One-year trajectories of self-care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study.

AIM AND OBJECTIVES: This study aimed to identify the associations between longitudinal trajectories of self-care behaviours and unplanned hospital readmissions in patients with heart failure. BACKGROUND: Adherence to self-care behaviours is crucial to prevent hospital readmissions; however, self-care behaviours remain unsatisfactory among patients with heart failure. Studies of long-term trajectories of self-care behaviours and their influence on hospital readmissions are limited in this population. DESIGN: A prospective, longitudinal observational study. METHODS: Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1-year follow-up data to determine the association between 1-year trajectories of self-care behaviours and hospital readmissions using Kaplan-Meier analysis and multivariable Cox regression, adjusted for confounding variables. RESULTS: Self-care behaviour trajectories of heart failure patients were classified as 'high-stable' (58.4%) or 'low-sustained' (41.6%). The cumulative rate of readmissions for the low-sustained class was higher than that of the high-stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self-care behaviours trajectories. The low-sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high-stable class. CONCLUSIONS: Longitudinal self-care behaviours pattern trajectories of heart failure patients were stratified as high-stable and low-sustained. Routine follow-up assessment of patients' self-care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions. RELEVANCE TO CLINICAL PRACTICE: Identification of trajectory patterns of self-care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self-care behavioural patterns in heart failure patients. REPORTING METHOD: The study has been reported in accordance with the STROBE checklist (Appendix S1). PATIENT OR PUBLIC CONTRIBUTION: Patients have completed a self-reported questionnaire after providing informed consent.

Postoperative delirium screening tools for post-anaesthetic adult patients in non-intensive care units: A systematic review and meta-analysis.

AIMS AND OBJECTIVES: To identify the most accurate postoperative delirium screening tools for detecting postoperative delirium among patients who underwent general anaesthesia surgery in general wards. BACKGROUND: The lack of detection of postoperative delirium can negatively affect the patient's condition, along with their postoperative treatment and rehabilitation, and it can prolong their hospitalisation, persists cognitive dysfunction and increases mortality. Screening for postoperative delirium in hospitalised patients as nursing assessment is routine clinical practice for early detection. DESIGN: A systematic review and meta-analysis. METHODS: MEDLINE, Embase, CINAHL, KoreaMed and Cochrane electronic databases were searched using the key words delirium, postoperative, assessment or screening, and adult for articles published up to April 2020, with no limit on the year of publishing. Only prospective cohort studies reporting sensitivity and specificity values were included. We followed the recommendations of the Cochrane Handbook of Diagnostic Test Accuracy Reviews and the PRISMA checklist. The Quality Assessment of the Diagnostic Accuracy Studies-2 tool was used for data extraction and quality assessment, while a bivariate random-effects meta-analysis model was used for pooling and comparing diagnostic accuracy and providing a summary of evidence. RESULTS: Six delirium assessment tools were evaluated from nine papers including 3088 patients. Due to the limited number of papers, the meta-analysis included the Confusion Assessment Method (CAM) and its variants, Delirium Detection Score (DDS) and Nurses' Delirium Screening Checklist (NuDESC). Overall, NuDESC demonstrated higher sensitivity than CAM or DDS, while all showed high specificity (0.90 or greater). CONCLUSION: This review suggested that NuDESC can be employed as an accurate screening tool with high specificity for assessing postoperative delirium during routine checkups. However, it is necessary to consider suitable cut-off values, which is the reference point, in accordance with the clinical setting and the patients' condition. RELEVANCE TO CLINICAL PRACTICE: NuDESC reported the best evidence of diagnostic accuracy, and we recommend clinical nurses to employ this easy-to-use and validated tool for daily screening of postoperative delirium in general wards to facilitate its early detection and the accurate estimation of its prevalence.

Effect of a prophylactic dressing for sacral pressure injuries in non-critically ill patients after general surgery: A randomized controlled trial.

