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Purpose : This study aimed to compare the validity and user evaluations of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and its 7-item version (CAM-ICU-7) for delirium assessment. Methods : Thirty-six intensive care unit (ICU) nurses from four university hospitals participated in this simulation-based methodological study. Four standardized patients with normal cognition, subsyndromal delirium, hypoactive delirium, and hyperactive delirium were recruited. The participants assessed all four standardized patients using the CAM-ICU and CAM-ICU-7. We analyzed the validity, assessment time, and user evaluations of both tools. DeLong's test and the paired t-test were used for comparisons. Results : The CAM-ICU showed sensitivity, specificity, and accuracy of 80.6%, 94.4%, and 84.0%, respectively, with an Area Under Curve (AUC) of 87.5%. CAM-ICU-7 demonstrated a sensitivity, specificity, and accuracy of 90.7%, 97.2%, and 92.4%, respectively, with an AUC of 94.0%. The CAM-ICU-7 showed a better AUC than the CAM-ICU for detecting subsyndromal delirium ( p=.029). However, the CAM-ICU-7 required more time for assessment across all patient types ( p< .001). ICU nurses reported that the CAM-ICU was faster to administer, whereas the CAM-ICU-7 was easier to use, better at detecting delirium, more effective at reflecting changes in delirium, and had a higher intention to use in clinical practice. Conclusion : The CAM-ICU-7 demonstrated superior validity compared to the CAM-ICU. Despite requiring more time, ICU nurses evaluated the CAM-ICU-7 as more useful. These findings support using the CAM-ICU-7 for delirium assessment in ICU settings. [ABSTRACT FROM AUTHOR]

Purpose : The aim of this study was to investigate sleep parameters and architecture in patients admitted to the intensive care unit (ICU) on the day of abdominal surgery. Methods : A total of ten patients who underwent laparotomy under general anesthesia at the hepatopancreatobiliary surgery department of a general hospital in Busan, South Korea participated in this observational study. We measured total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), and sleep stages on their first night in the ICU using the WatchPAT300. Furthermore, we used nonparametric statistics to examine differences in postoperative sleep based on sedative administration. Results : The Median (IQR) TST for the participants was 399.50(263.80) minutes; the SE was 75.1 (30.4)%; the WASO rate was 27.8(30.6)%; and the WASO frequency was 5.50(8.50) times. Patients' rapid eye movement (REM) sleep time was 114.31(87.88) minutes, with 55.8(11.9)% of N1, 18.2(5.3)% of N2, and 24.8 (11.7)% of N3 sleep stages. The sedation group had a longer TST (Z=-2.619, p=.008), higher SE (Z=-2.611, p=.008), lower WASO rate (Z=-2.611, p=.008), smaller number of WASOs (Z=-2.627, p=.008), and longer REM sleep (Z=-2.617, p=.008) compared to the non-sedation group. Conclusion : We observed a high rate of light sleep and awakenings during sleep in patients admitted to the ICU after surgery. Moreover, non-sedated patients lacked either deep or REM sleep. Sleep-improving interventions are needed for non-sedated surgical patients who are admitted to the ICU. [ABSTRACT FROM AUTHOR]

Purpose: Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care. Methods: This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM). Result: The R² values of the final model ranged from 0.35 to 0.51, while the Q2 values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from 'ICE-awareness of surroundings' to 'PICS-cognitive', from 'ICE-recall of experience' to 'PICS-cognitive', and from 'ICE-frightening experiences' to 'PICS-mental health'. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model. Conclusion: Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients. [ABSTRACT FROM AUTHOR]

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level. [ABSTRACT FROM AUTHOR]

This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93± 107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (χ²=7.86, p=.049), a greater number of WASO (χ²=5.69, p=.128), and a longer WASO duration (χ²=8.75, p=.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC. [ABSTRACT FROM AUTHOR]

Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33—1.40, p=.295). Among the non- pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients. [ABSTRACT FROM AUTHOR]

