (six items), and individuation (three items). For confirmatory factor analysis, the fit indices of the factor structure of K-ASF-E indicate appropriate model fitness. The Cronbach's alpha coefficients for each of the subfactors centered on the target were .59-.86, and the intraclass correlation coefficient (range) was .56-.85., Conclusions/implications for Practice: The K-ASF-E scale is the first attempt to develop a reliable and valid measurement tool for family effectiveness in South Korea. Initial testing was validated using a large number of stratified randomized clusters. The K-ASF-E scale accurately measures family effectiveness and may be used for family-related research, intervention, and training programs in community and clinical settings., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc.)

Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.

Background: Aging breast cancer survivors may be at an elevated risk of cardiovascular disease (CVD), but little is known about CVD risk assessment and breast cancer in Korean women. We hypothesized that Korean breast cancer survivors would have higher risks of future CVD within the next 10 years (i.e., Framingham Risk Score [FRS]) than women without cancer., Objectives: (1) To compare FRS-based CVD risks in women with and without breast cancer based on propensity score matching; and (2) To explore adiposity-related measures in relation to FRS in Korean women with breast cancer., Methods: Using the cross-sectional data from the 2014-2018 Korean National Health and National Survey (KNHANES), we identified 136 women with breast cancer aged 30-74 years who had no other cancer and no CVD. The comparison group of 544 women with no cancer were selected by 1:4 nearest-neighbor propensity score matching based on breast cancer diagnosis. CVD risk was assessed by FRS based on multiple traditional risk factors (e.g., cholesterol, blood pressure, diabetes, and smoking). Adiposity was measured by physical examination, including body mass index (BMI) and waist-to-height ratio (WHtR). Physical activity and health behaviors were assessed by self-reports., Results: Women with breast cancer (mean age of 57 years) had similar FRS levels at a low-risk category (< 10%) to women with no cancer (4.9% vs. 5.5%). Breast cancer survivors (mean 8.5 survival years) presented at significantly lower levels of total cholesterol, BMI, and WHtR (all p values < 0.05) than their counterpart. Within the breast cancer group, WHtR ≥ 0.5 was associated with higher FRS, compared to WHtR < 0.5. FRS was not different by survival < 5 years or ≥ 5 years after breast cancer diagnosis., Conclusions: FRS-based CVD risks were not different in Korean, mostly postmenopausal, women by breast cancer status. Whereas breast cancer survivors had even lower levels of lipid and adiposity measures than women without cancer, those values indicating borderline cardiometabolic risk suggest continued screening and management efforts for these aging women. Future studies are needed to examine longitudinal trajectories of CVD risk factors and CVD outcomes among Korean breast cancer survivors., (© 2023. The Author(s).)

This study aimed to measure unmet healthcare needs and investigate the factors affecting them in female baby boomers (individuals born between 1955 and 1963) using the Korea Health Panel Data 2017 from February to June 2017 by the Korea Institute for Health and Social Affairs and the National Health Insurance Corporation. The data were analyzed using descriptive statistics, chi-square test, t-test, and multiple logistic regression using SPSS WIN 25.0 program. The results showed that the proportion of unmet healthcare needs was 11.1%, and the primary reason for unmet healthcare needs was the lack of visitation time. Female baby boomers experienced more unmet healthcare needs when they had no spouse (1.63 times), eating problems (2.33 times), and stress (1.31 times). This study is significant because it measured the unmet healthcare needs of women in the baby boomer generation and identified the factors influencing unmet healthcare needs. The study's results can help provide essential data to decrease the unmet healthcare needs of female baby boomers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Park, Chung. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Peripheral venous catheterization (PVC) is the most commonly used invasive technique, and its importance to patient safety is increasing. And phlebitis is a common complication which can lead to increased costs and extended hospital stays. This study attempted to characterize the current status of phlebitis based on incident reports in the Korea Patient Safety Reporting & Learning System. This retrospective descriptive study analysed 259 phlebitis cases reported in that system from 1 July 2017 to 31 December 2019. The analysis results were summarized using numbers and percentages or means with standard deviations. Among the reported phlebitis cases, antibiotics and high-osmolarity fluids comprised 48.2% of the intravenous inflammatory drugs used. All reported cases presented blood-flow infections. Insufficient observation or management was the most common cause of phlebitis. It was found that interventions for phlebitis were inconsistent with those recommended in evidence-based guidelines. Recommendations for nurses to alleviate complications in PVC must be promoted and educated. It is necessary to provide feedback from the incident reports analysis.

