Psychometric properties of the Korean version of the Stanford Presenteeism Scale in a nurse population.

Presenteeism, which refers to going to work despite being ill, has been associated with loss of work productivity, decreased quality of care, and an increased risk of health problems. The prevalence of presenteeism is particularly high among nurses; therefore, a reliable and valid tool is needed to assess presenteeism. This study aimed to translate the Stanford Presenteeism Scale (SPS) and to examine its psychometric properties in a Korean nurse population. A methodological study was performed in January 2023. The original SPS-6 (English-language) was translated and adapted to the Korean language using a committee approach translation, cognitive interviews, and content validation with a review panel of experts. An online survey was completed by 608 Korean nurses. The internal consistency, item-to-total correlation, construct validity, concurrent validity, and discriminant validity were examined as psychometric properties of the Korean version of the SPS. The final version of the K-SPS consists of four items shortened from the original six items. Cronbach's alpha of the K-SPS-4 was 0.74, indicating adequate reliability. Confirmatory factor analysis showed a one-factor solution with a good fit. There was a positive correlation between the K-SPS-4 and the Work Limitations Questionnaire. Discriminant validity was evidenced by the positive correlation of the K-SPS-4 with job satisfaction and the negative correlation with job stress. The K-SPS-4 has acceptable psychometric properties, supporting the feasibility of its use in assessing the level of presenteeism among Korean nurses. The validated K-SPS-4 can provide a basis for developing intervention programs to enhance productivity and promote health among nurses in clinical settings.

The Effectiveness of Telenursing Interventions on Patient Outcomes for Colorectal Cancer Patients: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically review existing telenursing interventions for patients with colorectal cancer and determine the effects of such interventions on health-related quality of life and health care service utilization. DATA SOURCES: We conducted a systematic review and meta-analysis after protocol registration. International databases, including PUBMED, EMBASE, CINAHL, Web of Science, SCOPUS, and CENTRAL and Korean databases, were searched. The last search was conducted on June 8, 2021. Two authors independently selected relevant studies, evaluated their methodological quality, and extracted data. A meta-analysis of randomized controlled trials was conducted using the statistical software STATA 16.0. Of the 223 articles retrieved, 7 were included for narrative synthesis and 3 were used for the meta-analysis. There were 857 patients in the telenursing group and 842 patients in the conventional group. Three studies applied theoretical frameworks for designing the intervention. CONCLUSION: The effect of telenursing intervention was not different from that of usual care. However, both readmission rates and emergency department visits were lower in the telenursing group than in the usual care group, although these trends were not statistically significant. IMPLICATIONS FOR NURSING PRACTICE: These findings indicate that telenursing intervention did not differ from usual care in terms of health-related quality of life while reducing readmission and emergency department visits in a nonstatistically significant manner. Therefore, telenursing interventions could serve as a partial alternative to current face-to-face interventions for patients with colorectal cancer.

The Effects of Job Demand-control-support Profiles on Presenteeism: Evidence from the Sixth Korean Working Condition Survey.

Background: Presenteeism is closely related to work performance, work quality and quantity, and productivity at work. According to the job demand-control-support model, job demand, job control, and support play important roles in presenteeism. The present study investigated job characteristics profiles based on the job demand-control-support model and identify the association between job characteristics profiles and presenteeism. Methods: This secondary data analysis used the Sixth Korean Working Condition Survey, a nationwide cross-sectional dataset. The study included 25,361 Korean wage workers employed in the workplace with two or more workers. Participants were classified into four job characteristics profiles based on the job demand-control-support model, using latent profile analysis, and logistic regression was performed to examine the association between study variables. Results: Overall, 11.0 % of study participants reported experience of presenteeism in the past 12 months. Age, sex, location, monthly income, shift work, work hours, health problems, and sleep disturbances were significantly associated with presenteeism. The rate of presenteeism was the highest in the passive isolate group. The passive collective, active collective, and low-stain collective groups had a 23.0%, 21.0%, and 29.0% lower likelihood of experiencing presenteeism, respectively, than the passive isolate group. Conclusions: The job demand-control-support profiles and the risk of presenteeism were significantly associated. The most significant group that lowered the experience of presenteeism was the low-strain collective group, which had a low level of demand and high levels of control and support. Therefore, we need a policy to reduce job demand and increase job control and support at the organizational and national levels.

The Determinants of Adherence to Public Health and Social Measures Against COVID-19 Among the General Population in South Korea: National Survey Study.

BACKGROUND: The COVID-19 pandemic has created devastating health, social, economic, and political effects that will have long-lasting impacts. Public health efforts to reduce the spread of COVID-19 are the priority of national policies for responding to the pandemic globally. Public health and social measures (PHSMs) have been shown to be effective when used alone or in combination with other measures, reducing the risk of spreading COVID-19. However, there is insufficient evidence on the status of compliance with PHSMs in the general population for the prevention of COVID-19 in public areas, including Korea. OBJECTIVE: The aim of this study was to assess levels of compliance with the recommended PHSMs against SARS-CoV-2 infection and their predictors among the general population by using national data. METHODS: This study was a secondary data analysis of the National Survey of Infectious Disease Preventive Behaviors in Community, which was conducted by the Korea Centers for Disease Control and Prevention Agency (KDCA) between October 12 and October 30, 2020. The primary study was cross-sectional, using stratified sampling via an adjusted proportional allocation method to select representative samples and ensure the stability of samples. The data were collected through phone interviews conducted by trained enumerators using a structured questionnaire. PHSM adherence was measured using a 10-item comprehensive infectious disease prevention behavior (CIDPB) scale, and each sociocognitive factor, including perceived susceptibility to SARS-CoV-2 infection, perceived severity of SARS-CoV-2 infection, perceived confidence in performing preventive behaviors related to COVID-19, information comprehension ability, and trust in information from the KDCA, was measured. A total of 4003 participants were included in the final analysis. Tobit regression and a decision tree analysis were performed to identify the predictors of preventive measures and the target groups for intervention. RESULTS: We discovered that women scored 1.34 points higher on the CIDPB scale than men (P<.001). Compared to the group aged 19 to 29 years, those aged 50 to 59 years and those older than 60 years scored 1.89 and 2.48 points higher on the CIDPB scale (P<.001), respectively. The perceived severity of infection, confidence in preventive behaviors, information comprehension ability, and trust in information from the KDCA were significant positive determinants of CIDPBs (P<.001). The perceived susceptibility to infection showed a significant negative relationship with CIDPBs (P<.001). CONCLUSIONS: Female sex, older age, lower income, and sociocognitive factors were found to be significant determinants of adhering to PHSMs. The findings suggest the need for tailored interventions for target groups; specifically, the age group that was the most active at work indicated the highest potential to spread infection. Adequate public health education and health communication for promoting adherence to PHSMs should be emphasized, and behavior change strategies for those with low perceived confidence in performing PHSMs should be prioritized.

A systematic review and pooled prevalence of symptoms among childhood and adolescent and young adult cancer survivors.

AIMS AND OBJECTIVES: To systematically review the existing literature reporting symptoms in childhood and adolescent and young adult cancer survivors and to meta-analyse the pooled prevalence of symptoms. BACKGROUND: Cancer survivors experience various symptoms caused by cancer treatments and their late effects. These symptoms are associated with adverse health outcomes. However, estimates of symptom prevalence vary largely, and no comprehensive review of symptoms has been conducted for childhood and adolescent and young adult cancer survivors. DESIGN: A systematic review. METHODS: This systematic review is registered in PROSPERO registry and was performed following the PRISMA guidelines. PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched up to July 2021. Three investigators assessed the eligibility of studies, extracted data and performed quality assessment. The pooled prevalence of symptoms was calculated using a random-effect model. Subgroup analysis was conducted to identify heterogeneity. RESULTS: Sixty-one studies were used to synthesise symptom prevalence, involving 114,184 participants. There were 24 physical symptoms and 10 psychological symptoms reported in two or more studies. The most studied physical symptoms were fatigue and sleep disturbance, and the most studied psychological symptoms were anxiety and depression. Among physical symptoms, drowsiness had the highest prevalence, followed by dry mouth and fatigue. Among psychological symptoms, worry and nervousness had the highest prevalence, followed by difficulty concentrating. CONCLUSIONS: Physical and psychological symptoms are common in the target population. This review provides an up-to-date overview of symptom prevalence, identifying areas for future research. RELEVANCE TO CLINICAL PRACTICE: Education about possible symptoms related to cancer and its treatment should be given while in treatment. Symptoms should also be monitored throughout the survivorship period. Nurses have a critical role in identifying and making referrals for psychological symptoms as well as promoting preventative strategies that enhance well-being.

Overtime and alertness of rotating-shift nurses: An observational study using ecological momentary assessment.

AIMS AND OBJECTIVES: This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. BACKGROUND: Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. DESIGN: A prospective observational study was employed. The study followed STROBE checklist for observational studies. METHODS: Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness. RESULTS: A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts. CONCLUSIONS: The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. RELEVANCE TO CLINICAL PRACTICE: Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.

Work schedule characteristics associated with sleep disturbance among healthcare professionals in Europe and South Korea: a report from two cross-sectional surveys.

BACKGROUND: Healthcare professionals worldwide are prone to sleep disturbance. Such sleep disturbance is associated with lower patient safety and quality of care. Therefore, this study aimed to identify the prevalence of sleep disturbance and determine the effect of work schedule characteristics on sleep disturbance among healthcare professionals in Europe and South Korea. METHODS: We used the sixth European Working Conditions Survey and the fifth Korean Working Conditions Survey for analyses. The study included 2285 healthcare professionals aged 18-65 years. Work schedule characteristics included shift work, night work, working hours per week, long work hours (i.e., more than 10 hours per shift), quick return to work, having to come to work on short notice, and changes in work schedules. A multiple logistic regression analysis was performed. RESULTS: The overall prevalence of sleep disturbance was 37.7%. The multivariate logistic regression model indicated that long work hours, quick return to, having to come to work on short notice, and changes in work schedules were significant factors associated with sleep disturbance among healthcare professionals. CONCLUSION: The findings revealed that several work schedule-related factors were associated with sleep disturbances in healthcare professionals in Europe and Korea. Institutions and policymakers should implement strategies and policies to reduce the unpredictability of work schedules to ensure an adequate rest period between shifts and to reduce sleep disturbances.

A latent class analysis of life stress among female East Asian college students: A multi-country study.

BACKGROUND: This study aimed to identify subgroups of East Asian female college students experiencing life stress frequencies, and examine whether a difference in general characteristics existed between the extracted classes. METHODS: This used a cross-sectional design. Female college students from South Korea (n = 220) and Hong Kong (n = 300) participated in the study. Life stress frequencies using the Life Stress Scale were measured. Latent class analysis as well as binary and multinomial logistic regression analyses were performed to identify the factors associated with extracted classes, and ascertain whether a difference in general characteristics existed between the extracted classes. RESULTS: South Korean participants were classified into two latent groups: "life stress - high" (18.6%) or "life stress - low" (81.4%). Within the Korean latent groups, subjective health status was significantly associated with group classification. In Hong Kong, participants were classified into three latent groups: "life stress - high" (13.7%), "life stress - moderate" (43.9%), and "life stress - low" (42.4%), and the classified groups were significantly associated with the financial status of participants' parents, subjective health status, and body mass index. LIMITATIONS: It is difficult to generalize the results to college females in the whole of South Korea and Hong Kong due to the convenience sampling method. Furthermore, further studies using a longitudinal design will be needed to confirm the variables' causal relationship. CONCLUSIONS: For alleviating the experienced stress frequency, it is important for female college students to have interventions at the family, societal, and national levels, in addition to their individual efforts.

Factors influencing quality of life among childhood cancer survivors in Korea: A quantile regression approach.

Cancer treatment in childhood may negatively affect survivors' quality of life. In this study, we aimed to determine the contributing factors for health-related quality of life (HRQOL) in survivors of childhood cancer in Korea using quantile regression analysis. This study was a secondary analysis. Data were collected from 130 childhood cancer survivors (CCS) from November 2018 to July 2019. Participants completed the Memorial Symptom Assessment Scale, Depression Anxiety Stress Scale, Health-Promoting Lifestyle Profile-II, and 36-Item Short Form Health Survey (physical component summary [PCS] and mental component summary [MCS]). Quantile and multiple linear regressions were used to analyze the factors contributing to HRQOL. The quantile and linear regression models revealed different results on the contributing factors to HRQOL in CCS. Mean PCS and MCS scores were 78.55 (SD = 15.08) and 64.02 (SD = 18.00), respectively. Symptoms (e.g., difficulty concentrating, worrying, pain, and lack of energy), physical activity, spiritual growth, interpersonal relationships, stress management, depression, and anxiety were significant influencing factors in some PCS quantiles, while symptoms, spiritual growth, interpersonal relationships, depression, and stress were significant influencing factors in some MCS quantiles. The findings of this study showed specific contributing factors in CCS with different levels of HRQOL. There is a need for targeted interventions related to risk reduction and stratification for CCS with different HRQOL levels. Symptom management strategies, early detection programs for CCS with psychological distress, and clinical and counseling interventions for CCS with poor HRQOL need to be developed.

Work schedule characteristics and occupational fatigue/recovery among rotating-shift nurses: A cross-sectional study.

AIMS: To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea. BACKGROUND: Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety. METHODS: This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models. RESULTS: The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile. CONCLUSIONS: The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses. IMPLICATION FOR NURSING MANAGEMENT: These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery.

Alertness during working hours among eight-hour rotating-shift nurses: An observational study.

PURPOSE: The aim of this study was to identify the patterns of the decline in the alertness of rotating-shift nurses during working hours across different shift types (day, evening, and night) using an objective measure. DESIGN: An observational study using ReadiBand wrist actigraphs was conducted. METHODS: Data were collected from June 2019 to February 2020. Participants were rotating-shift nurses (N = 82) who provided direct nursing care for patients in acute care hospitals in South Korea. Nurses wore actigraphs continuously for 14 days on their non-dominant hand to identify sleep-wake cycles and predict their alertness scores hourly. All participants completed a sleep diary. FINDINGS: Nurses working during night shifts had lower average alertness scores (mean = 77.12) than nurses working during day (mean = 79.05) and evening (mean = 91.21). Overall, alertness showed a declining trend and the specific patterns of decline differed across shifts. Participants with alertness scores less than 70 or 80 demonstrated a significant decline in alertness across all shifts. CONCLUSIONS: Distinct patterns of decline in alertness per nursing shift were revealed. Each shift feature should be considered when developing interventions to increase nurses' alertness, promote high-quality care provision, and ensure patient safety. CLINICAL RELEVANCE: The implementation of interventions to increase alertness among shift nurses is needed at the organizational level, and the cooperation of nursing managers and administrators is required.

Sleep, fatigue and alertness during working hours among rotating-shift nurses in Korea: An observational study.

AIMS: To determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts. BACKGROUND: Shift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care. METHODS: An observational study using wrist actigraphs was conducted from 2019 to 2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift. RESULTS: Nurses demonstrated shorter sleep hours, lower sleep efficiency and longer sleep latency before night shifts compared with other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70. CONCLUSIONS: Sleep parameters and fatigue level contributed to the differences in decline in alertness across shifts. IMPLICATION FOR NURSING MANAGEMENT: Findings inform nurse managers, administrators to develop interventions to reduce fatigue, improve sleep quantity and quality and increase alertness among rotating-shift nurses. Management, institutional and individual factors should be considered when developing interventions.

Living with the Late Effects of Childhood Cancer Treatment: A Descriptive Qualitative Study.

Long-term childhood cancer survivors (CCS) may experience physical, social, and emotional struggles posttreatment. Our aim was to explore the experiences of CCS dealing with the late effects of cancer treatment from their own perspectives. This study employed a qualitative descriptive design to explore and describe the experience of dealing with late effects among CCS. Semi-structured interviews were conducted with 15 CCS in Korea. Participants were selected by purposive and snowball sampling and individually interviewed during the period from September to November 2020. Conventional content analysis was used to analyze data and identify themes. Two main themes and seven subthemes emerged. The two main themes were: "Things I encountered while crossing a bridge" and "Living as a survivor". The participants reported both positive and negative experiences with dealing with the late effects of cancer treatment. The main themes indicated that late effects exert significant impacts on the lives of CCS in both positive and negative ways. Healthcare providers and researchers should pay attention to early intervention needs of CCS and their support systems to strengthen their positive experiences in dealing with late effects during their survivorships.

Psychometric Properties of the Korean Version of the Smoking Media Literacy Scale for Adolescents.

Smoking media literacy has proven to be an effective competency for reducing adolescents' smoking. This study aimed to cross-culturally modify the smoking media literacy scale and evaluate the validity and reliability of the Korean version of the revised Smoking Media Literacy Scale for Adolescents (K-SMLS). The translation of the K-SMLS was conducted according to the World Health Organization's guidelines. After the translation process, an online survey was conducted with convenience samples of 215 total adolescents from five high schools in the capital city of Korea. Construct validity was examined by exploratory factor analysis and confirmatory factor analysis. Internal consistency reliability was examined with Cronbach's alpha. The final version of the K-SMLS consisted of 15 items. The goodness of fit, determined through a confirmatory factor analysis of the three domains, was acceptable [χ2 = 237.85 (p < 0.001), CFI = 0.93, TLI = 0.92, RMSEA = 0.09, SRMR = 0.09]. The reliability of the K-SMLS was satisfactory (Cronbach's alpha = 0.79). The findings provide evidence for a valid and reliable tool that can be used to assess smoking media literacy in Korean adolescents. Further studies with a probability sampling design are suggested as the use of convenience samples limits the generalizability of the results to other populations.

The effectiveness of digital self-management interventions on health outcomes among childhood cancer survivors: A systematic review and meta-analysis.

AIMS: The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019. REVIEW METHODS: This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before-and-after studies, were included. The main outcomes were health-related quality of life and moderate-to-vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta-analysis was conducted using statistical software STATA 16.0. RESULTS: Out of the eight eligible studies, four were included in the meta-analysis. The digital self-management interventions were not effective on health-related quality of life and moderate-to-vigorous physical activity. Additionally, the digital self-management interventions increased the moderate-to-vigorous physical activity over time but was not statistically significant. CONCLUSIONS: There is insufficient evidence on the effectiveness of digital self-management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers. IMPACT: Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well-designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.

Sickness Presenteeism in Shift and Non-Shift Nurses: Using the Fifth Korean Working Conditions Survey.

Nurses have reported higher rates of sickness presenteeism than other workers, which is particularly problematic because this problem is linked to care quality and patient safety. This secondary data analysis study aimed to identify the prevalence of sickness presenteeism and explore related factors among shift and non-shift nurses using the Fifth Korean Working Conditions Survey. A total of 272 nurses in Korean hospitals were included. The survey included questions on working conditions, health status, and sickness presenteeism. A multivariate logistic regression was used to identify associated factors of sickness presenteeism. Overall, 21.8% of the participants reported experiencing sickness presenteeism; shift nurses experienced more sickness presenteeism than non-shift nurses. Sickness presenteeism was greater in shift nurses who did not have rest breaks during work and in nurses who experienced quick return. Additionally, the odds of sickness presenteeism were approximately four times greater in shift nurses who experienced sleep disturbance and about four times higher in shift nurses who experienced health problems. Among non-shift nurses, the odds of sickness presenteeism were about 15 times greater in those who worked ≥53 h per week. Nurse managers and administrators should prevent sickness presenteeism in hospital nurses to provide quality care and enhance productivity.

Factors Influencing Nurses' Willingness to Speak Up Regarding Patient Safety in East Asia: A Systematic Review.

Speaking up for patient safety among health care professionals is important because it can contribute to the prevention of adverse patient events, such as medication errors, infections, wrong-site surgical procedures, and other sentinel events. This systematic review identified factors that facilitate or inhibit nurses' willingness to speak up regarding patient safety in East Asian hospitals. Following the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, four databases, including PubMed, CINAHL, PsycInfo, and Web of Science, were searched. Nine studies were analyzed in this review, including five qualitative and four quantitative studies published between 2014 and 2019. Quality of included studies were evaluated using the Mixed-Method Appraisal Tool. Data synthesis was based upon qualitative-led synthesis adopting two existing multilevel frameworks on safety voice and employee voice signals. Four studies were conducted in Japan, three in South Korea, one in Hong Kong, and one in Taiwan. We organized factors influencing East Asian nurses' willingness to speak up regarding patient safety according to the following four contexts: individual (motivation toward patient safety, organizational commitment, perceived effectiveness and importance of speaking up, and assertive personality), team (positive relationship and team trust, team culture, and mentoring), organizational (hospital administrative support and organizational culture) and sociocultural (hierarchy and power differential and collectivistic culture). However, due to the limited number of studies conducted in East Asian hospitals, further studies with larger cohort samples of nurses in various East Asian countries should be conducted to deepen our understanding of nurses' willingness to voice their concerns for patient safety.

Corrigendum: Psychometric Properties of the Korean Version of the Smoking Media Literacy Scale for Adolescents.

[This corrects the article DOI: 10.3389/fpubh.2021.675662.].

Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses.

PURPOSE: This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals. DESIGN: This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018. METHODS: A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone. FINDINGS: The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue. CONCLUSIONS: High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone. CLINICAL RELEVANCE: It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.

Symptom clusters in childhood cancer survivors in Korea: A latent class analysis.

OBJECTIVE: To identify the occurrence of late symptom effects among childhood cancer survivors (CCS), generate subgroups using a latent class analysis and determine whether the subgroups differ in demographic and health-related characteristics and health-promoting lifestyle. METHODS: A cross-sectional survey was conducted on 130 adult CCS in Korea. The Memorial Symptom Assessment Scale was used to perform a latent class analysis based on symptom occurrence to generate subgroups. RESULTS: Difficulty in concentration, lack of energy, worrying, drowsiness, irritability, pain, difficulty in sleeping, nervousness, sadness and dry mouth appeared in more than 50% of the CCS. The three symptom subgroups identified were "all high" (46.2%), "high physical moderate psych" (26.9%) and "moderate physical low psych" (26.9%). The percentage of non-smokers was the highest in the moderate physical low psych subgroup (85.7%; p = .009), and the percentage of heavy alcohol consumption was the highest in the high physical moderate psych subgroup (31.4%; p = .013). Spiritual growth scores and interpersonal relationship scores were statistically different between subgroups (F = 3.35, p = .038; F = 7.55, p = .001 respectively). CONCLUSION: The results could guide the development of intervention programmes to strengthen spiritual growth and interpersonal relationships and facilitate further examination of the causal relationship between smoking and drinking and late symptoms of CCS.