BACKGROUND: Hospital-acquired pressure injuries are strongly associated with surgeries performed under general anesthesia. AIMS: The aim of this study was to evaluate the effects of using a prophylactic multi-layer soft silicone foam dressing in non-critically ill patients with a Braden Scale score of ≤18 after undergoing routine surgery without sacral pressure injuries. METHODS: This randomized controlled trial included 156 patients who were admitted for surgery under general anesthesia in a tertiary general hospital. The patients were divided into a control group and an intervention group. A 5-layer soft silicone foam dressing was applied to the sacrum of patients in the intervention group immediately after surgery. For the control group, standard pressure injury prevention activities were performed alongside standard care without preventive dressings. RESULTS: There were no significant differences in general and clinical characteristics between the two groups; however, the incidence of pressure injury and blanching erythema was higher in the control group, showing a significant difference from the experimental group. Factors influencing the development of pressure injuries and blanching erythema through multivariate regression analysis were prophylactic dressing application and Braden Scale score at the time of admission. A statistically significant difference was noted in survival time from pressure injury between both groups. LINKING EVIDENCE TO ACTION: The incidence of pressure injuries and blanching erythema was lower when the prophylactic dressing was applied with standard protocol for general ward patients after surgery. Accurate evaluation of the patient's skin condition and pressure injury risk assessment before surgery are important. Progressive prophylactic dressings to prevent pressure injuries are effective, and tailored nursing interventions based on accurate assessment of patient's skin condition and risk factors are essential for maintaining skin integrity.

Factors related to dysphagia-specific quality of life in aged patients with neurologic disorders: A cross-sectional study.

This cross-sectional study aimed to analyze dysphagia-specific quality of life and its influencing factors in aged patients with neurologic disorders, and is reported according to the STROBE checklist for observational research. The study included 120 outpatients, aged ≥65 years, diagnosed with neurologic diseases at a general hospital Neurology Department in Seoul, Korea. Data collected during a one-month (March and April 2021) questionnaire survey were statistically analyzed using SPSS. Factors related to dysphagia-specific quality of life were gender, education level, neurological diagnosis, type of diet, subjective swallowing disturbance, and affectionate support-a subscale of social support. The combined explanatory power of these factors was 42.1%. It is essential to note that the factors related to the emotional, functional, and physical domains-the subscales of dysphagia-specific quality of life-are different. Therefore, each factor should be considered when planning nursing interventions to improve dysphagia-specific quality of life.

Educational needs and disaster response readiness: A cross-sectional study of clinical nurses.

AIM: To analyse clinical nurses' educational needs and disaster response readiness and the factors influencing their disaster response readiness. DESIGN: This was a cross-sectional study. METHODS: A convenience sample comprising 260 nurses with more than a year of working experience at a hospital in Korea was selected from 1-31 August 2019. Data on nurses' educational needs and disaster response readiness were collected from participants. A multiple regression model was used to examine the factors influencing disaster response readiness among nurses. RESULTS: Factors influencing personal readiness were number of years of clinical experience, being female, working in a medical ward, and educational needs for disaster response. Factors influencing self-protection were working in a medical ward and working in the emergency room. Factors influencing the emergency response were working in a medical ward and working in the emergency room. Factors influencing clinical management were a graduate-level education or higher, working in a medical ward, working in the emergency room, working in the paediatric ward, experience receiving disaster-related education, and educational needs for disaster response. CONCLUSION: It is essential to be aware of the educational needs and disaster readiness of hospital clinical nurses, to develop their capacity to respond such situations. In addition, to improve the disaster competency of nurses, it is necessary to develop an education programme that considers the factors influencing disaster response readiness in this study. IMPACT: Nurses must have the knowledge and skills to respond to a disaster. Nurse educators should help nurses strengthen their disaster-related knowledge, skills, and judgment. Hospital administrators should encourage nurse educators to provide disaster-related training and simulation-based education to increase nurses' disaster competency to act during disasters.

Warfarin Therapy After Mechanical Valve Replacement: A Tool for Predicting Bleeding Events.