Objectives: To investigate the association of depressive mood and frailty with mortality and health care utilization (HCU) and identify the coexisting effect of depressive mood and frailty in older adults., Design: A retrospective study using nationwide longitudinal cohort data., Setting and Participants: A total of 27,818 older adults age 66 years from the National Screening Program for Transitional Ages between 2007 and 2008, part of the National Health Insurance Service-Senior cohort., Methods: Depressive mood and frailty were measured by the Geriatric Depression Scale and Timed Up and Go test, respectively. Outcomes were mortality and HCU, including long-term care services (LTCS), hospital admissions, and total length of stay (LOS) from the index date to December 31, 2015. Cox proportional hazards regression and zero-inflated negative binomial regression were performed to identify differences in outcomes by depressive mood and frailty., Results: Participants with depressive mood and frailty represented 50.9% and 2.4%, respectively. The prevalence of mortality and LTCS use in the overall participants was 7.1% and 3.0%, respectively. More than 3 hospital admissions (36.7%) and total LOS above 15 days (53.2%) were the most common. Depressive mood was associated with LTCS use [hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.05-1.42] and hospital admissions [incidence rate ratio (IRR) 1.05, 95% CI 1.02-1.08]. Frailty had associations with mortality risk (HR 1.96, 95% CI 1.44-2.68), LTCS use (HR 4.86, 95% CI 3.45-6.84), and LOS (IRR 1.30, 95% CI 1.06-1.60). The coexistence of depressive mood and frailty was associated with increased LOS (IRR 1.55, 95% CI 1.16-2.07)., Conclusions and Implications: Our findings highlight the need to focus on depressive mood and frailty to reduce mortality and HCU. Identifying combined problems in older adults may contribute to healthy aging by reducing adverse health outcomes and the burden of health care costs., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to identify whether differences exist in postpartum depression (PPD) in US and Korean nurses and its related factors. Identifying occupational and personal factors that underlie potential differences will be helpful for women's occupational health., Methods: Baseline and postpartum survey data from employed nurses in the Korea Nurses' Health Study and Nurses' Health Study 3 (1244 Korean; 2742 US nurses) were analysed. Postpartum data collection was done via online survey. PPD was analysed based on cultural validation from prior studies using the Edinburgh Postnatal Depression Scale (cut-off of 10 for Korea and 13 for USA); depressive symptoms prior to pregnancy and childbirth, general characteristics and sleep satisfaction were also measured. Descriptive statistics, χ 2 tests and t-tests and multivariate ordinal logistic regression analysis were performed., Results: 45.9% of Korean participants had clinical symptoms of PPD (≥10), whereas US participants presented with 3.4% (≥13). Prior depressive symptoms were also higher in Korean participants (22.5%) compared with their US counterparts (4.5%). Prior depressive symptoms and poor sleep satisfaction were significant risk factors of PPD in both cohort groups, and vaginal birth was an additional influencing factor in Korean participants., Conclusions: Differences in PPD rates and related factors suggest the role of stress, cultural variation and differing work systems. Nurses and other women shift-workers noted to have depressive symptoms before and during pregnancy and exhibit PPD symptoms should especially be followed closely and offered supportive mental health services that include greater flexibility in returning to work., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The COVID-19 pandemic has transformed undergraduate education into non-face-to-face classes, and a novel methodology is required to aid students in career preparation behavior (CPB). This study aimed to assess the effects of self-rated abilities for health practices (SRAHP) as a psychological attribute and health-promoting lifestyle profile (HPLP) as a behavioral attribute in the dynamics between positive psychological capital (PPC) and CPB among undergraduate students taking non-face-to-face classes. A cross-sectional study was conducted involving 639 undergraduate students taking non-face-to-face classes; data were obtained via online survey in January 2022. A significant positive effect on CPB was observed for PPC ( b  = 0.261, p  < .001) and HPLP ( b  = 0.674, p  < .001). The effect of SRAHP on CPB was not significant; however, it mitigated the PPC-CPB dynamics ( b  = -.081, p  < .05) and strengthened the relationship between HPLP and CPB ( b  = .250, p  < .001). Lastly, the mediating effects after moderation for HPLP and SRAHP were positive, with statistical significance. To aid the students with career preparation in the current undergraduate education environment moving toward a non-face-to-face model, there is a need for resources to increase students' psychological confidence regarding health management and to promote their health practices.

