Asian Cohort for Alzheimer's Disease (ACAD) pilot study on genetic and non-genetic risk factors for Alzheimer's disease among Asian Americans and Canadians.

INTRODUCTION: Clinical research in Alzheimer's disease (AD) lacks cohort diversity despite being a global health crisis. The Asian Cohort for Alzheimer's Disease (ACAD) was formed to address underrepresentation of Asians in research, and limited understanding of how genetics and non-genetic/lifestyle factors impact this multi-ethnic population. METHODS: The ACAD started fully recruiting in October 2021 with one central coordination site, eight recruitment sites, and two analysis sites. We developed a comprehensive study protocol for outreach and recruitment, an extensive data collection packet, and a centralized data management system, in English, Chinese, Korean, and Vietnamese. RESULTS: ACAD has recruited 606 participants with an additional 900 expressing interest in enrollment since program inception. DISCUSSION: ACAD's traction indicates the feasibility of recruiting Asians for clinical research to enhance understanding of AD risk factors. ACAD will recruit > 5000 participants to identify genetic and non-genetic/lifestyle AD risk factors, establish blood biomarker levels for AD diagnosis, and facilitate clinical trial readiness. HIGHLIGHTS: The Asian Cohort for Alzheimer's Disease (ACAD) promotes awareness of under-investment in clinical research for Asians. We are recruiting Asian Americans and Canadians for novel insights into Alzheimer's disease. We describe culturally appropriate recruitment strategies and data collection protocol. ACAD addresses challenges of recruitment from heterogeneous Asian subcommunities. We aim to implement a successful recruitment program that enrolls across three Asian subcommunities.

An exploratory study of the practical impact of the COVID-19 pandemic on nursing tasks in clinical settings.

AIMS: To identify and compare new or increased nursing tasks in South Korea during the pandemic, categorized by hospital type and department. BACKGROUND: Although COVID-19 is no longer considered a global public health emergency, the threat of novel infectious diseases remains. Reflecting on the COVID-19 pandemic is essential to prepare effectively for future outbreaks. METHODS: This cross-sectional exploratory study, following the STROBE checklist, included 948 registered nurses with more than a year of clinical experience currently working in various hospitals. Questionnaires gathered demographic data, work characteristics, and the frequency of nursing task performance. Statistical analysis encompassed descriptive and inferential methods. RESULTS: The most common new or increased nursing task across all hospital types was 'Access control for family caregivers.' General wards prioritized tasks related to family caregivers, while specialized units like ICU and ER focused on infection control. CONCLUSION: Understanding how COVID-19 has impacted nursing tasks is crucial for gaining insights into efficient resource allocation, targeted education, and policy formulation during similar public health crises. The pandemic has given rise to new family caregiver-related tasks in the nursing profession. Consequently, continuous nursing research is essential for establishing guidelines and fostering a supportive work environment, which is crucial for the successful implementation of these tasks.

Korean nurses' energy drink consumption and associated factors.

This study aimed to examine the energy drink consumption pattern of Korean nurses and related factors. A descriptive cross-sectional design was utilized, and data were collected through a self-reporting questionnaire. Participants were Korean nurses working in hospitals. Data were analyzed by descriptive statistics, chi-square test, and binomial logistic regression test. A total of 388 nurses participated in the study. Approximately two-thirds of the nurses consumed energy drinks in addition to caffeinated coffee and/or tea. They usually consumed energy drinks during working hours and at the workplace. In comparison with nonconsumers, nurses who consumed energy drinks perceived that they had a stimulating effect and could replace regular drinks. Having colleagues who consume energy drinks and perceiving that energy drinks had an arousal effect were shown to be associated factors for energy drink consumption; thus, it is necessary to develop educational strategies targeting these groups of nurses. The reasons for the dependence of hospital nurses on energy drinks should be further investigated.

Health capacity building for middle-aged Laotian women with a risk of metabolic syndrome through a non-communicable disease prevention program.

The aims of the researchers were to develop an NCD prevention program including training for professionals who implement such programs, and to evaluate its effects on diabetes mellitus knowledge, hypertension knowledge, self-efficacy, and self-care in community-dwelling, middle-aged Laotian women. The study design was a randomized controlled trial. The study sample was composed of Laotian women aged 40 to 59 years living in Vientiane, Laos who fulfilled more than one diagnostic criterion for metabolic syndrome. This study provides a guide for low- and middle-income countries to develop future health capacity building programs for NCD prevention in middle-aged women.

