Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study.

AIM: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND: Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS: This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS: One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.

Comparison of factors associated with postpartum depression from two cohorts of nurses: the Korea Nurses' Health Study and the Nurses' Health Study 3.

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, χ2 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.

Impact of workplace violence on South Korean nurses' turnover intention: Mediating and moderating roles of depressive symptoms.

AIM: To identify the mediating and moderating roles of depressive symptoms in the relationship between workplace violence and nurses' turnover intention in South Korea. BACKGROUND: Workplace violence and depressive symptoms are known to influence turnover intentionsof employees. INTRODUCTION: Among healthcare workers, nurses may be at the greatest risk of exposure to workplace violence because they have frequent contact with patients and families of patients. Depressive symptoms reported to be related to workplace violence are one set of factors affecting turnover intention. METHODS: A cross-sectional study was designed and employed to investigate mediation and moderation roles of depressive symptoms between workplace violence and turnover intention. RESULTS: Verbal violence and sexual harassment increased depressive symptoms, which in turn increased turnover intentions in a sample of Korean nurses. Depressive symptoms showed partial mediation effects between verbal violence and sexual harassment and turnover intention. Depressive symptoms showed moderating effects on sexual harassment and turnover intention. DISCUSSION: It is necessary to reduce turnover intention not only by preventing violence but also by managing depressive symptoms in nurses who have experienced verbal violence and sexual harassment. CONCLUSION: Depressive symptoms were shown to have a mediating and moderation roles on the relationship between WPV and turnover intention. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Hospital managers such as hospital and nursing directors should provide effective policies to prevent verbal violence and sexual harassment to reduce turnover intention in the workplace. It is needed to educate patients and patient caregivers about the importance of preventing violence against nurses. Policies should be established to provide regular check-ups for depressive symptoms and psychological support for nurses who have experienced WPV.

Factors associated with regularity and length of menstrual cycle: Korea Nurses' Health Study.

BACKGROUND: Menstrual cycle characteristics are linked to reproductive function and long-term health outcomes. This study aimed to evaluate menstrual cycle patterns, characterized by regularity and length, and associated factors among women in the Korea Nurses' Health Study. METHODS: A total of 9335 premenopausal women aged 22-45 years were included in this cross-sectional study. Regularity and length of menstrual cycles were self-reported, and their associations with reproductive, lifestyle, and occupational factors were examined using binomial and multinomial logistic regression models. Adjusted least-square means of menstrual distress, depressive symptoms, stress, fatigue, anxiety, and sleep problems were estimated according to menstrual cycle characteristics using generalized linear models. RESULTS: Twenty-one percent of nurses reported having irregular menstrual cycles (variability > 7 days). Ten percent, 64%, and 26% had menstrual cycle length of < 26, 26-31, and 32-50 days, respectively. Variability and length of cycles decreased with age and increased with age at menarche. Parous women showed low tendency of irregular cycles. Women with body mass index (BMI) > 25 kg/m2 had higher odds of irregular (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.40-2.03) and long cycles (OR 1.31; 95% CI 1.08-1.58) than those with BMI 18.5- < 23 kg/m2. Irregular cycles were less common in women performing vigorous physical activity, but more common in those with prolonged standing or frequent heavy lifting at work. Frequent rotating night shift was associated with irregular cycles among nulliparous women. Levels of menstrual and premenstrual distress, depressive symptoms, perceived stress, physical and mental fatigue, anxiety, and sleep problems were higher in women with irregular cycles than in those with regular cycles (p < 0.001, each). CONCLUSIONS: The study suggests that irregular and long menstrual cycles are associated with reproductive, lifestyle, and occupational factors; also with menstrual distress and perceived health status. Our findings contribute to a better understanding of potential risk factors for menstrual dysfunction, and thus, may help improve women's health.

Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A cross-sectional study.