BACKGROUND AND AIM OF THE STUDY: Mechanical valve replacement is associated with positive outcomes, but patients must undergo life-long anticoagulation therapy with warfarin, which carries a significant risk of bleeding complications. Therefore, a systematic and continuous assessment and supervision of warfarin treatment is essential in such patients, and approaches that can predict the risk of bleeding in advance are required. The study aim was to develop a classification tool to predict bleeding events in South Korean patients with mechanical valve replacement undergoing oral warfarin therapy. METHODS: The retrospective cohort study included 2,453 patients followed up for at least one year after valve replacement surgery, between January 2003 and December 2012. Discriminant analysis was used to assess potential bleeding risk factors out of 31 patient- related and disease-related descriptors. The prediction capability of the descriptors was evaluated based on accuracy, sensitivity,specificity, positive predictive value, and negative predictive value. RESULTS: A total of 13 descriptors including general, clinical-related and medication-related risk factors was selected as suitable predictors for bleeding risk. A novel classification tool was developed using these risk factors, and evaluated for accuracy (91.5%), sensitivity (80.2%), and specificity (95.2%). CONCLUSIONS: The classification tool developed in the present study can be reliably used in a clinical context to predict bleeding events in patients with mechanical valve replacement undergoing oral warfarin therapy.

Professionalism and professional quality of life for oncology nurses.

AIMS AND OBJECTIVES: To identify the relationship between professionalism and professional quality of life among oncology nurses working at tertiary hospitals in Korea. BACKGROUNDS: Oncology nurses are combined with core competencies and qualities required in cancer patient care. Professionalism that means compassion satisfaction and compassion fatigue is a main concept in problem-solving strategies as motivation. Their satisfaction is representative of professionalism and professional quality of life. However, little research has focused on professionalism and professional quality of life. DESIGN: A cross-sectional study with self-administered questionnaires. METHODS: A total of 285 nurses from two tertiary hospitals were included. Data collection was undertaken using Korean version of professionalism scale derived from the Hall Professional Inventory Scale and professional quality of life. Data were analysed by spss 21.0 for Windows Program using t-test, anova, and multiple regression. RESULTS: The mean score of professionalism in oncology nurses was 77·98 ± 7·31. The mean professional quality of life score for compassion satisfaction, compassion fatigue and secondary traumatic stress was 33·84 ± 5·62, 28·38 ± 5·36 and 28·33 ± 5·48. Compassion satisfaction was affected by factors of professionalism with an explanatory power of 49·2%. Burnout and secondary traumatic stress were affected by factors of professionalism with an explanatory power of 39·3% and 4·8%. CONCLUSION: The higher the professionalism leads to the higher the compassion satisfaction, the lower the compassion fatigue. The relationship between professionalism and professional quality of life for a health work environment requires further investigation. RELEVANCE TO CLINICAL PRACTICE: Our study supports the idea that enhancing professionalism can increase professional quality of life. It is necessary to develop professionalism by recognised qualifications and applied rewards in advanced nursing organisational culture. Furthermore, compassion satisfaction is increased by continuing ethical and moral education programme for clinical nurses to force professional dedication and encouraging nurses to affiliate themselves with the professional communities. Nurses are connected to professionalism affect the quality of nursing service for patients and professional quality of life for themselves.

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.

Self-care Behavior Based on Integrated Behavioral Model in Patients With Atrial Fibrillation: A Structural Equation Modeling Approach.