Development of international nursing standard-based curriculum for North Korean nurses.

BACKGROUND: The types of nursing care and education have been advanced in different ways between South and North Korea during the past 73 years following division of Korea. The contents of the nursing education curriculum in North Korea do not match international standards. In preparation for the unification of the two Koreas, identifying and examining North Korean nursing education are needed. AIM: To develop a curriculum for North Korean nurses to in accordance with the international nursing standards. METHODS: This study consisted of two phases. First, we reviewed the literature, analyzed in-depth interviews with North Korean nurse defectors, and evaluated the contents and scope of nursing education in North Korea. Next, we developed a nursing education curriculum for North Korea through discussion with nursing education experts. RESULTS: The nursing curriculum for North Korean nurses comprised 96 credits (21 credits for fundamental major courses and 75 credits for mandatory major courses) according to the standards of the Korea Institute of Nursing Education and Evaluation. The proposed curriculum I comprised 84.5 credits, with 14.5 credits for major courses and 70 credits for mandatory major courses. Proposed curriculum II considered the capabilities and clinical experiences of North Korean nurses and comprised 52 credits with 6 credits for major courses and 46 credits for mandatory major courses. CONCLUSION: A nursing curriculum was proposed to match the nursing practice competencies of North Korean nurses to international standards. This curriculum can be expected to improve the quality of nursing care in North Korea, facilitate the integration of nursing workforces, and ultimately promote the health of the people during unification. IMPLICATIONS FOR NURSING POLICY: The nursing curricula proposed in this study could be a significant measure to nurture nursing manpower and contribute to narrowing the nursing gaps between South and North Korea in the process of Korea's unification.

Psychometric evaluation of drinking refusal self-efficacy questionnaire-shortened revised adolescent in Laos.

This study evaluated the psychometric properties of Lao version of Drinking Refusal Self-Efficacy Questionnaire-Shortened Revised Adolescent (L-DRSEQ-SRA). A total of 406 Laotian adolescents from six lower secondary schools, were randomly selected for the evaluation of the following psychometric properties. The original factor model was confirmed via confirmatory factor analysis in Lao adolescents, the convergent and discriminant validity were found appropriate. The mean score of L-DRSEQ-SRA in the non-drinking group was significantly higher than in the drinking group. The L-DRSEQ-SRA showed acceptable internal consistency and test-retest reliability. The psychometric characteristics of the L-DRSEQ-SRA were established throughout this study.

Caffeine and high energy drink use and knowledge by nurses in three countries.

AIM: The purpose of this study was to examine nurses' use and knowledge of caffeine and high energy drinks (HED) in three countries. METHODS: Nurses in each country completed a survey on caffeine and HED use and knowledge. RESULTS: In a sample of 182 nurses, caffeine use was high with 92% of nurses in Korea, 90.8% in Italy and 88.1% in the United States (US) having at least one cup of coffee a day while 64% of Koreans and 11.9% of those in the US had at least one HED per day. In Korea 68% of nurses (Italy 63.1% and 35.8% US) had at least one cup of caffeinated tea per day. Most agreed there is a need to educate nurses about HED, which contain high amounts of caffeine. Over half of nurses in Korea (58%) and the US (56.7%) said their colleagues consume HED at work. CONCLUSION: Findings of this study indicate many nurses are consuming caffeine at work and there is a need for education. It is unclear how caffeine affects nurses' clinical performance, which raises the issue of patient safety. Further research is needed regarding safe amounts of caffeine while nurses are on the job as well as an understanding of how HED additives may affect the well-being and clinical care of nurses.

COVID-19: Korean nurses' experiences and ongoing tasks for the pandemic's second wave.

Nurses are the largest group of healthcare workers in the world, and during the COVID-19 pandemic, nurses have been recognized worldwide as frontline warriors working hard to stem suffering, infection rates and deaths. Korean nurses experienced the effects of the pandemic earlier than in most other countries, and the work of our nurses has been recognized as a successful model in responding COVID-19. In this paper, we share the experiences of Korean nurses, including their experiences of workload, acute shortages of staff and equipment and work overload, and suggest ongoing tasks that need to be addressed to combat the pandemic's second wave and other possible waves. Specifically, the nursing issues relating to COVID-19 are critically reviewed and recommendations for each issue are suggested in terms of nursing staffing, practice and policy, as well as health policy.

Prevalence of behavioural and psychological symptoms of dementia in cognitively impaired elderly residents of long-term care facilities in East Asia: a cross-sectional study.