Purpose: This study aims to suggest the number of test items in each of 8 nursing activity categories of the Korean Nursing Licensing Examination, which comprises 134 activity statements including 275 items. The examination will be able to evaluate the minimum ability that nursing graduates must have to perform their duties., Methods: Two opinion surveys involving the members of 7 academic societies were conducted from March 19 to May 14, 2021. The survey results were reviewed by members of 4 expert associations from May 21 to June 4, 2021. The results for revised numbers of items in each category were compared with those reported by Tak and his colleagues and the National Council License Examination for Registered Nurses of the United States., Results: Based on 2 opinion surveys and previous studies, the suggestions for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination in this study are as follows: 50 items for management of care and improvement of professionalism, 33 items for safety and infection control, 40 items for management of potential risk, 28 items for basic care, 47 items for physiological integrity and maintenance, 33 items for pharmacological and parenteral therapies, 24 items for psychosocial integrity and maintenance, and 20 items for health promotion and maintenance. Twenty other items related to health and medical laws were not included due to their mandatory status., Conclusion: These suggestions for the number of test items for each activity category will be helpful in developing new items for the Korean Nursing Licensing Examination.

Regular health checkups allow early treatment when problems occur and prevent disease progression, but the rate of health checkups among young adults is low. This study aimed to investigate the factors affecting the intentions to receive health checkups among young adults in their 20s in Korea. The study design was a descriptive cross-sectional study and examined their intentions to receive health checkups, their health beliefs (perceived sensitivity, perceived severity, perceived benefit, perceived barrier, cue to action, self-efficacy), their attitude toward health checkups, and their knowledge of health checkups. The participants were 252 adults in their 20s in South Korea who were eligible for national health checkups. The intentions to receive check-ups model identified five variables, including sex, perceived sensitivity, cue to action, self-efficacy, and attitudes toward health checkups, were as significant influencing factors for the intentions to receive health checkups with 51.0% explanatory power (F = 53.18, p < 0.001). Different approaches must be adopted according to past experiences with health checkups when attempting to improve the intentions to receive health checkups in young adults.

Objective: Quarantine is the first response to the COVID-19 pandemic. Restricting daily life can cause several problems. This study aimed to measure the impact of the COVID-19 quarantine on health-related quality of life (HRQoL) by comparing to the pre-pandemic., Methods: HRQoL during COVID-19 quarantine was surveyed online using EQ-5D index and matched to that of the pre-pandemic-extracted from nationwide representative data of the Korea Community Health Survey- with propensity scores. A beta regression for the EQ-5D scores and a logistic analysis for individual dimensions of the EQ-5D index were performed to measure the impact of the COVID-19 quarantine on health utility., Results: The overall scores of the EQ-5D index were significantly higher in the group under quarantine during the COVID-19 pandemic (0.971 SD 0.064) than those before the pandemic (0.964 SD 0.079, Diff. 0.007 SD 0.101, p = 0.043). The beta regression for the overall scores of EQ-5D revealed that quarantining during the COVID-19 pandemic increased by 52.7% compared to normal life before the outbreak(p = 0.045). Specifically, "Depression/Anxiety" deteriorated significantly during quarantining (OR = 0.62, 95% CI:0.48-0.80). However, "Pain/Discomfort" and "Mobility" significantly improved (OR = 5.37, 95% CI:3.71-7.78 and OR = 2.05, 95% CI:1.11-3.80, respectively)., Conclusion: Although the world is facing a challenging moment that it has never been through before, mandatory quarantine has served as an experience that provided mental distress but physical comfort in the Korean context., (© 2022. The Author(s).)