BACKGROUND: There is limited research exploring the behavioral intentions, beliefs, and application of theoretical models in relation to self-care in patients with atrial fibrillation (AF). OBJECTIVE: This study aimed to identify the factors that influence self-care behavior in patients with AF. METHODS: The study used an integrated behavioral model and collected data from 216 patients diagnosed with AF. Data were analyzed using SPSS 24.0 and AMOS/WIN 24.0 to verify the fit of the hypothesis model, confirm factor analysis, and the validity of the hypothesis itself. RESULTS: Self-care behavioral intention (ß = 0.433, p < .001) and habit (ß = 0.395, p = .005) had a significant direct effect, while instrumental attitude (ß = 0.077, p = .045), injunctive norm (ß = 0.084, p = .037), and self-efficacy (ß = 0.249, p = .011) had a significant indirect effect on self-care behavior, explaining 64.4% of the variance. CONCLUSION: The final model validated the factors that impact self-care behavior in patients with AF, highlighting the importance of fostering positive recognition of instrumental attitude, bolstering social influence and self-efficacy through significant individuals to improve self-care behavior. It is recommended to create an intervention program that encourages intentions and motivations for self-care behavior and incorporates tactics to make self-care behavior a habit. The study's path diagram can serve as a conceptual framework for designing strategies to enhance self-care behavior in patients with AF.

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.

Factors associated with 30-day in-hospital mortality in critically ill adult patients receiving extracorporeal membrane oxygenation: A retrospective cohort study.

OBJECTIVE: To identify factors associated with the 30-day in-hospital mortality rate among adult patients requiring extracorporeal membrane oxygenation (ECMO) in intensive care units. RESEARCH METHODOLOGY: Retrospective cohort study including 148 patients who underwent ECMO for at least 48 h between March 2010 and August 2021. The patients were divided into survivors and non-survivors based on their 30-day in-hospital survival. We obtained the sociodemographic information and pre- and post-ECMO data from electronic medical records. Kaplan-Meier survival curves and Multivariate Cox proportional hazards regression were used to analyse the data. SETTING: A tertiary-care university hospital in South Korea. MAIN OUTCOME MEASURES: The 30-day in-hospital mortality rate was the principal outcome measure. RESULTS: The 30-day in-hospital mortality rate was 49.3% (n = 73). Kaplan-Meier analysis demonstrated that the duration of ECMO support in the 50th percentile of surviving patients was 13 days. Multivariable Cox regression analysis showed that new-onset renal failure, lower mean arterial pressure, and ECMO weaning failure were associated with an increased 30-day in-hospital mortality risk among patients who received ECMO. Subgroup analysis also revealed a significant association between weaning failure and 30-day in-hospital mortality after adjusting for covariates in patients undergoing veno-arterial ECMO. CONCLUSION: Close monitoring of post-ECMO renal function and mean arterial pressure is required to minimize the risk of 30-day in-hospital mortality, especially in adults within the first two weeks of ECMO initiation. Moreover, the success of ECMO weaning should be optimized by collaboration within the ECMO team. IMPLICATIONS FOR CLINICAL PRACTICE: Critical care nurses should pay close attention to patients' response to weaning trials as well as alternations in renal function and mean arterial pressure during ECMO support. Furthermore, developing nursing care guidelines for adult patients receiving ECMO and standardized training programs for nurses in intensive care, are required in Korea.

Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium.

An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.

A Systematic Review on Mobile Health Applications' Education Program for Patients Taking Oral Anticoagulants.

Warfarin is widely used as an oral anticoagulant. However, it is difficult to manage patients due to its narrow therapeutic range and individualized differences. Using controlled trials and real-world observational studies, this systematic review aimed to analyze health education's impact among patients on warfarin therapy by mobile application. Smartphone and tablet applications have the potential to actively educate patients by providing them with timely information through push notifications. MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane electronic databases were searched using the keywords "anticoagulants," "warfarin", "mobile application", and "smartphone" up to May 2020. Of the 414 articles obtained, 12 articles met the inclusion criteria for this review. The education and self-management programs using the mobile health application had diverse contents. A meta-analysis was not deemed appropriate because of the heterogeneity of populations, interventions, and outcomes. Thus, a narrative synthesis is presented instead. This review demonstrates that educating patients for anticoagulation management through their smartphones or tablets improves their knowledge levels, medication or treatment adherence, satisfaction, and clinical outcomes. Moreover, it has a positive effect on continuing health care. Future research concerning patients taking warfarin should include key self-management outcomes in larger, more rigorously designed studies, allowing for comparisons across studies. This study proposes a continuous application of timely education through smartphone applications to the current medical and nursing practice.