OBJECTIVE: The aim of this study was to compare the prevalence of behavioural and psychological symptoms of dementia (BPSD) in cognitively impaired elderly residents of long-term care facilities in East Asia and to explore the factors associated with these patterns. METHODS: This was a cross-sectional survey of BPSD in cognitively impaired elderly residents of long-term care facilities in Japan, South Korea, China, Taiwan, and Thailand. The Mini-Mental State Examination, Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory, Nursing Home version (NPI-NH), were used to assess cognitive status, dementia severity, and BPSD, respectively. NPI-NH subscale severity scores were multiplied by frequency scores to obtain the subscale scores and aggregated into two groups based on score (clinically insignificant = 1- 3; clinically significant ≥4). RESULTS: Data from 662 people were analyzed. Median age, median Mini-Mental State Examination scores, and median CDR scores differed significantly among the seven study sites. The prevalence of BPSD varied from 64% in Taiwan to 100% in dementia care units in Japan, and the median total NPI-NH scores ranged from 2 in Taiwan to 14 in dementia care units in Japan. After stratification of the sample by dementia severity and clinical significance of NPI-NH scores, differences in the prevalence of clinically significant BPSD were mostly observed among facilities dedicated to dementia patients in the CDR 1 group. In the CDR 3 group, the prevalence of some clinically significant BPSD, such as apathy, was high even among study sites with low median total NPI-NH scores. CONCLUSIONS: Our findings may suggest referral and selection biases in the study sites. Future prospective studies are needed to address the impact of environmental and care factors on the occurrence of BPSD in Asian countries.

Variations and factors associated with psychotropic use in cognitively impaired elderly residing in long-term care facilities in East Asia: a cross-sectional study.

BACKGROUND: The aim of this cross-sectional study was to compare patterns of psychotropic prescription drug use among cognitively impaired residents in long-term care facilities in East Asia and to explore factors associated with these patterns. METHODS: This study included elderly participants with cognitive impairments residing in long-term care facilities with and without dementia care units in Japan, South Korea, China, Taiwan, and Thailand. The Mini-Mental State Examination, the Clinical Dementia Rating, and the Neuropsychiatric Inventory, Nursing Home version were used to assess cognitive status, examine dementia severity, and evaluate behavioural psychological symptoms of dementia, respectively. The rate of psychotropic drug use and the relationship between the number of psychotropic drugs and clinical factors were examined. RESULTS: In total, 662 people were analyzed. Facilities with dementia care units had a higher rate of anti-dementia drug use than regular elderly care sites. Among the three dementia care sites, a Japanese hospital and a Korean site had a high rate of antipsychotic use and use of other types of psychotropics, whereas these drugs were used at a low rate in a Chinese nursing home. Patterns of psychotropic drug use may be partially associated with local regulations and facility type. Poly-pharmacy was identified as a common problem at all study sites. CONCLUSIONS: Our findings will be beneficial for health-care professionals and policymakers when developing practice guidelines and strategies to regulate overuse of psychotropics and poly-pharmacy. Prospective studies are needed to examine patterns of psychotropic prescriptions and to promote evidence-based practice.

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.

Self-care model based on the theory of unpleasant symptoms in patients with heart failure.

AIMS: This study aimed to test and develop the self-care model based on the theory of unpleasant symptoms in patients with HF. BACKGROUND: Although self-care may reduce unpleasant symptoms of heart failure (HF), reported rates of effective self-care in HF patients are very low. Modifiable factors, including disease severity, anxiety, depression, social support, unpleasant symptoms, and self-efficacy are considered to influence self-care, but little is known about their overall impact on self-care. METHODS: A model-testing design was used. Covariance structure analysis using the maximum likelihood method was used to evaluate the hypothetical model. RESULTS: A total of 209 subjects participated in the study. The model-fit indexes of the final model were χ2 = 163.473, Normed χ2 = 1.796, RMSEA = 0.054, IFI = 0.986, CFI = 0.986, GFI = 0.915, and AGFI = 0.873. Disease severity and anxiety had an indirect effect on self-care through unpleasant symptoms. Depression and social support had an indirect effect on self-care through self-efficacy. Lower unpleasant symptoms and higher self-efficacy were associated with greater self-care. These predictors explained 61.9% of variance in self-care. CONCLUSION: Findings from this study could underscore the need to consider nursing strategies that relieve unpleasant symptoms and improve self-efficacy to enhance self-care in HF patients.