Purpose : The purpose of this study was to systematically review the measurement tools that are used to assess the pain of intensive care unit (ICU) patients. Method : In this systematic review, the studies published between 2009 and 2018 were selected based on the PRISMA flow chart. Data sources included MEDLINE, EMBASE, CINAHL, and Cochran. We assessed the quality of pain assessment tools reported in individual studies using Terwee et al.'s the Quality Criteria for Measurement Properties. Results : We reviewed 67 studies and 12 pain assessment tools that included two self-reported, seven observational, and three multifaced tools with observations and physiological indicators. The most frequently used tool was the Critical Care Pain Observation Tool. The Multidimensional Observational Pain Assessment Tool was rated the highest quality. Nine of the ten tools that included observations reported content validity, four reported construct validity and nine reported correlation coefficient. Conclusion : It was found that observational tools are appropriate for assessing pain in ICU patients with limited communication skills. To increase the validity and reliability of pain assessment in ICU patients, further research on the physiological indicators of pain is needed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore public opinion on workplace bullying in the nursing field, by analyzing the keywords and topics of online news comments. Methods: This was a text-mining study that collected, processed, and analyzed text data. A total of 89,951 comments on 650 online news articles, reported between January 1, 2013 and July 31, 2018, were collected via web crawling. The collected unstructured text data were preprocessed and keyword analysis and topic modeling were performed using R programming. Results: The 10 most important keywords were "work" (37121.7), "hospital" (25286.0), "patients" (24600.8), "woman" (24015.6), "physician" (20840.6), "trouble" (18539.4), "time" (17896.3), "money" (16379.9), "new nurses" (14056.8), and "salary" (13084.1). The 22,572 preprocessed key words were categorized into four topics: "poor working environment", "culture among women", "unfair oppression", and "society-level solutions". Conclusion: Public interest in workplace bullying among nurses has continued to increase. The public agreed that negative work environment and nursing shortage could cause workplace bullying. They also considered nurse bullying as a problem that should be resolved at a societal level. It is necessary to conduct further research through gender discrimination perspectives on nurse workplace bullying and the social value of nursing work. [ABSTRACT FROM AUTHOR]

Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (β=-.25, p=.003), recurrence of CAD (β=.21, p=.008), and PTSD symptoms (β =-.33, p<.001). The mental component of health-related QoL was influenced by religion (β=-.17, p=.044), body mass index (β=.17, p=.033), and PTSD symptoms (β=-.37, p<.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. Methods: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. Results: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p<.001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's α=.84. Conclusion: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method: Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results: The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion: Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically. [ABSTRACT FROM AUTHOR]

Purpose: To explore the person-centered care (PCC) experienced by critical patients. Method: This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results: A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion: These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients. [ABSTRACT FROM AUTHOR]

Purpose: This qualitative study aimed to explore the experience of incivility among nursing students. Methods: Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Results: Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. Conclusion: The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method: Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results: A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multi-faceted instrument for ICU survivors. [ABSTRACT FROM AUTHOR]

Purpose: As the intensive care unit (ICU) survival rate increases, interest in the lives of ICU survivors has also been increasing. The purpose of this study was to identify the sentiment of ICU survivors. Method: The author analyzed the quotations from previous qualitative studies related to ICU survivors; a total of 1,074 sentences comprising 429 quotations from 25 relevant studies were analyzed. A word cloud created in the R program was utilized to identify the most frequent adjectives used, and sentiment and emotional scores were calculated using the Artificial Intelligence (AI) program. Results : The 10 adjectives that appeared the most in the quotations were 'difficult', 'different', 'normal', 'able', 'hard', 'bad', 'ill', 'better', 'weak', and 'afraid', in order of decreasing occurrence. The mean sentiment score was negative (-.31±.23), and the three emotions with the highest score were 'sadness'(.52±.13), 'joy'(.35±.22), and 'fear'(.30±.25). Conclusion : The natural language processing of AI used in this study is a relatively new method. As such, it is necessary to refine the methodology through repeated research in various nursing fields. In addition, further studies on nursing interventions that improve the coherency of ICU memory of survivors and familial support for the ICU survivors are needed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to conduct a systematically review of factors related to the reported intention of hospital nurses in Korea to leave their positions. Methods: Appropriate studies in the recent ten years were selected from databases. A total of 263 studies were selected for the systematic review on the basis of the PRISMA flow. The correlational effect size of 35 studies was analyzed through meta-analysis using CMA 3.0. Results: Through systematic review, 52 related factors were classified by ecological system: 18 individual, 12 microsystem, 11 mesosystem, 8 exosystem, and 3 macrosystem. The overall effect size of turnover intention was 3.26. The total correlational effect size of related factors was 0.28: 0.14 for individual, 0.50 for microsystem, 0.25 for mesosystem and 0.40 for exosystem. Among single factors with larger effect size, emotional labor, role conflict, and work-home conflict were classified into contributors whereas organizational commitment, job satisfaction, and internal marketing were classified as inhibitors. Conclusion: Previous studies focused on the individual and the microsystem in the quantitative respect. In addition, the effect size was relatively greater for the microsystem and the exosystem. It is therefore necessary to conduct further research on the systems with larger effects. [ABSTRACT FROM AUTHOR]