Pre-Hypertension and Its Determinants in Healthy Young Adults: Analysis of Data from the Korean National Health and Nutrition Examination Survey VII.

The purpose of this cross-sectional study was to identify risk factors in the normotensive and pre-hypertensive group based on the blood pressure results of healthy young adults from the Korean National Health and Nutrition Examination Survey 2018. The participants were 2225 healthy young adults between the ages of 19 and under 45, excluding those with a diagnosis of hypertension or taking antihypertensive medications. Of the 2225 participants, the normotensive group was 1498 (67.3%) and the pre-hypertensive group 727 (32.7%). Determinants of pre-hypertension were analyzed using multiple logistic regression based on a complex sample design. Factors related to pre-hypertension in young adults were age, smoking, waist circumference, diabetes, anemia, cholesterol levels including HDL cholesterol, and uric acid levels. Pre-hypertension is a pre-stage that can prevent the morbidity of hypertension through lifestyle control, so its management is very important. Furthermore, a young adult is a stage in the growth and development of human beings, in which lifestyles such as healthy behaviors, eating habits, and exercise are fixed. Therefore, it is very important to improve lifestyles such as diet, exercise, and smoking cessation and to control risk factors in young adults who are at the pre-hypertension stage for health promotion. Continuous health examinations should be conducted for young adults, and education that can be practiced based on clinical data through this should be implemented for community health.

Predictors of bleeding event among elderly patients with mechanical valve replacement using random forest model: A retrospective study.

ABSTRACT: Available classification tools and risk factors predicting bleeding events in elderly patients after mechanical valve replacement may not be suitable in Asian populations. Thus, we aimed to identify an accurate model for predicting bleeding in elderly patients receiving warfarin after mechanical valve replacement in a Korean population. In this retrospective cohort study, a random forest model was used to determine factors predicting bleeding events among 598 participants. Twenty-two descriptors were selected as predictors for bleeding. Steroid use was the most important predictor of bleeding events, followed by labile international normalized ratio, history of stroke, history of myocardial infarction, and cancer. The random forest model was sensitive (80.77%), specific (87.67%), and accurate (85.86%), with an area under the curve of 0.87, suggesting fair prediction. In the elderly, drug interactions with steroids and overall physical condition had a significant effect on bleeding. Elderly patients taking warfarin for life require lifelong management.

Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy.

Non-adherence is highlighted as one of the main contributors to the occurrence of adverse events and negative clinical outcomes in patients treated with warfarin. The aim was to examine knowledge on warfarin, medication belief, depression, and self-efficacy as factors influencing medication adherence for anticoagulation control. This was a cross-sectional study. The participants in this study were patients who visited an outpatient clinic of cardiovascular surgery to administer anticoagulants after mechanical valve replacement surgery at a tertiary hospital in Seoul. Responses of 154 participants on questionnaires were analyzed from 10 September to 26 December 2020. Multiple regression analyses were performed to assess the factors influencing medication adherence among the patients with anticoagulation control. Factors influencing medication adherence were consuming warfarin for 3 to 5 years, awareness of target prothrombin time international normalized ratio, knowledge of warfarin, and depression. Medication beliefs and self-efficacy had no significant influence on medication adherence. The most important factors associated with medication adherence in patients with mechanical heart valves were knowledge about warfarin and depression. In the control of oral anticoagulants that require continuous management, education and providing accurate guidance is more important than personal preferences. Clinical nurses should facilitate educational programs tailored to the characteristics of the patient, including their purpose and method of taking warfarin, specific diets, their knowledge on warfarin's interaction with other drugs, symptoms of adverse events, and self-management. In addition, healthcare providers should check whether warfarin therapy is being controlled by evaluating medication adherence and depression levels among patients.

Validation and Adaptation of the "Modified Transplant Symptom Occurrence and Symptom Distress Scale" for Kidney Transplant Recipients.