Evidence-based nursing practice and its correlates among Korean nurses.

AIM: The aim of the study was to explore evidence-based nursing practice (EBNP) in Korean and identify factors influencing its implementation. BACKGROUND: EBNP is relatively new in Korea, and there is a lack of consistency about the factors that affect EBNP implementation. METHODS: A descriptive correlational and cross-sectional design was employed and a convenience sample of 392 nurses were recruited from two general hospitals. Data were analyzed by using descriptive and inferential statistics. RESULTS: The overall model significantly explained 17.1% of variance in EBNP implementation. Among the predictors of EBNP implementation, regularly reading research articles, level of searching skills for literature, degree of understanding EBNP, professional autonomy, and EBNP beliefs had statistically significant influences on EBNP implementation. CONCLUSION: Findings suggest the necessity for Korean nurses to regularly read research articles, develop greater skills in developing searching research documents, gain clearer understanding of EBNP, EBNP beliefs, and particularly, high level of professional autonomy.

Recognizing global disparities in health and in health transitions in the 21st century: what can nurses do?

PURPOSE: To examine changes in patterns of health and disease in global context between rich countries (USA, Korea, South Africa) and poor countries (Cambodia, Malawi) by using the framework of epidemiology theory developed by Orman (1971, 2005), and to raise awareness of global health disparities thereby prompting actions to reduce such disparities. FINDINGS: 1) Life expectancy has increased across all selected countries except South Africa; 2) Korea and the USA have substantially lower mortality rates than other countries; 3) Infant and maternal mortality are still high in the poor countries; 4) The major cause of mortality in the poor countries is still communicable disease with evidence of the onset of non-communicable disease; and 5) The health transition theory provides a description and explanation of the differences in progress in economic development between countries but fails to explain differences in health status within and between countries. CONCLUSIONS: Life expectancy and mortality are enormously different among the five selected countries. This excessive health disparity is primarily due to the higher risk of communicable diseases in low-income countries. Social determinants of health are mainly responsible for the health disparities observed within and between countries. CLINICAL RELEVANCE: Future health care development and global research priorities will not be the same for all countries because the pattern of health transitions in the developing countries is not the same as the developed countries. Actions to reduce global health disparities need to recognize the conditions and social context in which persons live. An effective strategic approach to global health equality should develop a shared system of values, priorities, and delivery infrastructures with the populations who are targeted, aligning delivery within the local social contexts.

Cardiac self-efficacy and its predictors in patients with coronary artery diseases.

AIMS AND OBJECTIVES: To investigate cardiac self-efficacy and its predictors among patients with coronary artery diseases. BACKGROUND: Patients with coronary artery diseases must perform the health behaviour to prevent recurrent cardiac events. It has been already well known that self-efficacy is a vital factor in both initiating and maintaining health behaviours. DESIGN: Descriptive correlational and cross-sectional survey design. METHODS: Subjects were interviewed using structured study questionnaires. The data collected were statistically analysed by descriptive statistics and inferential statistics including the t-test, anova, Tukey's test, Pearson's correlation and hierarchical multiple regression analysis to determine the predictors of cardiac self-efficacy. RESULTS: A convenience sample of 214 patients with coronary artery diseases was included. The mean age of subjects was 60·71 ± 10·07 years, and three-fourths were men. The overall model significantly explained 15·8% of variance in cardiac self-efficacy. Among predictors, occupation, diagnosis, body mass index, experience of receiving patient education and awareness of risk factors had statistically significant influences on cardiac self-efficacy. CONCLUSIONS: Rather than disease knowledge, factors related to subject's perception were more likely to associate with cardiac self-efficacy. These findings might provide a theoretical basis to develop nursing interventions for enhancing cardiac self-efficacy of patients with coronary artery diseases. RELEVANCE TO CLINICAL PRACTICE: Clinical nurses taking care of patients with coronary artery diseases should consider the patients' perception on their coronary artery diseases including experience of receiving patient education, and awareness of risk factors in encouraging the cardiac self-efficacy to promote the health behaviours for the secondary prevention of coronary artery diseases.

The impact of changes in nursing practicum caused by COVID-19 pandemic on new graduate nurses.

