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This study investigated the effects of occupational stress, anxiety, depression, and sleep disturbance on the level of fatigue among public health nurses (PHNs).The study had a cross-sectional, correlational survey design.A total of 198 PHNs were enrolled from 30 public healthcare centers/offices. Data were collected between May and July 2021 using a structured questionnaire to investigate the general characteristics, occupational stress, anxiety, depression, sleep disturbance, and fatigue of the participants. Descriptive statistics and multiple regressions were used to determine fatigue and its influencing factors among PHNs.The participants showed high fatigue and occupational stress levels due to a lack of rewards. The percentage of participants with mild-to-severe anxiety and mild-to-severe depression, and those who identified themselves as poor sleepers were 44.9%, 50.5%, and 70.2%, respectively. High levels of sleep disturbance (β = .23, p .001), occupational stress (β = .21, p .001), anxiety (β = .20, p = .016), depression (β = .17, p = .043), being younger (β = -.15, p = .004), and being a regular worker (β = .13, p = .017) were influencing factors of fatigue.Individual efforts and organizational interventions to enhance sleep quality are needed to relieve fatigue among PHNs. Further, organizational support can be considerate of young nurses and regular workers, and alleviate their occupational stress. Moreover, anxiety and depression should be managed efficiently to reduce fatigue.

Specialist trauma nurses contribute to shortening hospital stay, lowering intensive care unit readmission rates, and improving treatment outcomes through early detection and management of health problems in trauma patients. However, Korean specialist trauma nurses have a higher turnover rate than other nurses due to negative factors like unclear job descriptions and inconsistent job activities.This study aimed to examine the levels of and relationships among role conflict, occupational stress, perceived organizational support, and intent to stay in Korean specialist trauma nurses.We enrolled 53 specialist trauma nurses from eight regional trauma centers in Korea. Data on role conflict, occupational stress, perceived organizational support, and intent to stay were collected using a structured questionnaire. Mann-Whitney U test, Kruskal-Wallis test, and Bonferroni post hoc tests were conducted to examine differences in intent to stay. Spearman's correlation coefficients were used to examine correlations between the key variables.High intent to stay was associated with periodic job training, job satisfaction, and perceived high workload. Role conflict was positively correlated with occupational stress, whereas both were negatively correlated with perceived organizational support. Intent to stay was negatively correlated with occupational stress and positively correlated with perceived organizational support.Effective improvement measures that lower occupational stress and increase perceived organizational support will help maintain the positions of specialist trauma nurses. These results highlight the need to specify the scope of practice and implement practical measures like career development programs that enhance professional nursing competencies to retain specialist trauma nurses.

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

Purpose The purpose of this study was to investigate the effects of home-and-workplace combined exercise on physical function, depression, and work-related disability in patients with ankylosing spondylitis. Methods This study adopted a non-randomized quasi-experimental design. Fifty-two patients were recruited: home-and-workplace combined exercise (n = 17), home exercise (n = 18), and control group (n = 17). Results The home-and-workplace combined exercise group showed improvement in spinal mobility and pulmonary function and significantly lower absenteeism and overwork impact than the home exercise group and control group. The home-and-workplace combined exercise and home exercise groups showed a higher level of activity improvement than the control group. Conclusion home-and-workplace combined exercise can be recommended to patients with ankylosing spondylitis to enhance their physical function, including spinal mobility and pulmonary function, and reduce work-related disability.

Purpose: The purpose of this study was to investigate the influence and relationship among anxiety, depression, self-esteem, and quality of life, along with factors affecting quality of life, on patients with rheumatoid arthritis.Methods: This study was a cross-sectional descriptive study, and 200 individuals with rheumatoid arthritis who visited a single university hospital as outpatients were recruited through convenience sampling. Using a structured questionnaire, a survey was conducted regarding the general characteristics, anxiety, depression, self-esteem, and quality of life. Collected data were analyzed using t-test, ANOVA, and regression analysis.Results: Results showed that lower levels of anxiety or depression and higher levels of self-esteem were associated with improved quality of life. Depression was identified as the main factor affecting quality of life, followed by anxiety, glucocorticoid treatment, time elapsed after diagnosis, and occupational status.Conclusion: These findings confirmed that depression, anxiety, and glucocorticoid medication are factors influencing quality of life in patients with rheumatoid arthritis, Duration since diagnosis, and occupation should be considered in order to improve the quality of life of these patients with rheumatoid arthritis. The occupation and treatment-related characteristics of the patients must be considered, with particular focus on depression and anxiety.