The aim was to adapt and validate the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) for kidney transplant recipients undergoing immunosuppressive therapy in Korea. The MTSOSD-59R has been used with solid organ transplant recipients globally to assess the adverse effects of immunosuppressive medication. A descriptive cross-sectional design was used. MTSOSD-59R was first translated, and pilot tested. Next, content validity was established with nine organ transplant experts. Then, from October 2017 to October 2018, the Korean MTOSOSD-59R was administered to a convenience sample of 122 kidney transplant recipients recruited from a single center. Ridit analysis was used to measure symptom occurrence and distress. The known-group approach was used to test the construct validity using Mann-Whitney U tests for between-group comparisons. The content validity index for MTSOSD-59R was 0.98, and known-group validity was confirmed. The split-half Spearman-Brown corrected reliability coefficient was 0.902 for symptom occurrence and 0.893 for symptom distress. The four most frequent and distressing symptoms were fatigue, lack of energy, thinning hair, and erectile dysfunction (male). Results suggest this Korean MTSOSD-59R adaptation has adequate language, construct validity, and reliability to gather meaningful information from kidney transplant recipients in Korea.

Predictors Affecting Postoperative Atrial Fibrillation in Patients After Coronary Artery Bypass Graft.

The aim of this study is to investigate the differences in POAF (postoperative atrial fibrillation) and non-POAF patients using demographic and clinical characteristics and identify predictors affecting POAF after coronary artery bypass grafts in South Korea. This retrospective cohort study included 999 patients followed-up for at least 1 year after coronary artery bypass graft, between January 2011 and December 2015. Multivariate logistic regression was performed to assess risk factors based on demographics, as well as preoperative and postoperative characteristics. The adjusted multivariate analysis demonstrated that risk factors for POAF were old age (⩾65 years; odds ratio [OR] = 3.022, p < .001), ejection fraction less than 45% (OR = 1.489, p = .036), electrolyte potassium level after surgery (OR = 1.765, p = .003), and the average pain score on Postoperative Day 1 (OR = 1.253, p < .001). The incidence of atrial fibrillation after coronary artery bypass graft surgery can be reduced through the screening of preoperative risk factors, strict potassium monitoring, and pain management strategies.

Nurses' Fatigue, Job Stress, Organizational Culture, and Turnover Intention: A Culture-Work-Health Model.

We examined the factors affecting clinical nurses' turnover intention and constructed a structural equation model based on the Culture-Work-Health Model. This cross-sectional study utilized self-administered questionnaires. Registered nurses (N = 252) from four tertiary hospitals participated. Factors affecting nurses' turnover intention included the organizational culture, job stress, and fatigue (explanatory power = 56.7%), and the model showed acceptable goodness of fit. In the final turnover intention model, fatigue and job stress had direct effects and the organizational culture had indirect effects. The organizational culture also had indirect effects on turnover intention through job stress and fatigue. This model, therefore, effectively explained how nursing organizational culture, job stress, and fatigue affect their turnover intention. The results provide support for theory-driven interventions to address developing intention to stay at work among experienced nurses.

Risk of Cardiovascular Disease Related to Metabolic Syndrome in College Students: A Cross-Sectional Secondary Data Analysis.

Early detection of metabolic syndrome (MS) in young adults can lead to decreased aggravation and help prevent diabetes and cardiovascular diseases. This cross-sectional study aimed to identify the prevalence of MS and its components in Korean college students and was based on the Korean National Health and Nutrition Examination Survey, which used a stratified multistage probability sampling design. In total, 6.5% male and 4.1% female students had MS; of these, 26.6% of male and 25.8% of female students presented with at least one MS component. Height, weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, high-density lipoprotein cholesterol, and triglycerides were significantly higher in men than in women, and all of these variables showed significant differences according to BMI. As the BMI increased, the level of each anthropometric, biochemical, and clinical variable increased. Although only a few students in Korea had three or more risk factors, the proportion of college students with one risk factor for MS was relatively high. Therefore, educational and intervention programs should be conducted in college students with overweight or obesity so that they can change their lifestyle to reduce the risk of cardiovascular diseases and diabetes.