Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea.

BACKGROUND: The Coronavirus disease pandemic is a global health crisis with psychological consequences for healthcare workers. PURPOSE: To identify the prevalence and potential factors influencing burnout among frontline nurses in South Korea. METHODS: This cross-sectional study comprised 161 nurses who voluntarily participated in the survey through advertisements at a general hospital. Data on sociodemographic and professional characteristics, insomnia, depression, anxiety, stress, and burnout were collected via an online questionnaire in 2021. RESULTS: Among the participants, 90 had a high level of burnout. Overall, 59.6 %, 23.0 %, 36.0 %, and 17.4 % of nurses experienced insomnia, depression, anxiety, and stress, respectively. The results showed that the assigned number of patients, insomnia, and depression were the major factors affecting burnout levels of nursing staff. CONCLUSIONS: Frontline nurses were the main force in the fight against public health emergencies. The government and medical institutions must consider professional and psychological factors in ameliorating burnout and safety for nurses.

Factors Related to Self-Confidence to Live Alone in Community-Dwelling Older Adults: A Cross-Sectional Study.

BACKGROUND: Many older adults prefer to live alone in their own homes, with age-related issues in physical movement, regardless of their cultural background. Importantly, however, to identify the features of successfully ageing in place (AIP), and foster independent living among these individuals, this study explored their level of self-confidence to live alone and its related factors. METHODS: We conducted a cross-sectional study using secondary data from an earlier study with older adults living alone in South Korea recruited by convenience sampling methods (N = 936, mean age = 77.1 years, 76.1% female). Data regarding the general, health-related, and social characteristics as well as self-confidence to live alone were collected via face-to-face interviews in 2019. Self-confidence to live alone was measured with a numeric rating scale of 0 to 10. RESULTS: The average self-confidence score to live alone was 6.59. A regression analysis showed that mould exposure at home, depression, emergency department visits, and loneliness hinder self-confidence to live alone. Meanwhile, such self-confidence was facilitated by independency in instrumental activities of daily living (IADL), interactions with family members, social service utilisation, and social support. CONCLUSIONS: This study suggests that healthcare providers need to consider the importance of self-confidence to live alone and influencing functional, mental, social, and environmental factors to promote quality of life as well as successful AIP for older adults living alone. Further, self-confidence to live alone could be a new practical index in the field of health and ageing to screen the successful AIP of older adults living alone.

Implementation of a multimodal infection control strategy in the nursing home.

The main cause of morbidity and mortality among residents of nursing homes (NHs) is healthcare-associated infections (HAIs). We conducted infection control intervention by applying the WHO multimodal strategy for one year from January to December 2018 in the one NH in South Korea. Healthcare workers (HCWs) in NH were observed by infection control nurse from February to December 2018. Hand hygiene (HH) compliance according WHO 5 moments and type of HH, glove use were measured as main outcomes. During the intervention period, a total of 1,461 cases were observed. HH compliance among HCWs increased from 12.6% to 55.2% after the intervention. According to WHO 5 moments, HH before touching a patient and after touching a patient saw significant improvements. Further, glove misuse decreased significantly from 45.9% to 25.4%. The multifaceted infection control program in the NH group significantly improved the HH compliance of HCWs.

Effectiveness of a community-based integrated service model for older adults living alone: A nonrandomized prospective study.

OBJECTIVE: Older adults living alone face physical, emotional, and social health problems, and prefer to age in place (AIP) in their homes. A community-based integrated model for AIP is needed and few studies have identified its impact on older adults living alone. METHODS: This was a non-randomized prospective study. Participants were 877 community-dwelling older adults living alone, aged above 65 years, in S* city in South Korea. The intervention group (n = 331) received a community-based integrated service (CBIS) model based on AIP for six months from October 2019 to April 2020. RESULTS: Scores on frailty (ß = -0.377, p < .001), loneliness (ß = -1.897, p = .018), and health-related quality of life (ß = 4.299, p = .021) significantly improved in the intervention group. Among the intervention group, loneliness scores significantly improved among participants aged under 80 years than those aged over 80 years. CONCLUSION: The CBIS model improved frailty, loneliness, and quality of life in community-dwelling older adults living alone.

MP-V1 from the Venom of Social Wasp Vespula vulgaris Is a de Novo Type of Mastoparan that Displays Superior Antimicrobial Activities.