Purpose: This study was done to determine the correlations among grit, social support, career barriers, and career preparation behavior in mature age nursing students, and identify factors influencing their career preparation behavior.Methods: This cross-sectional, descriptive study included 106 undergraduate nursing students aged 25 years or older at the time of entering three universities in Korea. Grit, social support, career barriers, and career preparation behavior were investigated using structured questionnaires. Data analyses included descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation analysis, and stepwise multiple regression analysis and were performed with the SAS program (version 9.4).Results: The factors influencing career preparation behavior of mature age nursing students included: persistence of efforts (β=.35, p

Purpose: The aim of this study was to investigate the influence of daily life functions, anxiety, and depression on pain catastrophizing among patients undergoing lumbar spinal surgery.Methods: This study was a cross-sectional descriptive research. The participants were 136 patients undergoing lumbar spinal surgery at one general hospital. They were surveyed using structured questionnaires on daily life functions, anxiety, and depression related to pain catastrophizing. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis.Results: The results indicate that pain catastrophizing was negatively correlated with all sub-domains of daily life functions, such as low back pain, low back function, gait ability, social life functions, and mental health, whereas it was positively correlated with anxiety and depression. However, only mental health, a sub-domain of daily life functions after surgery, was found to have a significant effect on pain catastrophizing.Conclusion: This study confirmed that mental health-related daily life functions after surgery were predictors of pain catastrophizing. Therefore, to alleviate pain catastrophizing in patients undergoing lumbar spinal surgery, it is necessary to develop nursing interventions that can assist with mental health-related daily life functions after surgery as well as physical recovery.

This study aims to investigate the relationship between patient safety awareness, knowledge (risk-Knowledge) and attitude about fire risk assessment during time-out (risk-Attitude) of perioperative nurses.A cross-sectional study.Perioperative nurses (N = 158) from 22 small- and medium-sized hospitals participated in the study. Participants' characteristics, knowledge and attitude about fire risk assessment were investigated using structured questionnaires.Patient safety awareness, risk-Knowledge and risk-Attitude scores were high among nurses who received frequent patient safety education or fire preparedness training, while patient safety awareness partially mediated the effect of risk-Knowledge on risk-Attitude. To increase perioperative nurses' risk-Attitude, it would be effective to increase not only their risk-Knowledge but also overall patient safety awareness.

This study identified factors related to the quality of life of older adults with coal workers' pneumoconiosis and determined the mediating effect of death anxiety on the relationship between depression and quality of life. The participants were 161 older adults who were admitted to five pneumoconiosis hospitals in South Korea. The results showed that higher levels of depression indicated higher levels of death anxiety, and higher levels of depression and death anxiety indicated poorer quality of life. While controlling for general characteristics, death anxiety (β = 0.47, P.001) had a complete mediating effect on the relationship between depression (β = 0.13, P = .075) and quality of life (R

The purpose of this study was to identify the mediating effects of perceived health status (PHS) and perceived organizational support (POS) in the association between emotional labor and burnout in public health nurses (PHNs). The participants were 207 PHNs convenience sampled from 30 public health centers and offices in Jeju, Korea. Data regarding emotional labor, PHS, POS, and burnout were collected between February and March 2021 using a structured questionnaire. Collected data were analyzed by Pearson’s correlation coefficient and multiple regression analysis. Burnout of PHNs was positively correlated with emotional labor (r = 0.64, p < 0.001) and negatively correlated with PHS (r = −0.51, p < 0.001) and POS (r = −0.51, p < 0.001). In the association between emotional labor and burnout, PHS (B = −1.36, p < 0.001) and POS (B = −0.42, p = 0.001) had a partial mediating effect. Reduction of burnout among PHNs requires not only effective management of emotional labor but also personal and organizational efforts to improve PHS and POS.