Objectives: To analyze the association between chronotype, tobacco use or alcohol use, and high-risk drinking by age group and examine the differences across groups., Methods: A cross-sectional descriptive study design was adopted. Data from 12,189 participants aged ≥ 12 years from 2016 to 2017, excluding shift workers, were gathered from the Korea Disease Control and Prevention Agency's Seventh Korea National Health and Nutrition Examination Survey. A general linear model was used to determine the aforementioned associations and differences across age groups. Chronotype was measured using the Munich Chronotype Questionnaire. It was divided into quintiles. We used current tobacco use, monthly alcohol use, and high-risk drinking as indexes of tobacco use and alcohol use. These data were extracted from the national representative data., Results: Among adolescents and adults, both tobacco use and alcohol use showed a linear increasing trend, although it was greatest among adolescents. In older adults, tobacco use showed a linear increasing trend with delayed chronotype. When the chronotypes of all age groups were aggregated, high-risk drinking was higher in both extreme types, Quintiles 1 and 5., Conclusions: Tobacco use and alcohol use were mostly associated with delayed chronotype. Therefore, interventions to address delayed chronotype at all ages are needed. As the trend of increase in tobacco use and alcohol use in adolescents was higher than in other age groups, a special strategy is required aimed at this population. Moreover, both extreme chronotypes should be considered risk factors for high-risk drinking., (Copyright © 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

This study aimed to examine the associations of handgrip strength (HGS) and asymmetry with health-related quality of life among South Korean older adults. We enrolled 7395 older adults from the Korea National Health and Nutrition Examination Survey. Health-related quality of life was measured using the EuroQol-5 Dimension. Weakness was defined as a HGS of <26 kg for men and <18 kg for women. Handgrip strength symmetry was defined as an HGS ratio of 0.9:1.1, and HGS asymmetry was defined as a ratio outside that range. Data were analyzed using the Rao-Scott χ 2 , F test, and multivariate logistic regression. Compared with those in the "symmetric HGS and not weak" group, those in the "asymmetric HGS and weak" group had impaired health-related quality of life for all variables among men (odds ratios [ORs] = 1.67-3.75). A greater risk of impaired self-care (SC; odds ratio [OR] = 2.33) and anxiety/depression (AD; OR = 1.40) was observed among women in the "asymmetric HGS and weak" group. Handgrip weakness and asymmetry are associated with impaired health-related quality of life. Handgrip asymmetry can be a clinical marker of health-related quality of life in older adults and must be measured alongside HGS.

Background: Although many studies have investigated the factors influencing frailty, few studies have confirmed the influence of social factors on the stages of frailty. This study was conducted to identify factors influencing the stages of frailty in Korean older adults, focusing on objective and subjective social isolation., Methods: This study analyzed the data of 10,041 older adults from the 2017 National Survey of Older Koreans. Two multiple logistic regression analyses were performed to identify the factors influencing the frailty stages. Frailty was calculated using the FRAIL scale with the five domains: fatigue, resistance, ambulation, illness, and loss of weight., Results: Among Korean older adults, 51.5% were in the robust stage, 42.5% in the pre-frail stage and 6.0% in the frail stage. As a multiple logistic regression analysis, participants with an intimate relationship (Odds ratio (OR) 0.93, 95% Confidential interval (CI) = 0.91-0.95) or objective social non-isolated participants were more likely to be in the robust group than the pre-frail group. Objective social-isolated participants were more likely to belong to the frail group than the pre-frail group: isolation from family member only (OR 1.57, 95% CI = 1.04-2.39), isolation from non-family member only (OR 1.75, 95% CI = 1.39-2.19), and isolation from both family and non-family member (OR 2.56, 95% CI = 1.67-3.92)., Conclusions: This cross-sectional study showed that social isolation was associated with the stage of frailty. Therefore, researchers need to consider issues of social isolation of older adults in the development of frailty prevention and management intervention., (© 2022. The Author(s).)