Mastoparans from the venom of social wasps have attracted considerable attention as effective antibiotic candidates. In this study, mastoparan V1 (MP-V1) from Vespula vulgaris was first disclosed to have a peptide amino acid sequence distinct from typical mastoparans and its biochemical properties and antimicrobial effects were compared with those of typical mastoparans MP-L, -X(V) and -B. Circular dichroism (CD) spectroscopy revealed that MP-V1 and -X(V) form more stable α-helical conformations in lipid membrane-like environments than MP-L and -B. In parallel, these two also showed more effective antimicrobial activities against the pathogens than did MP-L and -B. Although MP-V1 had a less stable α-helical conformation than MP-X(V), it showed stronger antimicrobial effects against Streptococcus mutans and Salmonella enterica than MP-X(V). In the meantime, analysis of hemolytic activity revealed a range of doses (~50 µM) that exhibited little potent cytotoxicity on human erythrocytes. Finally, the atypical MP-V1 peptide amino acid sequence provided important clues to understanding its antimicrobial mechanism from a structural perspective. Therefore, it has been concluded that MP-V1 is a de novo type of mastoparan with superior antimicrobial activities against both pathogenic bacteria and fungi, which may be useful in developing multipurpose antimicrobial drugs against infectious diseases.

Effectiveness of Simulation-Based Education for Caring Patients with COVID-19.

PURPOSE: The role of medical staff gained immense significance in the context of the prolonged coronavirus disease (COVID-19) pandemic. However, few studies had explored the impact of simulation-based education on the ability of nursing students to care for the patients of COVID-19. This study provided nursing students with simulation-based education in caring for the patients of COVID-19 and confirmed its effectiveness. METHODS: This study used a non-equivalent control group pretest-posttest design. The participants were recruited from the nursing departments of two universities in Korea through convenience sampling. A total of 79 participants were included: 37 in the intervention group and 42 in the control group. The intervention group received four sessions of simulation training based on the National League for Nursing Jeffries simulation theory. RESULTS: The intervention group showed an improvement compared to the control group in terms of knowledge related to coronavirus, confidence in performing infection control skills, and perception of preparedness for caring for the patients of COVID-19, with a high-level of satisfaction and self-confidence in learning. There was no significant difference between the two groups in terms of anxiety. CONCLUSION: This simulation is expected to be a significant strategy for alleviating the global burden in terms of staff safety and patient outcomes by improving the competencies of prospective medical staff in responding to pandemics.

Female crash fatality risk relative to males for similar physical impacts.

OBJECTIVE: This paper estimates the latest trends regarding the effect of sex on driver-side or right-front passenger-side occupant fatalities in fatal crashes. The focus is on how recent model year (MY) light vehicles with advanced occupant protection technologies compare to older vehicles without these protections in terms of female fatality risk relative to males. METHODS: Data from the Fatality Analysis Reporting System (FARS) from 1975 to 2019 is used to calculate estimates of female fatality risk relative to males using logistic regression models and the double-pair comparison method. These estimates are calculated in various groups of MY vehicles and occupant protection systems. Occupant protection systems observed are the use of seat belts, and the availability of dual air bags, pretensioners and load limiters in the vehicles. All vehicles used include occupants age 16 to 96. Occupants studied include front-row occupants (drivers and right-front (RF) passengers). The average between drivers and RF passengers is also calculated. RESULTS: Incremental female fatality risk estimates versus males are reduced in newer MY vehicles. Incremental relative risks for female front-row occupants (average of drivers and right-front passengers) are found to be 19.9% (± 1.3) in fatal crashes in MY 1960-1999 vehicles, and 9.4% (± 2.2) percent in MY 2000-2020 vehicles. The difference in fatality risk between females and males is further reduced when looking at MY 2010-2020 vehicles (6.3 ± 5.4%) compared to MY 1960-2009 vehicles (18.3 ± 1.2%). Incremental fatality risk estimates also decrease in vehicles with newer generations of occupant protection systems regardless of MY. When occupants are belted in vehicles with the latest generation of modern occupant protection systems (dual air bags, seat belt pretensioners and load limiters), the estimated female fatality risk relative to males (average of drivers and right-front passengers) becomes 5.8% (± 3.8), which is lower than for belted occupants in vehicles without those occupant protections. CONCLUSIONS: The disparity in fatality risk between males and females for the same physical impacts is reduced for later MY vehicles, as well as vehicles with more advanced occupant protection systems.

Changes in the health status and health-related quality of life of community-dwelling older adults living alone: one-year follow-up from a cohort study.