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 &lt, 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.

Background & Aim: Approximately 40% of lupus patients experience anxiety and depression. This study aimed to determine the effects of anxiety and depression on lupus patients’ quality of life. Methods & Materials: This study adopted a correlational predictive survey design. Using convenience sampling, we recruited 117 patients who had been diagnosed with lupus at a general tertiary hospital in Korea. Structured questionnaires were used to assess their demographic and clinical characteristics, the Hospital Anxiety and Depression Scale, and Lupus Quality of Life. Data analyses included descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation analysis, and stepwise multiple regression analysis and were performed with the SAS program (version 9.4). Results: The participants obtained a mean overall quality of life score of 63.49 out of 100. The highest and lowest means emerged for physical health and burden to others, respectively. Anxiety emerged as the strongest predictor of quality of life, followed by disease activity, depression, and duration since diagnosis. These variables explained 53 % of the variance in lupus patients’ quality of life. Conclusion: Medical professionals should pay close attention to each lupus patient's disease activity and duration to improve his or her quality of life. In particular, multidisciplinary efforts are needed to take proactive steps to screen for anxiety and depression in lupus patients.

Background & Aim: Bioethics education nourishes consciousness in bioethics and influences the attitude and perception of death. The purpose of this study was to investigate the effect of bioethics education by employing standardized patients for freshmen nursing students. Methods & Materials: A quasi-experimental single group pretest-posttest design was used to assess the effect of bioethics education employing standardized patients on 33 freshman nursing students’ perception of dignified death and empathy who took the course of bioethics of a university. Results: The perception of dignified death appeared higher in post-education than pre-education, and the subdomain of personal distress under empathy appeared higher in post-education than pre-education. In regard to the replies on the question of “disclosure of diagnosed cancer”, 54.6% of respondents approved, while 90.9% expressed “it should be at the discretion of doctors.” Conclusion: bioethics education employing standardized patients appeared assisting students experiencing changes in perception of a dignified death. It may be useful in applying the teaching module for students with courses in bioethics.

We investigated the effect of simulation education with problem-based learning (SIM-PBL) on nursing students' communication apprehension, assertiveness, and nursing clinical self-efficacy. Participants were 82 senior nursing students at a university in South Korea. Through the pre–post SIM-PBL comparison, we found that communication apprehension in group discussion decreased and nursing clinical self-efficacy increased, but no difference was found in assertiveness. Based on these findings, we recommend the development and application of SIM-PBL for various situations in the curriculum for nursing students prior to clinical practice.

The aim of this study was to examine the impact of physical function, anxiety, and depression on the fear of falling associated with everyday activities in patients with stroke. This was a cross-sectional descriptive survey. Convenience sampling was used to select 127 patients with stroke who were undergoing rehabilitative therapy at a single rehabilitation hospital in South Korea. Fear of falling, anxiety, and depression were assessed using structured questionnaires. Physical parameters, including lower extremity function, functional mobility, balance ability, and lower extremity muscle strength, were measured using objective methods. A multiple regression analysis was used to identify the predictors of fear of falling. Female patients had a higher fear of falling associated with walking outdoors compared to male patients. Lower extremity strength was the only significant predictor of fear of falling when adjusting for age, sex, Mini Mental State Examination scores, and fall experience. Lower extremity strength was identified as the most important factor affecting the fear of falling associated with everyday activities in patients with stroke. Preventing muscle weakness in the lower extremities and providing education and support to improve patients' self-efficacy in outdoor activities are strategies that can be used to reduce the fear of falling in patients with stroke.