We examined to compare menstruation and body mass index (BMI) in women with and without polycystic ovary syndrome (PCOS) and to explore the effects of BMI on menstruation, facial acne, and hirsutism in women with PCOS of child-bearing age. Data from the Korea Nurses' Health Study were analyzed. The effect of BMI on irregularity of menstruation, acne, and hirsutism in the PCOS group was analyzed by logistic regression. The prevalence of PCOS was 7.1% among 11,866 participants. We found that BMI affects menstrual irregularity, facial acne, and hirsutism in PCOS women. Healthcare providers should consider weight control to improve irregularity of menstruation and hirsutism in PCOS women.

Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study.

AIMS: To identify factors influencing turnover among Korean female nurses from a longitudinal perspective. DESIGN: A national cohort study called the Korea Nurses' Health Study (2013-2020) was used. METHODS: A national sample of female nurses from module 1 (N = 20,613, 2013-2014), module 5 (N = 11,527, 2016-2017), module 7 (N = 8,658, 2018-2019) and module 8 (N = 10,253, 2019-2020) was used. Based on a nurse turnover model, individual, health-related, social work environment and work organizational factors were considered explainable variables for nurse turnover. Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to identify the factors influencing female nurse turnover in South Korea. RESULTS: Female nurses who had less education, were unmarried, were pregnant, and had higher stress levels and an increased probability of experiencing turnover as they aged. Those who perceived moderate health rather than good/very good health, had depressive symptoms, had a higher salary, were charge nurses/unit managers/supervisors or advanced practice nurses, were advanced practice nurses rather than registered nurses, worked shifts, worked in special care units or outpatient wards/administration as opposed to general wards, and worked in larger hospitals had a decreased probability of experiencing turnover as they aged. A two-way interaction analysis revealed that those who had depressive symptoms and increased perceived stress were more likely to experience turnover as they aged. CONCLUSION: Multiple factors influenced female nurse turnover, including individual, health-related, social work environment and work organizational factors. A multidimensional approach is needed to reduce nurse turnover. IMPACT: Various factors predict nurse turnover as nurses age, implying that a multifaceted approach is needed to manage nurse turnover. The influence of depressive symptoms on turnover should be evaluated by considering the perceived stress level. Nursing managers and policy makers could use our results to develop programs/policies to reduce nurse turnover.

Prediction model for abnormal eating behaviour among hospital nurses: A structural equation modelling approach.

BACKGROUND: Nurses are at a high risk of developing abnormal eating behaviour. However, few studies have attempted to identify the factors that influence such behaviour. AIM: This study identifies factors that can predict abnormal eating behaviour in hospital nurses. DESIGN: This study adopted a cross-sectional, descriptive correlational research design. METHODS: A literature review was used to establish a hypothetical model, comprising the eight factors of shift work, job stress, depression, sleep quality, fatigue, coping strategy (active coping and passive coping) and abnormal eating behaviour. A convenience sample of 298 nurses aged less than 45 was recruited from two university hospitals, and structured questionnaire was administered between March and April 2017. The hypothesized model was tested using structural equation modelling. RESULTS: Sleep quality and passive coping directly affect abnormal eating behaviour, which implies that poor sleep quality and increased passive coping worsens the behaviour. Shift work and depression indirectly affect abnormal eating behaviours. CONCLUSION: Nursing managers and health policy makers should adopt strategies such as improving the shift-work pattern, providing adequate rest time after a night shift and enabling coping strategies by providing educational programs for hospital nurses.

Secondary traumatic stress and compassion satisfaction mediate the association between stress and burnout among Korean hospital nurses: a cross-sectional study.