Background: The percentage of older adults living alone is rapidly increasing, improving the health status and health-related quality of life (HRQoL) in this group is becoming a more significant public health issue. This study aimed to examine the changes in the HRQoL of older South Korean adults living alone and identify the factors that affect their HRQoL. Methods: A longitudinal study design was followed. Data were collected at baseline and 1-year follow-up. Participants consisting of 789 older adults living alone in S*City aged>65 years completed a cohort survey regarding health status and HRQoL from August 2018 to August 2019. Trained interviewers conducted face-to-face interviews with the participants using a validated questionnaire (physical health, mental health, social health, and HRQoL). Generalized estimating equations were used to assess the change in health status and the interaction effect of time and gender. Then, a stepwise multiple logistic regression analysis was performed to identify factors related to HRQoL. Results: Time differences were observed in the subjective evaluation of health status (SEH), IPAQ scores, frailty, nutritional status, and depression. Gender differences were observed in the SEH, IPAQ, frailty, loneliness, depression, and social support. The interaction between time and gender was observed in the IPAQ and HRQoL. At baseline, SEH, depressive symptoms, gender, frailty, and age were associated with HRQoL. After one year, HRQoL was associated with SEH, frailty, depressive symptoms, cost of living, suicidal thoughts, gender, social support, loneliness, and suicide attempts. Conclusion: Our results highlight that HRQoL is associated with physical health, mental health, and social support. Future detailed studies are needed to determine whether governments and communities can prevent depression, loneliness, and suicidal thoughts through psychological support and provide economic support to improve the quality of life of older adults living alone.

Impact of COVID-19 on the social relationships and mental health of older adults living alone: A two-year prospective cohort study.

BACKGROUND: Owing to the COVID-19 outbreak, older adults living alone, who can only connect socially outside their homes, are at risk of social isolation and poor mental health. This study aimed to identify the changes, before and after COVID-19, by sex and age, in social relationships (social activity, social network, and social support) and mental health (depression and suicide ideation) among older adults living alone. METHODS: This is a prospective cohort study of community-dwelling older adults who were at least 65 years old and living alone in South Korea. The study was conducted during 2018-2020 with 2,291 participants (795, 771, and 725 for the 1st to 3rd waves, respectively). The data were collected via face-to-face interviews. A generalized linear mixed modeling framework was used to test for changes over three years. RESULTS: Social activity was reduced after the COVID-19, with an interaction effect of sex: older women (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.15-0.23; p < .001) showed greater reduction than older men (OR, 0.50; 95% CI, 0.34-0.75; p < .001). Interaction with neighbors also reduced after the pandemic, but there was no significant evidence of interaction effects. Interaction with family members increased in both sexes during the pandemic, with the interaction effect of sex: older women (OR, 1.40; 95% CI, 1.11-1.76; p = .004) showed greater increase than men (OR, 1.55; 95% CI, 1.13-2.14; p = .007). Social support increased in both sexes during the pandemic, but there was no significant evidence of interaction effects. Depression and suicide ideation showed no significant differences before and after the pandemic. CONCLUSIONS: The findings provide health administrators and health providers with explorative insights into the impact of the COVID-19 on social relationships and mental health among older adults living alone and can guide further studies of interventions considering specific properties of social relationships.

[Nurses' Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation].

PURPOSE: The purpose of this study was to explore nurses' experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic. METHODS: This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis. RESULTS: Two main themes emerged from the analysis: 'Struggling in an isolated space' and 'Limitations of nursing infrastructure and system'. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system. CONCLUSION: The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

A Psychometric Analysis of the 20-item Revised University of California Los Angeles Loneliness Scale Among Korean Older Adults Living Alone.

The current study aimed to explore the factor structure of the Korean version of the Revised University of California Los Angeles loneliness scale for the Korean older adult population. Analyses were based on a cross-sectional cohort of 1,041 community-dwelling older adults (age ≥65 years) living alone in one Korean city. Exploratory factor analysis (EFA) was conducted to determine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to ascertain the validity of the outcomes. For reliability, Cronbach's alpha was computed. Based on EFA and CFA results, a two-factor structure was found. The first factor reflected "intimate loneliness" and the second "relational loneliness." Derived factors demonstrated satisfactory reliability (>0.8). The two factors of loneliness identified in this study could be considered when attempting to treat loneliness among older adults. Nevertheless, future studies should confirm the findings of this study and evaluate aspects of validity beyond factorial validity to further support the conceptual separation of the two identified factors. [Research in Gerontological Nursing, 14(6), 305-316.].