BACKGROUND: The impact of the COVID-19 pandemic has brought about major changes throughout nursing education. Most clinical practicum has been substituted by skills laboratories, simulation laboratories, virtual simulation or written assignments. Nursing students who have experienced this change in practicum have fears about their future role as new graduate nurses. However, to date, no studies have been conducted exploring how their fears work when they become new graduate nurses. OBJECTIVES: To investigate the status of nursing practicum at nursing universities before and during the COVID-19 pandemic, and to explore the relationship between difficulties in nursing tasks, work readiness, reality shock, and organizational socialization among new graduate nurses with nursing practicum experience during this pandemic. DESIGN: Descriptive comparative research design. PARTICIPANTS: 178 new graduate nurses with a clinical experience from 1 month to less than 12 months and graduating from nursing universities in 2021, the 3rd grade in 2020 and the 4th grade in 2021. METHODS: Cross-sectional study via a self-administered online questionnaire measuring difficulties in nursing tasks, work readiness, reality shock, and organizational socialization. Data were analyzed by descriptive statistics, independent t-tests, Pearson correlation. RESULTS: New graduate nurses were divided into 72 in the Clinical/Clinical group and 106 in the Clinical/Substitute group. There was a significant difference in the difficulties in nursing tasks (t = -2.342, p = .020), but there were no significant differences in work readiness, reality shock, and organizational socialization between the two groups. CONCLUSIONS: Efforts in the clinical field to increase the adaptation of new graduate nurses could prevent problems that may arise due to the restrictions and absence of clinical practicum. Discussions should be continued to develop and implement efficient nursing practicum education that not only can reduce the gap between nursing education and nursing practice, but also respond appropriately to any pandemic situation.

Factors contributing to chronic obstructive pulmonary disease patients' functional performance: Structural equation modelling based on theory of unpleasant symptoms.

AIM: This study aimed to predict the functional performance of patients with chronic obstructive pulmonary disease by clarifying the relationship among disease severity, uncertainty, social support, symptom experience, coping, and functional performance. DESIGN: A model-testing design was used. METHODS: The subjects of this study were outpatients with chronic obstructive pulmonary disease who visited the respiratory clinic of a general hospital in Seoul, Korea. The data were collected using validated instruments from July 2018 to April 2019, of which 202 questionnaires in total were used for data analysis. Collected data were analysed by using IBM SPSS v27.0 and Mplus 8.0. RESULTS: The severity of the disease, uncertainty, and symptom experience should be reduced to improve the functional performance of chronic obstructive pulmonary disease patients. Furthermore, reduced uncertainty can improve functional performance by reducing symptom experience. Nursing interventions for the improvement of pulmonary function and reduction of symptom experience should be developed.

Suggestion for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination: a survey-based descriptive study.

PURPOSE: This study aims to suggest the number of test items in each of 8 nursing activity categories of the Korean Nursing Licensing Examination, which comprises 134 activity statements including 275 items. The examination will be able to evaluate the minimum ability that nursing graduates must have to perform their duties. METHODS: Two opinion surveys involving the members of 7 academic societies were conducted from March 19 to May 14, 2021. The survey results were reviewed by members of 4 expert associations from May 21 to June 4, 2021. The results for revised numbers of items in each category were compared with those reported by Tak and his colleagues and the National Council License Examination for Registered Nurses of the United States. RESULTS: Based on 2 opinion surveys and previous studies, the suggestions for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination in this study are as follows: 50 items for management of care and improvement of professionalism, 33 items for safety and infection control, 40 items for management of potential risk, 28 items for basic care, 47 items for physiological integrity and maintenance, 33 items for pharmacological and parenteral therapies, 24 items for psychosocial integrity and maintenance, and 20 items for health promotion and maintenance. Twenty other items related to health and medical laws were not included due to their mandatory status. CONCLUSION: These suggestions for the number of test items for each activity category will be helpful in developing new items for the Korean Nursing Licensing Examination.

Comparative study between depression in Korean elderly with mild cognitive impairment and normal cognitive function.

This cross-sectional comparative study compares differences in depression in the elderly with mild cognitive impairment and those with normal cognitive function in a community. Study subjects were drawn from elderly people visiting one particular public health center in Seoul, South Korea and included 81 people with mild cognitive impairment and 81 with normal cognitive function who were matched based on age, sex, education, and daily living activities. Study variables, including cognitive function, activities of daily living, instrumental activities of daily living, and depression, were measured with standardized instruments. Collected data were statistically analyzed with Student's paired t-test and χ(2) test. The results showed no significant differences between these groups in terms of depression. Therefore, in community practice settings, nurses should understand that depression is not a manifestation of cognitive impairment and should develop effective nursing strategies to assess depression while considering other factors including age, sex, education, and daily living activities.