BACKGROUND: Burnout among nurses is a worldwide public health epidemic that adversely affects nurses' quality of life as well as the patient's outcomes. The aim of this study was to evaluate the influence of stress on nurses' burnout and to identify the mediating effects of secondary traumatic stress and compassion satisfaction among clinical nurses in South Korea. METHODS: A quantitative, cross-sectional study evaluated the survey data from 10,305 female registered hospital nurses who participated in the Korea Nurses' Health Study (KNHS) Module 5. The survey included a demographic questionnaire and the Professional Quality of Life version 5 (ProQOL 5). Bootstrap analyses (using the PROCESS macro) were employed to evaluate the mediating effect between variables. RESULTS: Stress was significantly associated with burnout and mediated by secondary traumatic stress and compassion satisfaction (ßindirect 1 = 0.185, Bootstrap confidence interval (BS CI) [0.175, 0.194]; ßindirect 2 = 0.226, BS CI [0.212, 0.241], respectively). In addition, the magnitude of the indirect effects of compassion satisfaction was significantly greater than the magnitude of the indirect effects of secondary traumatic stress (ßindirect 1-ßindirect 2 = - 0.042, BS CI [- 0.058, - 0.026]). The findings of this study indicate that the positive aspect (compassion satisfaction) of work experiences can offset the negative aspects (secondary traumatic stress), consequently reducing burnout level. CONCLUSIONS: Our study findings suggest that a multidimensional approach to assessing nurse burnout and implementation of proper management will improve quality of life for nurses and help maintain positive attitudes and quality of patient care.

Vitamin D deficiency and associated factors in south Korean childbearing women: a cross-sectional study.

BACKGROUND: Adequate levels of vitamin D are important for women of childbearing age as vitamin D helps maintain the pregnancy and ensures proper maternal and fetal bone metabolism and fetal skeletal development. However, vitamin D deficiency is a health problem prevalent in women of all ages, worldwide. This study aimed to determine the current status of serum vitamin D levels and the risk factors for vitamin D deficiency among South Korean nurses of childbearing age. METHODS: Serum levels of 25-hydroxyvitamin D (25[OH]D) were measured in 1594 registered nurses aged 20 to 45 years who are participants in an ongoing prospective cohort study of the Korean Nurses' Health Study initiated in 2013. The participants completed surveys about demographic and occupational characteristics and physical and psychological health. We examined associations with vitamin D deficiency through multivariable logistic regression analysis. RESULTS: The average blood 25(OH) D concentration of the participants was 12.92 ng/mL (4.0-63.4 ng/mL), while the prevalence of vitamin D deficiency (< 20 ng/mL) was 89% (1419/1594). Multivariable logistic regression showed that significant risk factors for vitamin D deficiency included month of sampling (there was a lower level of vitamin D deficiency in winter than in spring, summer, or fall), age (women in their 20s had a lower vitamin D level than those in their 30s and 40s), and stress symptoms. Vitamin D levels were not associated with body mass index, physical activity, and depressive symptoms. CONCLUSIONS: This study showed a high prevalence of vitamin D deficiency in Korean female nurses. Serum levels of vitamin D were associated with age and season. Vitamin D deficiency should be recognized as one of the primary health concerns among young women. More proactive actions, such as vitamin D supplements and food fortification, are needed to improve vitamin D deficiency in high-risk groups.

Predictors of actual turnover among nurses working in Korean hospitals: A nationwide longitudinal survey study.

AIM: To examine the factors affecting actual turnover among nurses working in hospitals using the Brewer-Kovner synthesis model. BACKGROUND: To increase retention of nurses, it is important to understand factors contributing to actual turnover among nurses. METHODS: A longitudinal study design was utilized with 2,633 of 20,613 eligible female hospital nurses who participated in Korea Nurses' Health Study. We created two age groups: a younger group (20-35 years) and an older group (36-49 years). Multivariate logistic regression was used to identify the factors influencing turnover by age group. RESULTS: Pregnancy and childbirth increased young nurses' turnover. When we excluded intent to leave, depression and burnout were significant factors affecting young nurses' turnover. Salary and hospital size were factors predicting nurse turnover among nurses older than 36 years. CONCLUSIONS: It is essential to develop prevention strategies of female nurse turnover based on the age group in Korea. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and health care institutes need to develop new managerial and policy strategies to reduce nurse turnover in each age group.

Factors affecting frontline Korean nurses' mental health during the COVID-19 pandemic.