Extensive research on the coronavirus disease 2019 (COVID-19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID-19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence-based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences., (© 2022 John Wiley & Sons Australia, Ltd.)

This quasi-experimental study used a cancer prevention program delivered by community health workers (CHWs) as an intervention to improve health literacy and increase screening uptake. The intervention group was educated by trained CHWs and received information about the nearby hospitals. After education, participants received telephone counseling once a month for 6 months. In the intervention group, CHWs met the participants individually and delivered the CD-ROM containing conversation scenarios with voice during the cancer screening test. The control group was provided educational materials related to breast and cervical cancers and a booklet containing information on mammography and Pap test. This study assessed the difference in mammography and Pap tests between the intervention and control groups. The results showed that the participants' knowledge improved, and the rate of cancer screening tests did not decrease in the intervention group. Therefore, it is necessary to develop and apply various programs that train CHWs and apply them to immigrant women to promote health-related behaviors under the health system that they are not familiar with while living in another country.

Purpose: The purpose of this study is to translate the Perceived Therapeutic Efficacy Scale (PTES) into Korean and investigate its validity and reliability., Methods: The authors conducted a cross-sectional survey using baseline data from a randomized controlled study to psychometrically validate the PTES-Korean (PTES-K) among 108 adults with type 2 diabetes from an outpatient clinic at a university-affiliated hospital in Korea. The original PTES was forward-translated and back-translated to ensure translation equivalence of the PTES-K. Structured questionnaires were used for psychometric evaluation; exploratory and confirmatory factor analysis assessed validity, and Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were used for reliability., Results: The interitem correlation analyses revealed that 5 items were redundant; thus, the scale was reduced to 5 items. A 1-factor model explained 76.85% of the variance; confirmatory factor analysis showed that this model adequately fit the data. The ICC for test-retest reliability was .78; Cronbach's alpha was .92. The PTES-K showed significant associations with the scores of diabetes self-care activities for physical activity, quality of life, and depressive symptoms. Participants with good glycemic control and regular physical activity tended to have a higher score on the PTES-K than their counterparts, demonstrating known-groups validity., Conclusions: The cross-cultural applicability, reliability, and validity of the PTES-K were confirmed. The PTES-K may be used in clinical settings to examine the potential role of perceived therapeutic efficacy for physical activity in enhanced glycemic control among patients with diabetes.

Purpose: This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES)., Methods: Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001-2002) to fifth follow-up visit (2011-2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model., Results: The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05-1.13) and HbA1c (HR=1.21, 95% CI=1.07-1.37) or the duration of DM (HR=1.05, 95% CI=1.00-1.09) were found to be independently associated with cataract development., Conclusion: Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible., Competing Interests: The authors declared no conflict of interest., (© 2022 Korean Society of Nursing Science.)

Aim: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum., Methods: A quasi-experimental design and convenience sampling technique were used. The participants (fourth-grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self-efficacy were outcome variables., Results: Significant improvements in handover performance ability, handover clinical judgement ability and handover self-efficacy were observed in the intervention group compared with the control group., Conclusion: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory-based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students., (© 2021 John Wiley & Sons Australia, Ltd.)

Background: The aim of this study was to estimate the 8-year prevalence and mortality statistics of autism spectrum disorder (ASD) according to birth year (2002-2012)., Methods: We used the National Health Insurance Service database with 4,989,351 children born from 2002 to 2012 including 35,529 children diagnosed with ASD until 8 years of age. The 8-year cumulative prevalence of ASD was calculated annually (2010-2020) with 8 years of follow-up. The 8-year mortality was estimated using Cox models adjusted for sex, household income, area of residence, and year of birth., Results: Of the 473,494 children born in 2002, 2,467 (5.2 per 1,000 births) were diagnosed with ASD until 2010. The ASD prevalence was 2.6 times higher among boys (1,839; 7.4 per 1,000 boy births) than girls (628; 2.8 per 1,000 girl births). Of the 467,360 children born in 2012, 4,378 (9.4 per 1,000 births) were diagnosed with ASD until 2020. The ASD prevalence was 2.7 times higher among boys (3,246; 13.5 per 1,000 boy births) than girls (1,132; 5.0 per 1,000 girl births). The risk of all-cause mortality was higher among children with ASD than those without (hazard ratio [HR], 2.340; 95% confidence interval [CI], 2.063-2.654), which is substantially higher among girls (HR, 4.223; 95% CI, 3.472-5.135) than boys (HR, 1.774; 95% CI, 1.505-2.090)., Conclusion: The present study demonstrated that national-level prevalence and mortality statistics of ASD can be estimated effectively using claims data comprising newborns born each year and followed up for to the age of interest. Because this information is essential to establish evidence-based policies, health authorities need to consider producing epidemiological information of ASD continuously using the same methodology., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2022 The Korean Academy of Medical Sciences.)

