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Purpose: The purpose of this study was to analyze the trends and characteristics of infection-related patient safety incident reporting before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and to provide basic data for preventing infection-related patient safety incidents and improving their management. Methods: A cross-sectional analysis of secondary national data (Patient Safety Reporting Data) was conducted. In total, 517 infection-related patient safety incidents reported from 2018 to 2021 were analyzed. Changes in the number of reports before and during the COVID-19 pandemic and differences in variables related to infection-related patient safety incidents were analyzed using the chi-square test and independent t-test in SPSS 29.0. Results: This study found that infection-related patient safety incidents decreased during the COVID-19 pandemic compared to before the pandemic. Furthermore, incident-related characteristics, such as the type of healthcare organization, severity of harm, and post-incident actions, changed during the COVID-19 pandemic. Conclusion: The many changes in the infection control system and practices during the COVID-19 pandemic may have contributed to a decrease in the reporting of infection-related patient safety incidents. It is hoped that longitudinal studies on patient safety incidents related to the pandemic and analytical studies on factors influencing patient safety incidents will continue to be conducted to prevent and improve patient safety incidents. [ABSTRACT FROM AUTHOR]

Purpose: This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic. Methods: This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho's Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach's α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson's correlation coefficient, and multiple linear regression. Results: Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, ρ = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior. Conclusion: Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas. [ABSTRACT FROM AUTHOR]

Purpose: Delirium is a common symptom among heart surgery patients, and its prevalence is reported to range from 16.0~73.0%. As patients with delirium exhibit multiple negative prognoses, it is important to identify and prevent the risk factors for delirium. However, little research has been conducted to identify the prevalence of delirium and its risk factors among patients who have undergone heart surgery in Korea. Therefore, the aim of this study is to explore the prevalence of delirium and its risk factors in heart surgery patients in the Intensive Care Unit (ICU). Methods: This is a retrospective descriptive correlational study. From 623 patients who entered the ICU after heart surgery in a tertiary referral hospital from September 2016 to August 2017, 421 were selected for this study. Data were collected using electronic medical record. Delirium was evaluated using the Korean Nursing Delirium Screening Scale (Nu-DESC). Results: A total of 63 participants (15.0%) were diagnosed with delirium. Multivariate logistic regression analysis of the variables identified that complex surgery (Odds Ratio [OR]=7.24, 95% Confidence Interval [CI]= 2.80~18.74, p<.001), aortic aneurysm surgery (OR=3.30, 95% CI=1.40~7.77, p=.006), creatinine (OR=2.32, 95% CI=1.17~4.60, p=.016), and ICU length of stay (OR=1.72, 95% CI=1.48~1.99, p<.001) were associated with delirium after heart surgery. Conclusion: The prevalence of delirium after heart surgery in Korean ICU patients is similar to that reported by the American Heart Association study. Type of surgery, lab data, ICU length of stay should be considered in the prevention and management of delirium in heart surgery patients in Korea. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability. Methods: Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios. Results: The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91. Conclusion: Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients. [ABSTRACT FROM AUTHOR]

Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients’ urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to identify gender and age differences in health status and health behaviors of community-dwelling older adults in an urban city. Methods: A convenience sample of 500 older people were recruited. Participants completed eight study instruments by face to face interview. The instruments were the Korea Instrumental Activities of Daily Living (K-IADL), Short Physical Performance Battery (SPPB), Body Mass Index (BMI), Mini Nutritional Assessment-Short Form, Stanford Research Instruments for Chronic Disease, Geriatric Depression Scale Short Form Korea version, EuroQol-5 Dimensions scale (EQ-5D), and the Study of Osteoporotic Fracture Frailty Index. Results: 71.6% were females and mean age of all participants was 74.4 years. Participants were divided into three age groups: 60 to 74 years (n=263, 52.6%), 75 to 84 years (n=207, 41.4%), and ≥85 years (n=30, 6.0%). Significant gender differences were found in educational level, marital status, family type, religion, perceived economic status, K-IADL, SPPB, grip strength, BMI, fatigue, smoking, drinking, communication with physicians and nurses, and EQ-5D. There were significant differences among the three age groups on educational level, marital status, family type, SPPB, grip strength, regular health check-up, communication with physicians and nurses, and frailty. Conclusion: Gender difference should be taken into consideration more than age when policy and preventive programs for community-dwelling older adults in an urban city is developed. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were to identify prevalence and identify factors related to sarcopenic obesity among communitydwelling elderly women. Methods: This is a secondary analysis of the prospective cohort study. Our analysis included 338 elderly women (≥65 years old) in South Korea as a part of the Community-dwelling Older Adult Health Cohort (COHC) Study (2014-2015). Sarcopenic obesity was defined as the Asian Working Group of Sarcopenia recommendations and upper two quintiles for percentage body fat. Logistic regression analysis was used to determine the factors related to sarcopenic obesity including chronic diseases, medications, stress, fatigue, depression, exercise, level of proteins on body compositions, smoking, and alcohol use. Results: The prevalence of sarcopenic obesity was 6.2%. A lower protein on body compositions (OR 0.017, 95% CI 0.003-0.081, p<.001), a larger number of medications (OR 2.104, 95% CI 1.404-3.152, p<.001), and a higher level of fatigue (OR 1.255, 95% CI 1.023-1.541, p=.030) were related factors of sarcopenic obesity. Conclusion: The findings suggest that nutritional interventions focusing on protein intakes should be needed to prevent sarcopenic obesity among the elderly women. Polypharmacy issue for preventing adverse outcomes and level of fatigue as indicator for early identification are also considered to develop community prevention programs. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to identify thinking strategies in the complicated decision-making process based on real patient-based data of triage nurses in the emergency department (ED). Methods: This study used the ‘think aloud’ method to collect data from 8 triage nurses from one general hospital ED in South Korea. The data were analyzed with protocol analysis using thinking strategies. Results: The triage process was divided into three stages. The first stage consisted of 8 thinking strategies, including searching for information. They used intuition based on directly observed concepts for identifying a crisis. The second stage consisted of 17 thinking strategies related to the decision-making process. They assessed patients and generated a hypothesis to try to understand their health problems through analytic thinking. The third stage consisted of 10 thinking strategies, including qualifying. They considered the situation of the ED and properly triaged the patients. During the triage process, they frequently used judging the value and searching for information on 17 thinking strategies. Conclusions: Triage nurses demonstrated various connected thinking strategies for each stage. Based on our results, further studies should be done to develop a triage education program. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October 1st to December 5th in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants’ ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions. [ABSTRACT FROM AUTHOR]

Purpose: Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents. Methods: A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014. Results: The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'. Conclusion: The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe health status and to identify the factors related to health behavior in older adults in South Korea. Methods: A cross-sectional survey was conducted with a convenience sample of 186 older people (mean age =68.2yrs, 65.1% Female) registered at one senior center. Data were collected by self-report questionnaires or through face to face interview. The instruments were the Modified Health Behavior Assessment Scale, Stanford Research Instruments for Chronic Disease, Self-Efficacy, SOF Frailty Index and Quality of life questionnaire. The data were analyzed using t-test, ANOVA, Pearson’s correlation, and stepwise multiple regression. Results: 58.6% older adults perceived their health status positively. Education level and economic status were significantly related to health behaviors of older adults. Self-rated health, sleep, stress, quality of life, health distress, depression, and frailty were significantly correlated with the health behaviors of older adults. Frailty, education level, and sleep disturbance were the significant factors predicting the health behaviors. Conclusion: The findings from this study suggest that nurses should take into consideration education level of older adults to promote their health behaviors and health promotion program which focuses on maintaining the quality of sleep and preventing frailty. [ABSTRACT FROM AUTHOR]