AIM: To identify the factors affecting fear, anxiety and depressive symptoms among frontline nurses working with COVID-19 patients or are in charge of COVID-19 screening in Korea. BACKGROUND: Nurses are at a higher risk of COVID-19 infection because they are in closer, longer-duration contact with patients. These situations can negatively affect the mental health of nurses. METHODS: This study analysed data from COVID-19 module in the Korean Nurses' Health Study. Data from 906 participants were analysed. To identify the factors influencing mental health, descriptive statistics, Pearson's correlation and hierarchical multiple regression analyses were performed. RESULTS: Caring for patients who are COVID-19-positive increased levels of fear, anxiety and depressive symptoms of nurses. The hospital safety climate influenced mental well-being among nurses. CONCLUSION: Caring for patients with COVID-19 had a negative impact on fear, anxiety and depressive symptoms. However, the higher was the perceived hospital safety climate, the lower were the nurses' psychological symptoms. Further research on the mental health of nurses is warranted. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Institutions should manage human resources to enable periodic rotation of nurses' work and working periods related to COVID-19. In addition, hospital managers should provide sufficient personal protective equipment, related education, and safety climate.

Factors affecting depressive symptoms in employed hemodialysis patients with chronic renal failure.

Depressive symptoms are commonly experienced by hemodialysis patients, generally related to withdrawal from dialysis and compliance with dialysis prescription. This study aimed to identify the factors affecting depressive symptoms in employed hemodialysis patients with chronic renal failure. A cross-sectional, correlational study design was utilized, consisting of 71 patients with chronic renal failure receiving hemodialysis treatment, all employed. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) and fatigue by the Chalder Fatigue Scale. Psychosocial adaptation was measured by the Korean version of the Social Profile. In this study, 32.4% of the participants were depressed. Female patients had a higher score for depressive symptoms than males (25.78 ± 10.15 vs. 16.42 ± 10.25, p = .013). Mental fatigue (ß = .425, p < .001), psychosocial adaptation (ß = -.275, p < .001), and subjective health (ß = -.199, p < .05) were predictive variables of depressive symptoms in hemodialysis patients, with mental fatigue being the most important factor. Depressive symptoms can affect the self-management of hemodialysis patients; therefore, it is important that healthcare providers identify factors that affect depressive symptoms, particularly those associated with mental fatigue.

Relationships between depression, family function, physical symptoms, and illness uncertainty in female patients with chronic kidney disease.

This study investigated the relationship between depression, family function, physical symptoms, and illness uncertainty in women with chronic kidney disease. Data were collected through structured questionnaire that was completed by 120 women undergoing hemodialysis. Assessment instruments consisted of the Family Adaptability, Partnership, Growth, Affection, Resolve Scale, Symptom Experience Scale, Mishel's Uncertainty in Illness Scale for Adults, and the Center for Epidemiological Studies-Depression Scale. The higher the uncertainty about illness and physical symptoms, the higher is the level of depression, and the better the family function, the lower is the level of depression. Greater uncertainty was associated with poorer family function and worsening physical symptoms. A regression model explained 41% of the variance in depression. Significant predictors of depression were physical symptoms, living alone, illness uncertainty, and "poor" subjective health status. To improve depression of women with chronic kidney disease, nurses need to reduce physical symptoms and illness uncertainty in these patients and improve their subjective health status. In addition, the establishment of a therapeutic support system considering living arrangement will help to reduce depression in women with chronic kidney disease.

The effectiveness of virtual reality for people with mild cognitive impairment or dementia: a meta-analysis.

BACKGROUND: Virtual Reality (VR) is increasingly used in health-related fields and interventions using VR have the potential to be powerful tools in patient management. The aim of this study was to synthesize the effects of VR interventions for people with mild cognitive impairment (MCI) or dementia. METHODS: Electronic databases were searched to identify studies that used an experimental design to investigate VR intervention outcomes for patients with MCI or dementia. Studies were excluded if the intervention did not focus on VR, if relevant quantitative outcomes were not reported, or if the intended study purpose was assessment or diagnosis. Data were extracted and analyzed from studies that met criteria. To synthesize the intervention effect sizes (ES), we used random effects models to accommodate heterogeneity in the main effect and sub-group analyses. To identify the potential reason for heterogeneity and compare ES according to the moderator variables, subgroup analyses were conducted based on study characteristics and intervention outcomes. RESULTS: Data from eleven studies that met eligibility criteria were analyzed. VR intervention delivered to participants with MCI or dementia produced small to medium effects (ES = 0.29, CI = 0.16, 0.42). The ES for studies using semi-immersive technology (ES = 0.37, CI = 0.25, 0.49) was greater than the studies using full-immersive VR (ES = 0.03, CI = -0.14, 0.21). The results showed small-to-medium effects for VR interventions affecting key outcome variables such as cognition (ES = 0.42, CI = 0.24, 0.60) and physical fitness (ES = 0.41, CI = 0.16, 0.65). CONCLUSION: VR interventions, particularly of the semi-immersive type, are useful for people with MCI or dementia. These results should contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.