Background:Academic ethical awareness is an important aspect especially for nursing students who will provide ethical nursing care to patients in future or try to tread the path of learning toward professional acknowledgement in nursing scholarship.Purpose:The purpose of this study was to explore academic ethical awareness and its related characteristics among undergraduate nursing students.Methods:This study commenced the survey with cross-sectional, descriptive questions and enrolled convenient samples of 581 undergraduate nursing students from three universities in South Korea. It was investigated with structured questionnaires including general characteristics and academic ethical awareness related.Ethical considerations:This study was reviewed and approved by the Institutional Review Board at National University.Findings:Academic ethical awareness was the highest regarding behaviors violating the respect or confidentiality of patients and cheating on exams, while it was the lowest for inappropriate behaviors in class. From the result of general characteristics difference, male students showed higher score than female students in relative; first-year students showed higher score than other year students; the higher score was rated from students who were highly satisfied with their major than the other not satisfied with their major; and students with low academic stress showed higher ethical awareness score than persons with higher stress.Conclusion:Personal behaviors were rated with low ethical awareness in relative, but items related to public rules and actual effects on patients or others were rated with higher score. Nursing satisfaction and academic stress are main factors on ethical awareness. To improve overall ethical awareness level of nursing students, it is required to provide more education about the importance of personal behaviors in class and need to improve the understanding of how it will be connected with future situation and effect.

With industrialization, increasing workforce participation of women, and advances in information and communications technology, South Korean society is experiencing conflict and confusion regarding sexual ethics. We investigated the relationships among sexual discrimination, attitudes toward sexual health, and consciousness of biomedical ethics with a sample of 142 Korean adults in Seoul, South Korea. Men exhibited greater sexual discrimination than did women. Consciousness of biomedical ethics was higher in those with religious faith and married individuals, those with a higher level of education, individuals in paid employment, and those with firmly held ethical values, than in people without these characteristics. Finally, consciousness of biomedical ethics was higher in individuals with a more positive attitude toward sexual health. On the basis of these results, we proposed the development of a sex education program in South Korea to encourage gender-equality awareness, strengthen sound attitudes toward sexual health, and increase consciousness of biomedical ethics.

Background Breast cancer patients fear the relapse of their disease and subsequent death the most. Dying Well Education Program, a death education program, was offered for breast cancer patients to help them to reflect on the meanings of life and death. Purpose This study evaluated the effects of a death education on fear of death, anxiety and depression, hope, and spiritual well-being among breast cancer patients. Methods Twenty-three women with breast cancer at a university hospital in South Korea who received Dying Well Education Program, once a week for 10weeks, were compared with 25 participants in a control group who received the treatment as usual. Results Participants in the experimental group were satisfied with the program and showed a decreased level of fear of death, and increased levels of hope and spiritual well-being when compared to the control group. The anxiety and depression scores for both experimental and control groups were initially within normal ranges before the program and further decreased over time. Conclusion This study confirmed that a properly designed death education program could serve as a means of increasing breast cancer patients' hope and spiritual well-being.

Purpose We conducted a descriptive study to identify the symptoms, emotional status, and quality of life experienced by hospitalized ovarian cancer patients undergoing chemotherapy, and influencing the factors of symptom clusters on their quality of life. Methods A total of 192 patients who had been diagnosed with ovarian cancer and received adjuvant chemotherapy after surgery more than once from 2 university hospitals with over 800 beds located in the Seoul and Gyeonggi areas of South Korea were included in this study. Using a structured questionnaire, the symptoms, emotional status, and quality of life by these patients were investigated from May 2012 to June 2013. Results We identified the following 7 symptom clusters among ovarian cancer patients undergoing chemotherapy: psychological distress, fatigue-pain, abdominal discomfort, flu-like symptoms, fluid accumulation, and peripheral neuropathy. Patients with a high level of anxiety or depression experienced all symptoms at a higher level, and the 7 symptom clusters influenced all aspects of the patients’ quality of life. Conclusions This study provides to need interventions for the quality of life of ovarian cancer patients need to include the management of not only the physical symptoms and treatment-related side effects, but also the changes in their emotional status and daily lives.