Background: There has been limited evidence on the association between employment status and mental health among young adults. Therefore, this study investigated the association between employment status and mental health in Korean young adults., Methods: Data from 15,649 adults aged 19-39 years who participated in the Korea National Health and Nutrition Examination Survey (2007-2013, 2015, and 2017) were analyzed. Employment status was categorized by those who worked in paid jobs or those who did unpaid work for relatives. Mental health problems included depressive mood and suicide ideation. We performed a multiple logistic regression analysis., Results: Of the participants, 33.5% were unemployed. The odds ratio (OR) of depressive mood (1.28, 95% CI: 1.06-1.55) was higher in unemployed 20-year-olds than employed ones and ORs of suicide ideation were higher among unemployed males (1.59, 1.16-2.20) and 30-year-olds (1.38, 1.13-1.70) than employed ones, respectively. Further, compared to employed males, the ORs of depressive mood (3.10, 2.54-3.77) and suicide ideation (4.44, 3.57-5.53) were the highest among unemployed females., Limitations: This study could not explain the causal relationship between employment status and mental health because it was a cross-sectional study. We did not include the relationship between mental health and employment status before the last week., Conclusions: Among young adults, unemployed status was significantly associated with an increased risk of mental health problems such as depressive mood and suicide ideation. Multifaceted efforts are required to reduce these mental health issues among unemployed young adults., (Copyright © 2021. Published by Elsevier B.V.)

This was a methodological study to evaluate the validity and reliability of the Korean version of the Self-Care of Diabetes Inventory (SCODI-K). A total of 210 patients with type 2 diabetes from a university hospital were enrolled. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. The SCODI-K consisted of 40 items in four dimensions (self-care maintenance, self-care monitoring, self-care management, and confidence). Four factors (activity-nutritional behavior, health-adherence behavior, health-promotion behavior, diet-restriction behavior) in the dimension of self-care maintenance, two factors (health status monitoring, symptom recognition) in the dimension of self-care monitoring, three factors (glucose self-control, problem-solving behavior, consultative self-care) in the dimension of self-care management, and one factor (self-care confidence) in the dimension of confidence were extracted. Confirmatory factor analysis supported a good fit with reliable scores for the SCODI-K model (normed chi-square( χ² / df) < 5, root mean square error of approximation (RMSEA) < 0.1, comparative fit index (CFI) ≥ 0.9, goodness-of-fit-index (GFI) ≥ 0.9). The SCODI-K showed a high positive correlation coefficient of 0.75 with the summary of diabetes self-care activities (SDSCA), confirming convergent validity. Cronbach's α was 0.92 for the overall scale and 0.69 to 0.90 for the four dimensions. Therefore, the SCODI-K is a valid and reliable instrument for assessing self-care of patients with type 2 diabetes in Korea.