Illness uncertainty and complementary and alternative medicine use in patients undergoing hemodialysis.

In this study, we identified the relationships between illness uncertainty, subjective health, and the use of complementary and alternative medicine in patients undergoing hemodialysis. In total, 138 participants who were diagnosed with stages 4-5 chronic kidney disease and currently receiving hemodialysis were included. A cross-sectional, correlational design was utilized. Illness uncertainty was associated with education, monthly income, employment, and subjective health. The use of complementary and alternative medicine was not related to illness uncertainty. Among the subdomains of illness uncertainty, ambiguity and unpredictability were related to subjective health; 24.6% of the participants were currently using complementary and alternative medicine and 19.6% had used it in the past. Such methods were mainly used for the effective treatment of diseases or relief of symptoms; 88.5% of those using complementary and alternative medicine consumed vitamins, specific foods, or dietary supplements. However, the proportion of participants who consulted with health-care providers was not high. When planning nursing interventions for patients treated with hemodialysis, assessments on illness uncertainty and complementary and alternative medicine use are needed.

Development and validation of an emotional labour scale for nurses.

PURPOSE: This study aimed to develop an instrument to measure nurses' emotional labour and to examine the scale's validity and reliability. BACKGROUND: Nurses experience emotional labour when they interact with patients. In previous research, nurses' emotional labour was measured using tools developed for other occupations, which made it difficult to clarify the attributes specific to nursing. METHODS: Preliminary items were developed through a literature review, interviews and constructing a conceptual framework. The confirmed 25 items were applied in data collection. Data collected from 304 nurses working at metropolitan area hospitals were utilized to test the preliminary tool's validity and reliability. For this purpose, item analysis, factor analysis, Pearson correlation coefficients and Cronbach's alpha were used. RESULTS: The final scale comprised 16 items, divided and three factors. The factors comprised "emotional control effort in profession," "patient-focused emotional suppression," and "emotional pretense by norms." The explanatory variance of the three factors was 52.1%. Cronbach's α was 0.81, and the split-half coefficient was 0.84. CONCLUSIONS: Results indicate that the proposed scale was valid and reliable, and suitable for assessing nurses' emotional labour. IMPLICATIONS FOR NURSING MANAGEMENT: The scale could contribute to devising an efficient strategy to manage nurses' emotional labour.

Gastroesophageal reflux disease and its related factors among women of reproductive age: Korea Nurses' Health Study.

BACKGROUND: Recently, the number of patients diagnosed with gastroesophageal reflux disease (GERD) has increased in Korea. Risk factors of GERD include age, sex, medication use, lack of physical exercise, increased psychological stress, low or high body mass index (BMI), unhealthy eating habits, increased alcohol consumption, and cigarette smoking. However, few studies examined the major factors affecting GERD in women of childbearing age. Therefore, this study assessed the risk factors of GERD among 20,613 female nurses of reproductive age using data from the Korea Nurses' Health Study. METHODS: Participants were recruited from July 2013 to November 2014. They provided their history of GERD 1 year prior to data collection, along with information on their demographic characteristics, health-related behaviors, diet, medical history, and physical and psychological factors. Of the total sample, 1184 individuals with GERD diagnosed in the year prior to the study were identified. Propensity score matching was used for analysis. RESULTS: Cigarette smoking, increased alcohol consumption, low or high BMI, depression, and increased psychosocial stress were associated with the prevalence of GERD among Korean young women. Multivariate ordinal logistic regression analysis revealed significant positive relationships between GERD and being a former smoker; having a low (< 18.5 kg/m2) or high BMI (> 23 kg/m2); and having mild, moderate, moderately severe, and severe depression. CONCLUSIONS: Smoking, BMI, and depression were associated with GERD. To reduce this risk among female nurses, intervention strategies are required to help nurses maintain a normal weight and manage their depression.

