The needs for digital health and eHeath literacy of cancer patients, caregivers, and healthcare providers: A multicenter, descriptive correlational study.

PURPOSE: Digital health is an indispensable tool, but its use depends on the eHealth literacy (eHL) of end-users. This study aimed to understand the need for digital health and eHL among cancer patients, caregivers, and healthcare providers and to identify differences in digital health needs related to the eHL of cancer patients. METHODS: A multicenter, descriptive correlational study was conducted and included a total of 209 patients, 150 caregivers and 150 healthcare providers. Digital health needs were identified, and eHL was measured using the Korean version of the eHealth Literacy Scale. Differences in digital health needs in relation to the eHL of patients were analyzed. RESULTS: The most necessary digital health functions among cancer patients and caregivers were 'information and education on symptom management after cancer treatment' and 'education on coping methods for each type of cancer' (87.1-94.0%). Healthcare providers reported the need for a digital health function for 'medication information' and assisting in 'medical appointments' (96.7-98.0%). The preferred types of digital health were telemonitoring, mobile services, and telemedicine by telephone (81.3-90.5%). The mean eHL score of the cancer patients was 28.84 ± 6.75. Differences existed in the need for digital health functions and preferences for digital health types between cancer patients with high and low eHL. CONCLUSIONS: Cancer patients and caregivers expressed strong needs for digital health that provide information and education about symptom management and coping with cancer. Digital health interventions for cancer care need to be developed to reflect the identified needs and preferences and eHL of end-users.

Translation and validation of the patient-Generated Subjective Global Assessment against the Mini-Nutritional Assessment for patients with gastric cancer.

Objective: This study aimed to (1) translate the PG-SGA into Korean according to a translation guideline, (2) validate the translated version against the Mini-Nutritional Assessment, and (3) determine the prevalence of malnutrition in patients with gastric cancer. Methods: The translation of the PG-SGA was based on the Guidelines for Translation by the International Society for Pharmacoeconomics and Outcomes Research Task Force for Translation and Cultural Adaptation Group. The translated version was validated in 226 patients with gastric cancer, using the area under the receiver operating characteristic curve analysis (AUC-ROC), measures of sensitivity, specificity, and the Youden index. The prevalence of malnutrition was analyzed using descriptive statistics. Results: The AUC-ROC Korean version of the PG-SGA was 0.85, and a score of 12 was the most optimal cut-off score, with a sensitivity of 78.6% and a Youden index of 0.54. One-third of participants were malnourished, and 70% of them had more than one physical symptom affecting their food intake. Conclusions: The Korean version of the PG-SGA is an effective and valid assessment tool for evaluating malnutrition in patients with gastric cancer. A new cut-off score could be used in patients with gastric cancer to assess malnutrition.

The Refined Middle-Range Theory on Women's Leadership in Asian Culture.

Introduction: Because virtually no theories were available to explain unique characteristics of Asian women's leadership in nursing, a middle-range theory on women's leadership in Asian culture was previously published. To reflect recent political and social changes in different countries, there is a necessity to refine the theory. The purpose of this article is to present the refined middle-range theory on Asian women's leadership in nursing. Methodology: Using an integrative approach, the theory was further developed based on two major sources: literature reviews and exemplars/cases from six different countries. Results: The Refined Middle-Range Theory on Women's Leadership in Asian Culture has two main domains: (a) leadership frames and (b) leadership contexts. The domain of leadership contexts has been extended with two additional main concepts including demographic contexts and health workforce/system contexts. Discussion: The refined theory is expected to guide Asian women's leadership in nursing across the globe.

Health-related quality of life among migrant workers: The impact of health-promoting behaviors.

Health-related quality of life is an important aspect of migrant workers' overall well-being and adaptation. The aims of this study were to develop a structural model and test the health-related quality of life among migrant workers. A cross-sectional study design was used, and data were collected from 228 migrant workers from China who are currently living in Korea and using the services of free clinics for health issues. The structured questionnaire disseminated for the study was designed to measure health-related quality of life, health-promotion behaviors, barriers, resources, and perceptual factors. Structural equation modeling was used to test the hypotheses. Health-promotion behaviors and self-efficacy have significant positive direct effects on health-related quality of life, and acculturative stress has a significant negative direct effect on health-related quality of life. These findings suggest that certain strategies are needed for developing health-promotion programs aimed at the betterment of migrant workers' health-related quality of life. Specifically, health-promotion behaviors and self-efficacy among migrant workers should be encouraged, and strategies for decreasing their acculturative stress should be formulated.

Development and Assessment of a Social Network Service-Based Lifestyle-Modification Program for Workers at High Risk of Developing Cardiovascular Disease.