Aim: This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students., Design: It used a randomized pre-post-test comparison group design to compare the effects of a global health competency programme among nursing students., Methods: Data collection for the pre-test was carried out for 2 days (25-26 October 2018) and that of post-test was conducted for 2 days (23-24 December 2018). A total of 38 fourth-year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju., Results: There were no statistically significant differences between the groups in the pre-test homogeneity test. The international nursing group showed statistically significant improvements between the pre- and post-tests in global health competency, cultural competency, global health confidence and cultural nursing confidence., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Children whose parents have mental disorders are more likely to be vulnerable and exposed to an environment where they may not be cared for by parents or guardians in Korea. Particularly, young children often develop mental disorders or maladaptive behaviors. This study aimed to implement a structured program to enhance the resilience of school-aged children whose parents have mental disorders and to analyze its effectiveness through a single-group pretest-posttest experimental design. The Korean Child Personality Inventory for Self-Report self-resilience and clinical scales were used, and daily behavioral observation logs showed decreases in psychosis scores among all children, anxiety scores among girls, and somatization and physical development among boys. Self-efficacy, social competency, and acceptance toward families increased. Therefore, the improvement of resilience and clinical symptoms was confirmed through this program, suggesting it should be expanded and developed in local community healthcare sites to help support children with mentally ill parents., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Abstract: Although the number of mothers with gestational diabetes mellitus (GDM) is on the rise, only few studies have examined the cumulative stress associated with breastfeeding after childbirth. GDM mothers are susceptible to stress due to insulin resistance, and their level of stress is associated with breastfeeding. This study aimed to identify patterns of stress change over time in GDM mothers and healthy mothers and to identify the factors influencing those patterns.The participants of this study were mothers within 14 days after childbirth. The GDM group consisted of 32 mothers, and the healthy group comprised 30 mothers. Cumulative stress was measured in terms of heart rate variability, and linear mixed models were used to analyze changes over time.The cumulative stress of healthy mothers was about 8 points higher than that of mothers with GDM (t = -2.95, P = .005). The cumulative stress level was inversely associated with the mother's age (β=-1.20, P = .018), the mother's weight (β=-0.64, P = .008), and the baby's body mass index (β=-3.09, P = .038). Furthermore, an insufficient amount of breast milk was associated with higher stress (β=16.09, P = .007).GDM mothers and healthy mothers experienced different patterns of cumulative stress. Breastfeeding should be started quickly to promote health and stress reduction among mothers who are physically and psychologically vulnerable after childbirth.It is necessary to incorporate programs to promote breastfeeding considering stress levels at an appropriate time according to the mother's health condition., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: This study aimed to investigate the association between autism spectrum disorder (ASD) diagnosis and mortality among children using the data from a large-scale national cohort of Korean infants and children. We also explored the association between hearing impairment detected during early infancy and mortality., Materials and Methods: We performed a retrospective cohort study using the nationwide claims data of the Republic of Korea. Children born between 2007 and 2014 (n=3598904) were followed up until 2020. Cox proportional hazard models were used to examine the association between ASD diagnosis and mortality among children. Then, in order to evaluate the association between hearing impairment and mortality, Cox proportional hazard models were built using the responses related to hearing impairment asked during the first health screening (at age 4-6 months)., Results: Of the 3598904 children born between 2007 and 2014, 32878 children (0.9%) were diagnosed with ASD until the end of 2020. We identified that ASD diagnosis was associated with higher mortality among children [hazard ratio (HR)=2.5, 95% confidence interval (CI): 2.2-2.9]. This association was stronger among girls (HR=4.8, 95% CI: 3.9-5.8) compared to boys (HR=1.9, 95% CI: 1.6-2.2). We found that hearing impairment detected during infancy was associated with higher mortality among children with ASD diagnosis., Conclusion: ASD diagnosis was associated with higher mortality among Korean children. This association was stronger in girls than in boys. Hearing impairment detected during infancy was also associated with higher mortality among children diagnosed with ASD., Competing Interests: The authors have no potential conflicts of interest to disclose., (© Copyright: Yonsei University College of Medicine 2021.)

The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in Korea between January and February 2021. A structured questionnaire was used to survey their levels of burden, depression, AIC, adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). The study results showed that the influencing factors of ASB for COVID-19 were AIC ( β = 0.265, p < 0.001), the burden of "not receiving hemodialysis on time" ( β = 0.233, p = 0.008), and the burden of "social exclusion of hemodialysis patients" ( β = 0.186, p = 0.032). The influencing factors of DSB were the burden of "social exclusion of hemodialysis patients" ( β = 0.258, p = 0.003) and AIC ( β = 0.217, p = 0.004). As the COVID-19 pandemic continues, the latest evidence-based information must be provided to hemodialysis patients to promote self-care and prevention behavior that encourages ASB and discourages DSB.