Development of a Community-Based Integrated Service Model of Health and Social Care for Older Adults Living Alone.

The number of elderly people living alone worldwide is increasing, and the responsibility of the state in this context is emerging. This study aimed to develop a community-based integrated service (CBIS) model of health and social care for older adults living alone. The model was designed based on a literature review of previous community care models and per older adults' health and daily life needs. Thereafter, feedback on the integrated model was taken from older adults living alone by conducting a survey (n = 1023) and focus group interviews, after which the opinions of the Public type Health Management Promotion Council were considered and content validity was confirmed. The model, comprising eight healthcare services and five social care services, was tested on 22 older adults for two weeks to assess its feasibility and preliminary efficiency. Each service included screening, assessment, providing service, evaluation, and quit. Participants rated their overall satisfaction with the services as 9 out of 10. Care navigators reported feeling comforted and discovered their own sense of being while providing the services. We believe that the CBIS model may foster independence among community-dwelling older adults living alone, thereby improving their quality of life through "aging in place".

Gender differences in health status, quality of life, and community service needs of older adults living alone.

OBJECTIVES: The aim of this study was to identify gender differences in the health status, community service needs, and quality of life of older adults living alone in an urban city in South Korea. METHODS: A cross-sectional descriptive correlational design was used. The study sampled 1023 older adults (≥65 years) living alone in S* City, during the period from August to October in 2018. Trained interviewers conducted face-to-face interviews with the participants, using the UCLA Loneliness Scale, Short Form Geriatric Depression Scale - Korean version, ENRICHD Social Support Instrument (ESSI), the Mini-Mental State Examination Standard Version (MMSE-2SV), and Health-Related Quality of Life (EQ-5D). RESULTS: 77.8% were women and the mean age was 77.38 years (men = 74.65, women = 78.16). Women had lower socioeconomic and health status than men. Men felt more lonely, depressed, and had suicidal thoughts more frequently than women. Women had more needs regarding care, residential environment, movement, connection, and emergency services than men. In men, depressive symptoms, suicidal thoughts, loneliness, and right-hand grip strength were identified using the EQ-5D. The EQ-5D was also used to explain depressive symptoms, suicidal thoughts, cognitive function, and physical activity in women. CONCLUSION: Health status and community service needs were dependent on gender; therefore interventions should be tailored according to gender. Our research found that to decrease depression and suicidal thoughts, improve physical health, and enhance quality of life for older adults living alone, interventions need to be designed to decrease male loneliness and to enhance female cognitive function.

Bioactive secondary metabolites produced by an endophytic fungus Gaeumannomyces sp. JS0464 from a maritime halophyte Phragmites communis.

Endophytes, important plant-associated mycobionts, have attracted a great deal of attention because of their bioactive secondary metabolites. Even though halophytes have been reported to overcome salt stress via associations with their endophytes, few studies have investigated the metabolites produced by the endophytes from halophytes. In this study, a dark septate endophytic fungal strain (JS0464), identified as Gaeumannomyces sp. by ITS sequencing, was isolated from the rhizome of a halophyte, Phragmites communis, in Suncheon bay, South Korea. This strain was cultured on a large scale and extracted with ethyl acetate. Chemical investigations of extracts of JS0464 led to the isolation of two glycosylated dialkylresorcinol derivatives (1-2), an anthraquinone derivative (3) and eight known compounds (4-11), which were identified by spectroscopic analyses incorporating one-dimensional/2D NMR and MS. Nine compounds showed significant nitric oxide reduction activity in lipopolysaccharide-stimulated microglia BV-2 cells, seven of which did not impair cell viability. The results suggest that endophytes from the halophytes could be potential resources for bioactive natural products.

Complete mitogenome sequences of a Korean spine loach, Iksookimia koreensis (Kim, 1975).

Here, we present the complete mitogenome sequences from a Korean spine loach (Iksookimia koreensis Kim 1975), an endemic species of Korea. The total length of mitogenome was 16 563 bp, consisting of 13 protein-coding genes, 22 tRNA genes, 2 rRNA genes and one control region (D-loop). Except for ND6 and eight tRNA genes, all of the other mitochondrial genes were encoded on the heavy strand. The control region harbored conserved sequence blocks (CSB-D, E, F, CSB-1, CBS-2 and CBS-3) and TA-nucleotide microsatellite repeats in its 3' end. Our complete mitogenomes will be valuable resources for phylogeny, genetics and conservation of the genus Iksookimia.