Purpose : This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions. Methods : The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi. Results : Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing. Conclusion : The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients’ health. It is necessary to develop a practical and integrative curriculum for critical care nursing education. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta- synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the attributes of the concept, of psychological resistance to antihypertensive medication. Methods: The study was conducted in accordance with Walker and Avant’s conceptual analysis process. We reviewed 47 related studies selected from 4 international and Korean databases including Medline, CINAHL, NDSL, and RISS to perform the analytical processes from January 1980 to September 2015. Results: The attributes of psychological resistance to antihypertensive medication include 1) reservation, 2) opposition, 3) denial, 4) refusal, and 5) seeking alternative therapy. The antecedents of the concept can be classified into patient factors such as reactance trait and knowledge deficit, provider factors, interpersonal factors, and environmental factors. The consequences of psychological resistance to antihypertensive medication are non-compliance, deterioration of the disease, developing complications, increased anxiety, and changes in life. Conclusions: The concept of psycho logical resistance to antihypertensive medication can provide guidance for the development of an intervention program that promotes the compliance to medication regimen of hypertensive patients. Further research needs to be done to develop a measurement tool for psychological resistance to antihypertensive medication. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses. Methods: Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. Results: A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses' workplace bullying experience was revealed as 'teaching that has become bullying', and the core category was extracted as 'surviving in love-hate teaching' consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase. Conclusion: The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to estimate the pooled prevalence of workplace bullying among nurses and examine the effect of moderate factors. Methods: Studies that assessed nursing workplace bullying using the negative act questionnaire developed by Einarsen et al. were searched for in 8 databases. The pooled prevalence was calculated with overall event rate and meta-ANOVA was performed for subgroup analysis. A funnel plot and Egger’s linear regression asymmetry test were performed to confirm the publication bias of meta-analyzed studies. Results: A total of 23 studies (N=11,748) were included in the systematic review, and 14 studies (N=4,585) that reported prevalence using operational criteria of victim were selected for meta-analysis. The pooled prevalence of workplace bullying was 22.2% (95% CI: 19.0~25.7). Domestic studies reported lower prevalence than international studies (18.6% vs. 27.0%, Q=8.75, p =.003). The prevalences were different according to publication year (30.6% in 2008~2010, 19.5% in 2011~2014, 21.8% in 2015, Q=11.89, p =.003). Studies that recruited only new nurses reported higher prevalence than others (28.4% vs. 20.6%, Q=3.92, p =.048). Publication bias was not found. Conclusions: Workplace bullying is prevalent in the nursing profession, and is more serious for new graduate nurses. Individual and organizational measures for preventing workplace bullying among nurses need to be sought. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ≥36 months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the mediating effect of the resilience on the relationship between type D personality and compliance of Coronary Artery Disease (CAD) patients. Methods: The subjects were 236 CAD patients who visited the cardiology outpatient clinics of D University Medical Center in B City in Korea. The type D personality, resilience, and compliance of subjects were measured using structured questionnaires from July to August, 2014. The mediating effect was analyzed by a multiple hierarchical regression. Results: The subjects with type D personality accounted for 30.9% of all study subjects. The resilience and compliance of type D subjects were significantly lower than those of non type D subjects. There was a significant correlation between resilience and compliance. The direct effect of type D personality on compliance was not significant (β=-.07, p=.243), while the indirect effect of type D personality on compliance via resilience was significant (β=.23, p<.001). Conclusion: On the basis of above results, it can be concluded that the resilience had completely mediating effect on the relation between type D personality and compliance of CAD patients. Further studies need to be done to develop the intervention enhancing resilience of CAD patients with Type D personality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the attributes, antecedents, and consequences of post-intensive care syndrome. Methods: The study was conducted in accordance with Walker and Avant’s conceptual analysis process. We searched the Medline, ProQuest, Google scholar, NANET (Korean National Assembly Library), and RISS (Korean Education and Research Information Service) databases resulting in 29 studies for in-depth review. Results: The attributes of post-intensive care syndrome include (1) new or worsening impairment persisting after discharge, (2) physical impairment, (3) psychological impairment, (4) cognitive impairment, and (5) symptom experience. The antecedents of the concept include a critical condition that requires intensive care, stressful events, immobility, sedation, delirium, insomnia, frailty, and invasive procedures. The consequences of post-intensive care syndrome are increased dependency in activities of daily life, decreased social interaction, delayed return to previous occupation, decreased quality of life, familial post-intensive care syndrome, and readmission/death. Conclusion: The concept of post-intensive care syndrome has multifaceted and integrative features. Further research needs to be conducted to develop a measurement tool that reflects the attributes of the concept and to develop multidisciplinary interventions to prevent post-intensive care syndrome. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop a valid tool for measuring the work environment of Korean nurses and test the validity and reliability of the instrument. Methods: This is a methodological study for developing and testing a measurement tool. The conceptual framework for the tool was formed through a literature review and in-depth interviews with clinical nurses. 260 meaningful statements were derived through this process, and 59 of the primary items were generated out of these statements. On the basis of the content validity test, 41 items were selected for the preliminary tool. A total of 350 nurses from 7 hospitals responded to the preliminary questionnaire in October 2011. Results: After the item analysis and the principal component analysis using varimax rotation methods, 11 items were deleted. Considering the conceptual framework and the scree plot, we extracted 4 factors from the final 30 items. These factors were organizational support, head nurse's leadership, support system, and relationship with coworkers, and their total variance was 54.4%. The value of Cronbach's α of the final tool was 0.92. Conclusion: The above findings revealed that the Korean Nursing Work Environment Scale (K-NWES) is an appropriate, valid, and reliable tool for evaluating the work environment of Korean nurses. Further research to perform a criterion validity test of the K-NWES is needed. [ABSTRACT FROM AUTHOR]