Cardiovascular disease is a leading cause of mortality in the United States. This study examined the cardiovascular disease risk factors and health beliefs of workers for the purpose of developing a social network service (SNS)-based (e.g., Facebook and KakaoTalk) lifestyle-modification program for workers. Participants included 68 hospital workers (aged 25-60 years), with more than two metabolic syndrome or cardiovascular disease risk factors. Participants were randomly assigned to one of three groups: SNS intervention group (n = 23), education-only intervention group (n = 19), or nonintervention group (n = 26). Data were collected to compare changes in risk indicators according to the intervention method and time and analyzed using repeated-measures analyses of variance. Compared to the education and nonintervention groups, the SNS intervention group demonstrated significant improvements in waist circumference, body mass index, total cholesterol, low-density lipoprotein cholesterol, health promotion behaviors, and self-efficacy. This type of program has potential for allowing occupational health professionals to work with workers to improve lifestyle behaviors that promote health and reduce the risk of cardiovascular disease.

Effects of a safe transition programme for discharged patients with high unmet needs.

AIMS AND OBJECTIVES: To examine the effects of the Patient-Oriented Safe Transition programme on 30-day unplanned readmissions and emergency department visits, medical costs, caregiver burden and patient health-related quality of life. BACKGROUND: With the success of hospitals' quality improvement efforts, the number of discharged patients has been increasing. Successful management of discharged patients is needed in order to reduce unplanned readmissions and to improve patient health outcomes. DESIGN: A nonequivalent control group pretest-posttest design. METHODS: This study was conducted by following TREND guideline. Eighty-three patients were assigned to either the intervention (n = 40) or control (n = 43) group. The intervention group received individual discharge planning by case managers and home visits by homecare nurses followed by telephone calls throughout the month following discharge. The outcome variables measured were 30-day unplanned readmissions and emergency department visits, medical costs, caregiver burden and patient health-related quality of life. Data were analysed by paired t test, multivariate analysis of variance and repeated-measure analysis of variance. RESULTS: The baseline characteristics of the two groups were homogeneous with respect to gender, age, length of hospital stay and medical conditions. In the intervention group, the caregiver burden decreased 30 days after discharge, whereas the control group increased (F = 12.888, p = 0.001). The patient physical (p = 0.005) and mental (p < 0.001) quality of life of the intervention group were improved more than the control group. CONCLUSIONS: This study suggests that nurses can play a significant role during discharge transitions in improving patient outcomes. The Patient-Oriented Safe Transition programme could be a beneficial service for discharged patients expected to experience high unmet needs. RELEVANCE TO CLINICAL PRACTICE: The findings of this study provide the evidences on the needs of transition programmes for discharged patients with high unmet needs.

International Nursing: Needs Assessment for Training in Disaster Preparedness for Hospital Nurses: A Modified Delphi Study.

Despite high awareness of the need, opportunities for nurses to gain disaster experience or training are limited. In Korea, most disaster training is done in an undergraduate curriculum where there is very limited practice, and the educational topics are mostly focused on the field aspect of disaster events. The purpose of this study was to determine the need for such training for hospital nurses and to determine appropriate and relevant components of the training contents. A qualitative survey approach using the modified Delphi method was used to collect and analyze the data. The surveys were conducted in 3 rounds. After the results were analyzed from the third-round survey, the authors finalized the contents for a training program to prepare nurses for their roles during disasters. Through a structured needs analysis using a modified Delphi survey, the framework for the content development of disaster training curriculum for hospital nurses was developed.

Research activities and perceptions of barriers to research utilization among critical care nurses in Korea.

BACKGROUND: Research utilization is vital to promote evidence-based practice in the critical care area, where nursing practice continues to grow in complexity and nurses have greater responsibility and accountability for patient care. However, information about research activities and barriers to research utilization of critical care nurses is limited. AIMS: This study aimed to describe research activities, to identify barriers to research utilization for practice and to examine factors related to research barriers among critical care nurses. METHODS: Data from 63 critical care nurses were analyzed from a national study examining research utilization of clinical nurses working in university affiliated and educational hospitals in Korea. FINDINGS: Research activities were relatively low. A lack of guidance for clinical implication and insufficient time to implement new ideas in the clinical area were identified as the highest-ranking barriers to use of research in this group. Perceptions of barriers to research utilization were significantly higher in those staff nurses with lesser clinical experience. The critical care nurses in this study shared a strong sense of valuing the contribution of research, but also shared perceptions on barriers for administrative aspects. Organizational support is crucial for critical care nurses to achieve evidence-based practice.

Development and evaluation of a PBL-based continuing education for clinical nurses: a pilot study.

PURPOSE: The purposes of this study were to develop a PBL program for continuing nurse education and to evaluate the program after its implementation. METHODS: The PBL program was developed in the core cardio-pulmonary nursing concepts through a collaborative approach with a nursing school and a hospital. The PBL packages with simulation on ACLS were implemented to 40 clinical nurses. The entire PBL program consisted of six 3-hour weekly classes and was evaluated by the participants' subjective responses. RESULTS: Two PBL packages in cardio-pulmonary system including clinical cases and tutorial guidelines were developed. The 57.5% of the participants responded positively about the use of PBL as continuing nurse education in terms of self-motivated and cooperative learning, whereas 20.0% of the participants answered that the PBL method was not suitable for clinical nurses. Some modifications were suggested in grouping participants and program contents for PBL. CONCLUSION: The PBL method could be utilized to promote nurses' clinical competencies as well as self-learning abilities. Further research is needed in the implementation strategies of PBL-based continuing education in order to improve its effectiveness.