Summary Purpose This study identifies degree of awareness and legal knowledge about overall abuse and violence, and investigates attitudes towards domestic violence in emergency nurses. Methods The data collection period was between August and December 2012 for 131 nurses who worked in the emergency center of five hospitals in South Korea. This study surveyed emergency nurses about the recognition of abuse and violence, the legal knowledge of abuse and violence, and the attitudes towards domestic violence. Results This study showed that approximately 60.0% of participants experienced incidents of suspected abuse or violence, but the reporting rates were low. Of all the participants, 70.2% knew that they must report the discovery of abuse or violent incidents, but 45.0% did not know that if someone who had duty to report but did not report that he/she had a legal responsibility. Most emergency nurses agreed that "even if the domestic violence is severe it should not be suggested to victims that they run away, leaving children at home", and "perpetrators are patients who need treatment." Conclusions Appropriate awareness about abuse and violence, and systematic education are required for emergency nurses so that they can provide appropriate interventions.

Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.

Purpose: The objective of this study was to investigate the relationship between fatigue, sleep disturbance, and gestational stress in women during late stage of pregnancy. Methods: This study was conducted with 113 healthy pregnant women at gestational age greater than 27 weeks who were registered at community health centers and received prenatal care. A structured questionnaire regarding fatigue, sleep disturbance, and gestational stress was used. The data was analyzed using a t-test, an ANOVA, and Pearson correlation coefficients. Results: The subjects with unplanned pregnancies and irregular exercise patterns showed a higher level of fatigue than those with planned pregnancies and regular exercise patterns. Pregnant women with caffeine intake manifested higher levels of gestational stress and sleep disturbance than those without. The levels of sleep disturbance and gestational stress increased as the fatigue levels increased. The fatigue levels increased with increased levels of sleep disturbance. Conclusion: Planned pregnancy, regular exercise patterns, and caffeine intake were related with fatigue, sleep disturbance, and gestational stress in women during late stages of pregnancy. Fatigue, sleep disturbance, and gestational stress had close associations to each other. In the future, such results should guide development of nursing intervention programs for women in late stages of pregnancy.

Purpose: The purpose of this study was to investigate the degree of knowledge of hepatitis A, health perception, and health promoting behavior among young and middle-age adult`s. Methods: 207 young and middle-age adult`s workers living in Gyeonggi-do participated in this study and completed structured questionnaire. The knowledge of hepatitis A was assessed by the questionnaire which researchers developed. Health perception was measured by Health Perception Scale (Ware, 1979) while health promoting behavior was assessed by Lee`s(2006) questionnaire. These data were analyzed with Pearson correlation coefficient, t-test, ANOVA. Results: The knowledge score of hepatitis A was 9.53; the health perception score was 3.71; the health promoting behavior score was 3.38. There were no significant differences in knowledge of hepatitis A, health perception, and health promoting behaviors. However, A significant correlation was found between health perception and health promoting behaviors. Conclusion: The knowledge of hepatitis A found to be low. Therefore further study needs to develop nursing interventions that could improve knowledge and awareness of hepatitis A.

Aims and objectives To develop and validate an eye care educational programme for intensive care unit nurses. Background Eye care guidelines and protocols have been developed for increasing eye care implementation in intensive care units. However, the guidelines lack consistency in assessment or intervention methodology. Design This was a one-sample pre/postprogramme evaluation study design for testing the effects of the eye care educational programme, developed for and applied to intensive care unit nurses, on their levels of knowledge and awareness. Methods The eye care educational programme was developed based on literature review and survey of educational needs. Thirty intensive care unit nurses served as subjects for the study. Results The levels of eye care-related knowledge, awareness and practice were enhanced following the implementation of the educational programme. Moreover, satisfaction with the educational programme was high. Conclusion It is necessary to intensify eye care education aimed at new nurses who are inexperienced in intensive care unit nursing and provide continuing education on the latest eye care methods and information to experienced nurses. Relevance to clinical practice The eye care educational programme developed in this study can be used as a strategy to periodically assess the eye status of patients and facilitate the appropriate eye care.