Owing to a growing older adult population, dementia is emerging as an important health issue. Given that maintaining cognitive functions is crucial for the prevention of dementia, this study aimed to identify the predictors of cognitive function in community-dwelling older adults, through a secondary data analysis of the 2017 National Survey of Older Koreans. A total of 9836 participants were classified into three age groups-young-old (65-74 years), old-old (75-84 years), and oldest-old (≥85 years)-and were separately analyzed using multiple linear regression models. The final model explained 28.0%, 35.0%, and 37.0% of variance in cognitive function in the three age groups, respectively. The most potent predictors of cognitive function in the young-old were electronic device-based activities, instrumental activities of daily living (IADL), and nutrition management; the predictors for the old-old group were electronic device-based activities, IADL, and dementia screening, and those for the oldest-old group were frequency of contact with acquaintances, traveling, and religion. Thus, age group-specific interventions are needed to effectively promote cognitive function among older adults. Digital literacy education, use of community-based elderly welfare programs, opportunities for social interactions, and physical activities can help older adults in maintaining a functional status and muscle strengthening.

This study aimed to develop and evaluate the effects of a Salutogenic program on sense of coherence, depression, and suicidal ideation among rural older adults. Quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were female, aged 65 years and older from G and O province, South Korea. The experimental group ( n  = 22) received a 12-session Salutogenic program for 6 weeks, twice a week. The control group ( n  = 19) was put on a waiting list to receive the intervention after completing the study. Collected data were analyzed using descriptive statistics, a χ 2 test, independent t -test, and repeated measure ANOVA with SPSS WIN 26.0. There were significant differences in sense of coherence ( F  = 19.34, p < .001), depression ( F  = 12.93, p < .001), and suicidal ideation ( F  = 4.40, p = .027) over time pretest, posttest, and follow-up test after intervention between two groups. The study discussed the effect of Salutogenic program on sense of coherence, depression, and suicidal ideation, and considered its benefits in suicide prevention for elderly women. The Salutogenic program can be recommended as useful strategies to enhance sense of coherence and to reduce depression and suicidal ideation of elderly women in community.

Metacognition is a higher-level cognition of identifying one's own mental status, beliefs, and intentions. This research comprised a survey of 184 people with schizophrenia to verify the reliability of the metacognitive rating scale (MCRS) with the revised and supplemented metacognitions questionnaire (MCQ) to measure the dysfunctional metacognitive beliefs of people with schizophrenia by adding the concepts of anger and anxiety. This study analyzed the data using principal component analysis and the varimax method for exploratory factor analysis. To examine the reliability of the extracted factors, Cronbach's α was used. According to the results, reliability was ensured for five factors: positive beliefs about worry, negative beliefs about uncontrollability and danger of worry, cognitive confidence, need for control, and cognitive self-consciousness. The negative beliefs about uncontrollability and danger of worry and the need for control on anger expression, which were both added in this research, exhibited the highest correlation (r = 0.727). The results suggest that the MCRS is a reliable tool to measure the metacognition of people with schizophrenia.

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate the effects of a web-based educational program of physical restraint reduction on nursing students' knowledge and perceptions. A cluster randomized controlled and single-blind design was used. This study was conducted at four nursing schools in South Korea. A total of 169 undergraduate nursing students completed this study. Using random allocation, two nursing schools (85 students) were allocated as the experimental group and the other two schools (84 students) as the control group. The experimental group received the web-based educational program, and the control group did not receive the educational program. Data were collected immediately before and after the web-based educational program. The experimental group's knowledge and perceptions significantly improved between pre-test and post-test. The analysis of covariance showed statistically significant differences between groups in knowledge ( p < 0.001) and perceptions ( p < 0.001) over time, revealing positive effects of the web-based educational program. The web-based educational program regarding physical restraint reduction positively affected nursing students' knowledge and perceptions. Future studies are required to examine the educational program's longitudinal effects with more rigorous measurements and research methods.