Radiation safety education and compliance with safety procedures-The Korea Nurses' Health Study.

AIMS AND OBJECTIVES: To examine the current state of radiation safety education and its influence on nurses' compliance with safety procedures. BACKGROUND: Use of radiation in therapy and diagnosis has prolonged and improved millions of lives, but it presents potential hazards for healthcare professionals. DESIGN: A cross-sectional design. METHODS: Participants included 1,672 female nurses of childbearing age who had recently been exposed to radiation-emitting generators or radiation. Quantitative data were taken from the Korea Nurses' Health Study, the Korean version of the Nurses' Health Study conducted in the USA. Confounding variables included sociodemographic factors, duration of employment in a department where work involved radiation, hospital's geographical location, bed size and hospital safety climate. Statistical analyses included descriptive statistics, Spearman's correlation coefficients and multivariable ordinal logistic regression. RESULTS: Half (50.3%) of nurses received no safety training, whereas the other half received some safety training as follows: only once (14.4%), irregularly (10.2%) and regularly (25.1%). Of the six radioactive safety compliance questionnaires, 29.4%, 20.2%, 30.7% and 19.7% complied to none, one, two and more than three, respectively. After controlling for confounding variables, relative to that observed with no safety education, irregular education that occurred more than twice (OR = 1.597, CI = 1.177-2.164) and regular education (OR = 2.223, CI = 1.770-2.792) increased the likelihood that nurses would comply with safety procedures. CONCLUSIONS: Low levels of safety education and adherence raise critical concerns regarding nurses' well-being. As routine safety education increases safety adherence, healthcare managers and policymakers should emphasise regular safety education. RELEVANCE TO CLINICAL PRACTICE: Radiation safety education for nurses and their compliance with safety procedures have seldom been discussed in South Korea. However, as nurses' safety is directly related to the quality of patient care, additional safety education should be provided for hospital nurses to minimise their occupational exposure to harmful radioactive substances in clinical settings.

Association between shift work and severity of depressive symptoms among female nurses: the Korea Nurses' Health Study.

AIM: To determine the prevalence of depression and the relationship between shift work and depression severity among female nurses in South Korea. BACKGROUND: Shift work has been associated with higher risks of depressive symptoms, but there is a dearth of research on nurses, particularly investigating the severity of depressive symptoms. METHODS: Quantitative data including survey response from 9789 participants were analysed. Statistical analysis included descriptive, Spearman's correlation and multivariable ordinal logistic regression. RESULTS: The numbers of nurses according to the severity of depressive symptoms were 35.2% (n = 3445), 38.0% (n = 3716), 16.1% (n = 1578), 7.6% (n = 747) and 3.1% (n = 303) for normal, mild, moderate, severely moderate and severe level of depressive symptoms, respectively. After adjusting for sociodemographic and health behavioural factors, nurses who worked shifts had 1.519-times greater odds of experiencing a higher severity of depressive symptoms (OR = 1.519, CI = 1.380-1.674, P < 0.001). CONCLUSION: This study shows a higher prevalence of depressive symptoms among nurses who worked shifts and suggests that shift work may increase the severity of depressive symptoms among female nurses in South Korea. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing professionals, managers and health policy makers need to understand the factors influencing depressive symptoms and to use appropriate interventions based on the severity and not just the onset.

Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy.

PURPOSE: This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. METHODS: The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. RESULTS: The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. CONCLUSIONS: Stroke patients with fall experience and walking aids might be considered at increased risk of falling. CLINICAL RELEVANCE: Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients.