Nursing students' clinical practice education experience during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Nursing education, including some elements of clinical practice, has largely been conducted online during the coronavirus disease 2019 (COVID-19) pandemic. Numerous studies have examined the experiences of nursing students in academia during the pandemic. However, research on nursing students' clinical practice experiences is limited. This study aimed to analyze nursing students' clinical practice experiences during the COVID-19 pandemic. METHODS: This study used a qualitative research design and performed thematic analysis. Participants comprised 13 nursing university students with clinical practice experience at a hospital during the COVID-19 pandemic. Interviews were conducted either online or face-to-face. Data were collected during June‒July 2021. RESULTS: Four themes and eight subthemes were generated through thematic analysis. Theme 1 was "Nursing students' anxiety and strict adherence to quarantine practices," with the subthemes of "Fear of infection" and "Protecting themselves." Theme 2 was "Nursing students' belief that their organization is protecting them," with the subthemes of "Strict quarantine rules at hospitals and universities" and "The nursing students regretted the limited scope of practice but felt safe." Theme 3 was "Learning through valuable practice," with the subthemes of "Recognizing the importance of practice" and "Realizing the benefits of practice." Theme 4 was "A sense of duty as a prospective nurse," with the subthemes of "Accepting a sense of duty as a nurse" and "Establishing the expanded role of a nurse." CONCLUSIONS: The nursing students recognized the importance of nursing practice during the pandemic and worked harder. A better understanding of the experiences of nursing university students who completed their clinical practice during the COVID-19 pandemic can help nursing professors and managers more effectively train students during times of high stress.

Influence of AI ethics awareness, attitude, anxiety, and self-efficacy on nursing students' behavioral intentions.

BACKGROUND: Artificial intelligence (AI) technology has recently seen rapid advancement, with an expanding role and scope in nursing education and healthcare. This study identifies the influence of AI ethics awareness, attitude toward AI, anxiety, and self-efficacy on nursing students' behavioral intentions to use AI-based healthcare technology. METHODS: The participants included 189 nursing students in Gyeonggi-do, with data collected from November to December 2021 using self-reported questionnaires. We analyzed the data using the SPSS/WIN 26.0 program, including a t-test, Pearson's correlation coefficient, and hierarchical multiple linear regression. RESULTS: The results revealed that AI ethical awareness (t = - 4.32, p < .001), positive attitude toward AI (t = - 2.60, p = .010), and self-efficacy (t = - 2.65, p = .009) scores of the third and fourth-year nursing students were higher, while their anxiety scores were lower (t = 2.30, p = .022) compared to the scores of the first and second-year nursing students. The factors influencing behavioral intention included a positive attitude toward AI (ß = 0.58) and self-efficacy (ß = 0.22). The adjusted R2 was 0.42. CONCLUSION: It is necessary to inculcate a positive attitude toward AI and self-efficacy by providing educational programs on AI-based technology in healthcare settings.

Nurses' duty to care during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: Despite the increased demand for nurses worldwide, discussion of nurses' duty to care is lacking. This study aimed to examine nurses' duty to care during the coronavirus disease 2019 (COVID-19) pandemic and to identify the influencing factors. METHODS: This was a cross-sectional descriptive research study that used a structured online questionnaire. Registered Korean nurses answered a demographic questionnaire and the Nash Duty to Care Scale. RESULTS: Age and employment at tertiary hospitals increased nurses' duty to care. Male sex, a highly educated status, and employment at tertiary hospitals increased the perceived risk. Male sex and employment at tertiary or general hospitals increased confidence in the employer, while a high level of education and a longer total clinical career decreased the same. Age and a higher monthly wage increased perceived obligation. Age, lack of religious beliefs, and clinical experience of 3-7 years increased professional preparedness. CONCLUSION: Without enough nursing manpower, the disaster response system could prove to be inefficient. Considering that adequate nurse staffing is essential in disaster management, it is crucial to ensure that nurses have a will to provide care in the case of disaster. In the future, a more active discussion on nurses' duty to care and additional research on factors that may hinder and facilitate the same are needed.

Factors influencing posttraumatic growth in ovarian cancer survivors.

PURPOSE: The purpose of this study was to examine posttraumatic growth (PTG), cancer coping, posttraumatic stress, and genetics knowledge among ovarian cancer survivors and to identify factors affecting PTG. METHODS: This cross-sectional study included 148 outpatient ovarian cancer survivors at a cancer center. Data were collected between February 25 and April 11, 2019, and were analyzed using t tests, ANOVA, Pearson-correlations, and multiple regression. RESULTS: On average, the ovarian cancer survivors scored 68.09 ± 20.17 in PTG, 59.75 ± 13.37 in cancer coping, 29.30 ± 17.25 in posttraumatic stress, and 9.42 ± 3.33 in genetics knowledge. There were significant differences in PTG according to religion (t = - 2.92, p = .004), marital status (F = 3.06, p = .050), and family history of cancer (t = 2.00, p = .047). In the final analysis, the statistically significant factors influencing PTG were religion (ß = .170, p = .004) and cancer coping (ß = .691, p < .001), and posttraumatic stress had borderline statistical significance (ß = - .107, p < .068). These factors explained 52.2% of the variance in PTG. CONCLUSIONS: Ovarian cancer survivors showed a moderate level of genetics knowledge while having a high risk for posttraumatic stress. Overall, this study showed that cancer coping was a powerful factor that influenced PTG in ovarian cancer survivors. Religion was found to positively affect PTG, and posttraumatic stress had a small negative effect. Spiritual nursing interventions and improving cancer coping while reducing posttraumatic stress are necessary to increase the PTG of ovarian cancer survivors.

Impact of emotional labour and workplace violence on professional quality of life among clinical nurses.

AIM: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. BACKGROUND: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. METHODS: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. RESULTS: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. CONCLUSIONS: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational-level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed.

Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study.

OBJECTIVES: The purpose of this cross-sectional study was to examine potential associations between handgrip strength and health-related quality of life, or subjective health status, in the elderly. METHOD: We performed secondary data analysis on 2377 elderly individuals aged >65 years. Raw data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), were drawn from a representative national sample. RESULTS: Of those aged ≥65 years or older, 25.4% had low handgrip strength. After adjusting for confounding variables, the odds ratios of elderly individuals with low handgrip strength were 1.30 (95% confidence interval [CI]: 1.00-1.69) for mobility, 2.18 (95% CI: 1.47-3.22) for self-care, 1.70 (95% CI: 1.30-2.23) for usual activities, 1.30 (95% CI: 1.01-1.67) for pain/discomfort, 1.03 (95% CI: 0.74-1.44) for anxiety/depression, 1.44 (95% CI: 1.10-1.87) for the EQ-5D index, and 1.37 (95% CI: 1.08-1.73) for subjective health status. CONCLUSION: Health-related quality of life and subjective health status differ according to handgrip strength. Therefore, handgrip strength should be addressed to improve quality of life in elderly individuals. Elderly individuals require exercise education and adequate nutritional intake to increase handgrip strength.

Mediating effects of workplace violence on the relationships between emotional labour and burnout among clinical nurses.

AIMS: To test a model of the relationship between nurses' burnout and emotional labour using structural equation modelling to identify the mediating effects of workplace violence. BACKGROUND: Nurses are a group that experiences high emotional labour and are exposed to various types of violence in the clinical setting. Burnout is related to emotional labour and exposure of workplace violence, but alternatives to reduce burnout in the context of emotional labour (e.g., reduction in workplace violence) have not been extensively investigated. DESIGN: This study adopted a cross-sectional design. METHODS: A convenience sample comprising 400 nurses from four university hospitals in Korea was selected from 10 to 30 October 2016. Data on nurses' level of emotional labour, burnout and workplace violence were collected from participants. A composite-indicator structural equation model was used to examine the mediation model. RESULTS: Overall, 356 nurses (89.0%) returned the completed questionnaires. Burnout was significantly and positively associated with emotional labour and workplace violence. In addition, workplace violence mediated the relationship between emotional labour and burnout related to the nursing job. CONCLUSION: The findings suggest that, to alleviate burnout in clinical nurses due to emotional labour, various programs and policy measures should be adopted to prevent their exposure to workplace violence and to enhance the organizational management of violence.

Irregular menstruation according to occupational status.

This cross-sectional study explored associations of irregular menstruation with occupational characteristics, using secondary analyses of data from 4,731 women aged 19-54 years, collected from a nationally representative sample, the Korea National Health and Nutrition Examination Survey-V during 2010-2012. The associations between irregular menstruation and occupation were explored using multiple logistic regression. Compared to non-manual workers, service/sales workers had a greater odds of irregular menstruation (adjusted odds ratio [aOR]: 1.44; 95percent confidence interval [CI]: 1.04-1.99) as did manual workers and unemployed women (aOR: 1.56; 95percent CI: 1.10-2.22, aOR: 1.46; 95percent CI: 1.14-1.89, respectively). Compared to regular workers, temporary workers and unemployed women had aORs of 1.52 (95percent CI: 1.08-2.13) and 1.33 (95percent CI: 1.05-1.69), respectively. Also, when compared to full-time workers, part-time workers and unemployed women had greater odds of irregular menstruation (aOR: 1.41; 95percent CI: 1.00-2.00 and aOR: 1.29; 95percent CI: 1.03-1.63, respectively). Furthermore, compared to daytime workers, shift workers and unemployed women had greater odds irregular menstruation (aOR: 1.39; 95percent CI: 1.03-1.88 and aOR: 1.28; 95percent CI: 1.04-1.59, respectively). Women with these occupational characteristics should be screened for early diagnosis and intervention for irregular menstruation.

Association between smoking type and prevalence of atopic dermatitis and asthma in men and women.

AIM: This study aimed to examine the association between smoking type and the prevalence of atopic dermatitis and asthma in men and women. BACKGROUND: Cases of allergic diseases have been steadily increasing worldwide. Smoking is associated with serious diseases. Only a few studies have assessed the association between smoking and atopic dermatitis and asthma in adults, and gender difference studies are scarce despite a significant difference in smoking rates. METHODS: We conducted a secondary cross-sectional analysis of 17 886 adults with atopic dermatitis and 17 889 with asthma aged ≥19 years, using raw data from the Fifth Korea national Health and Nutrition Examination Survey (2010-2012). RESULTS: The prevalence of atopic dermatitis in men was not associated with active or passive smoking, whereas asthma prevalence in men was associated with indoor passive smoking exposure at home. We found that atopic dermatitis prevalence in women was associated with current smoking status, whereas asthma prevalence in women was associated with the presence of an indoor daily smoker at home and indoor passive smoking exposure at home. CONCLUSION: Asthmatic adults should be informed of the hazards of passive smoking, and women with atopic dermatitis should in particular be dissuaded from smoking.

Urinary incontinence in women in relation to occupational status.

Through this cross-sectional study the authors explore urinary incontinence in women in relation to occupational status and environment. Data from the fourth Korea National Health and Nutrition Examination Survey (2008-2009) were used (n = 5,928) excluding those aged under 19 or over 65 years, male, with renal disease, and with missing data. Urinary incontinence was prevalent in working women. Compared to unemployed women, the adjusted odds ratio (95% confidence intervals) for women working in services/sales was 1.62 (1.21-2.19); for paid workers was 1.81 (1.20-2.73); and for self-employed workers was 1.46 (1.05-2.03). Compared to unemployed women, the adjusted odds ratio for working women with a daytime work schedule was 2.14 (1.18-3.87), while for those with evening work schedules, it was 1.35 (1.05-1.74). Urinary incontinence was significantly associated with various occupational environments: an unclean and uncomfortable workplace, dangerous job and probability of accidents, feeling pressed for time, awkward position for long periods, and carrying heavy weights. These findings suggest that urinary incontinence was prevalent in working women and was associated with occupational status and working environment. Therefore, improving occupational status and environment for working women-such as modifying the working schedule, posture, and workplace atmosphere-are needed to prevent urinary incontinence.

Associations between prevalence of adult atopic dermatitis and occupational characteristics.

AIM: To examine the prevalence of adult atopic dermatitis according to occupational status. BACKGROUND: While atopic dermatitis is more prevalent among children, some adults also suffer from it. The disease causes considerable difficulty in these adults' social lives at school or work, suggesting that they require high-quality health care. Given the chronic nature and environmental determinants of atopic dermatitis, its associations with occupational characteristics must be clarified. DESIGN: An exploratory cross-sectional analysis using secondary data. METHOD: Participants were 662 people diagnosed with atopic dermatitis, all 19 years old or older; raw data were taken from the Korea National Health and Nutrition Examination Survey V (2010-2012) and VI (2013-2014). RESULTS: Manual workers (adjusted odds ratio 2.50, 95% confidence interval, 1.30-4.83), paid workers (1.70, 1.15-2.51), regular workers (1.83, 1.18-2.85), and full-time workers (1.88, 1.23-2.89) all showed increased odds of currently suffering from atopic dermatitis. CONCLUSION: Prevalence rates of atopic dermatitis differed by occupational characteristics, which suggests the need for interventions seeking to prevent symptom recurrence that are tailored to occupational characteristics. We expect this study to provide helpful baseline data for better policy-making.

Health-related Quality of Life and Mental Health of Adults With Atopic Dermatitis.

AIM: This cross-sectional study aimed to examine the association between the prevalence of atopic dermatitis in Korean adults and their health-related quality of life and mental health. METHODS: Data from a nationally representative sample of 11,913 adults who participated in the Korea National Health and Nutrition Examination Survey V (2010-2012) were analyzed by using SAS version 9.3. RESULTS: The adults with atopic dermatitis had significantly lower quality of life and higher stress than did those without it. Moreover, the health-related quality of life of the adults with atopic dermatitis was significantly lower than those without the disease, after adjusting for all covariates. The adjusted odds ratios of the adults with atopic dermatitis were 1.74 (95% confidence interval [CI]: 1.14-2.65) for stress, 1.69 (95% CI: 1.00-2.84) for depression, and 1.66 (95% CI: 1.02-2.69) for suicidal ideation. CONCLUSION: Improving our understanding of atopic dermatitis should help nurses and patients manage the stress, depression, suicidal ideation, and reduced quality of life associated with this chronic disease. There is a need to develop and conduct intervention of programs for improving mental health as well as clinical aspects of adult atopic dermatitis.

Health-related quality of life and mental health in older women with urinary incontinence.

OBJECTIVES: The purpose of this cross-sectional study was to compare health-related quality of life (QOL) and mental health between older women with and without urinary incontinence. METHOD: This study is a secondary data analysis using raw data from 1874 women aged 65 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2008-2009), a nationally representative sample. RESULTS: In the pain/discomfort dimension of the EuroQol-5, 25.4% of the participants experienced urinary incontinence and 14.7% did not (p = .001). In the anxiety/depression dimension, urinary incontinence was present in 8.3% of the participants and absent in 3.6% (p = 0.012). In addition, the results of an ANCOVA showed that scores in both the EuroQol visual analogue scale and the EQ-5D index were significantly lower in participants with urinary incontinence relative to those without. The risk of stress and depression in older women with urinary incontinence was approximately 2 and 1.5 times higher, respectively, than that of participants without urinary incontinence. CONCLUSION: Health-related QOL in older women with urinary incontinence was relatively low, while levels of stress and depression were high. Therefore, in order to improve QOL and mental health in older women, the understanding and management of urinary incontinence interventions is required.

The association between suicide ideation and sensory impairment among elderly Koreans.

OBJECTIVES: The purpose of this cross-sectional study was to examine the relationship between sensory impairment and suicide ideation among elderly Koreans. METHODS: Data from the 2010-2012 Korea National Health and Nutrition Examination Survey V was used. Participants included 3636 older adults (≥65 years) who received hearing and vision tests; participants also completed assessments of covariates and suicide ideation. RESULTS: The risk of suicide ideation was 1.43-1.65 times higher among participants with visual impairment than in those without impairment. Moreover, the risk was 1.60-1.76 times higher among those with both auditory and visual impairments than the risk for those without any impairment. CONCLUSION: This study found an association between sensory impairment and suicide ideation in elderly individuals. Therefore, it seems necessary that interventions that reduce or prevent sensory impaired elders' suicide ideation are needed, which may be an indicator of mental health problems or poor quality of life.

Factors associated with health-related quality of life on mental and oral health in patients with cancer and cancer survivors using the Korea National Health and Nutrition Examination Survey (2005-2018).

Objective: To investigate the association of mental and oral health with the health-related quality of life (HRQOL) in patients with cancer and cancer survivors. Methods: This cross-sectional study involved 1643 patients with cancer and 1628 individuals who survived cancer (aged ≥ 19 years) using data from the 2005-2018 Korean National Health and Nutrition Examination Survey. The data were analyzed using SAS survey procedures (version 9.4), t-tests, χ2 test, and multiple regression. Results: Regarding differences in mental and oral health factors by group, the results revealed significant differences between depression, suicidal ideation, subjective oral health, chewing problems, and speaking problems due to oral issues. The HRQOL of patients with cancer was lower than that of cancer survivors. The factors influencing HRQOL in both patients with cancer and cancer survivors were education status, economic activity, subjective health, suicidal ideation, and speaking problems due to oral issues. HRQOL was also associated with depression in patients with cancer. Conclusions: Patients with cancer had a lower HRQOL than cancer survivors. The two groups of patients showed significant differences in the factors associated with HRQOL. Therefore, customized health programs and policies should be developed and implemented for each group to improve their QOL.

Exploring factors influencing health-related quality of life in adult females with injuries: a cross-sectional nationwide study.

Objectives: This study aimed to identify the types of injury experiences affecting adult females and the associations between injury experiences and health-related quality of life. Methods: This study used a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey, which employed a stratified multistage probability sampling design to obtain nationally representative data. Health-related quality of life was measured with the EuroQol Five-Dimension and consisted of mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Results: Among women aged 19-64, the prevalence of injury experience was 5.9%. Women's injury experience varied by age, subjective health perception, menstruation details, osteoporosis status, and osteoarthritis status. The following injury experience-related factors were significantly associated with health-related quality of life: self-care (odds ratio [OR] = 0.32, 95% confidence interval [CI]: 0.17-0.60), usual activity (OR = 0.43, 95% CI: 0.27-0.70), and pain/discomfort (OR = 0.56, 95% CI: 0.44-0.72). Conclusion: Health-related quality of life among adult women was significantly associated with injury experience. The results of this study highlight risk factors for injury that are associated with aging, such as menopause, osteoporosis, and osteoarthritis. Accurate assessments of pain and discomfort, as well as daily activities, are essential for designing effective interventions for injured women. Tailored training and education can promote self-management and improve outcomes for recovery.

Health-related quality of life in older women with injuries: a nationwide study.

Objectives: This study aims to describe the health-related quality of life (HRQoL) and influencing factors of older women who experienced injuries. Methods: This study is a secondary analysis of data from 4,217 women aged 65 years or older sampled from the Korea National Health and Nutrition Examination Survey (KNHANES) (2016-2020) database. Two-way analysis of variance was used to analyze the data. Results: The mean HRQoL scores of older women with and without injuries were 0.81 ± 0.19 (n = 328) and 0.85 ± 0.17 (n = 3,889), respectively, which were significantly different (p < 0.001). The results of multiple regression analysis revealed that working, physical activity, BMI, osteoarthritis, stress, and subjective health status significantly affected the HRQoL of older women with injuries, and the explanatory power of the model was 29%. Conclusion: The results of this study on factors affecting HRQoL can contribute to the understanding of the experience of older women with injuries and can be used as a reference to develop health promotion programs.

Mental Health and Handgrip Strength Among Older Adults: A Nationwide Study.

Handgrip strength is used as an important indicator of health in older adults. We aimed to explore the association between stress, depression, and suicidal ideation and handgrip strength among older adults. We conducted this cross-sectional study involving 1254 individuals (aged ≥65 years), using data from the 2015 Korean National Health and Nutrition Examination Survey VI. We used logistic regression analysis to examine associations between handgrip strength and mental health. Among mental health factors, a significant difference was noted between stress and handgrip strength among the older adults. After adjusting for confounding factors, the odd ratio (OR) of stress among older adults with low handgrip strength was statistically significant in Models 1 (1.61 (95% CI: 1.01-2.57)) and 2 (1.59 (95% CI: 1.01-2.52)) but not in Model 3 (1.52 (95% CI: .96-2.43)). No significant association was found between depression or suicidal ideation and handgrip strength. The risk of stress was 1.59-1.61 times higher in older adults with low handgrip strength, compared to that in older adults with normal handgrip strength. It is necessary to develop strategies aimed at managing stress among older adults with low handgrip strength and educating them about the importance of handgrip strength and exercises that increase handgrip strength.

Impact of Internet usage time on mental health in adolescents: Using the 14th Korea Youth Risk Behavior Web-Based Survey 2018.

Dependency on the Internet in daily life is increasing, and the negative consequences this dependence may have on mental health are not sufficiently understood. The aim of this study was to investigate the relationship between Korean adolescents' Internet usage time and their mental health. This cross-sectional study included 29,811 high school students ages 16-18 from the 2018 Korea Youth Risk Behavior Web-Based Survey. Participants' mean Internet usage time was 193.4±1.6 min/day. Internet usage time was associated with sex, grade level, type of school, living arrangement, economic status, academic achievement, and experience of school violence. With regard to mental health, subjective health status, stress, feelings of sadness, and suicidal ideation were also related to Internet usage time. The group with more than average Internet usage had poorer subjective health, higher level of stress, and had feelings of sadness and suicidal ideation compared to the group with less than average Internet usage. To effectively manage Internet usage time, interventions to lower Internet usage and leisure programs that could replace Internet usage need to be developed.

Health Risk Behaviors Affecting Internet Usage in Adolescents: Evidence from the 2018 Korea Youth Risk Behavior Web-Based Survey.

Background: The purpose of this cross-sectional study was to assess the effects of health risk behaviors on the daily Internet usage of Korean high school students. Methods: The data of 19,830 high school students who responded to the Korea Youth Risk Behavior Web-based Survey were analyzed from June to July 2018. Results: The mean daily Internet usage of high school students was 193.3±125.7 minutes. There were differences in daily Internet usage according to body mass index, grade level, school type, academic achievement, economic status, physical activity, number of physical education classes attended, safety accidents, and safety education (p<.05). Daily Internet usage also differed according to health risk behaviors, including smoking (t=8.32), alcohol consumption (t=9.36), drug use (t=4.51), and risky sexual behaviors (t=5.94). The daily Internet usage of students significantly increased in the absence of physical activity and with health risk behaviors such as smoking, alcohol consumption, drug use, and risky sexual behaviors. Conclusion: It is necessary to develop an intervention program and provide education on increasing physical activity and reducing health risk behaviors for the proper management of health and Internet usage in adolescents.