This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by x2-test, t-test, and multi-variate logistic regressionwith forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by x2-test, t-test, and multi-variate logistic regression with forward step wise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the nursing work environment and family satisfaction in Korean intensive care units (ICUs). Methods: The study participants were 190 critical care nurses and 133 family members of ICU patients who were randomly chosen from four of the hospitals located in B city. The Korean Nursing Work Environment Scale was used to assess the work environment of critical care nurses. Family satisfaction was measured with the Korean version of the Critical Care Family Needs Inventory. Results: Critical care nurses reported moderate satisfaction with their work environment. The mean score for family satisfaction was 3.59 on a 5-point scale, and satisfaction with information provision received the highest score. Family satisfaction was higher in hospitals where the critical care nurses evaluated their work environment positively. Conclusion: This study revealed that the work environment of nurses affects family satisfaction in ICUs. Therefore, it is necessary to explore various methods of improving the critical care nursing work environment in order to provide the highest possible level of nursing care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the relationship between organizational culture and workplace bullying of intensive care unit (ICU) nurses. Methods: A secondary analysis was conducted using three different data sets on workplace bullying of hospital nurses. This analysis focused on the relationship between organizational culture and workplace bullying of 240 ICU nurses. The original data were collected using self-reporting questionnaires and were analyzed using hierarchical multiple regression. Results: ICU nurses were aware of their organizational culture as being rank-oriented, relationship-oriented, innovation-oriented, and task-oriented in that order. The results showed that 15.0% of the ICU nurses reported being victims of workplace bullying, mostly work-related bullying. The perception of a relationship-oriented culture explained a variance of 29% in the workplace bullying of ICU nurses. Conclusion: The findings suggest that ICU nurses who are strongly aware of a relationship-oriented culture would experience less workplace bullying. Further research is needed to develop interventions that can foster a relationship-oriented culture in ICUs. [ABSTRACT FROM AUTHOR]