Twenty Years of Progress and the Way Forward: Immunization Registry Information System in Korea.

The National Immunization Program in The Republic of Korea offers mandatory and free vaccinations to children under 12, regulated by the Infectious Disease Prevention and Control Act. Tracking vaccination coverage is crucial for population protection and public health strategies. Since 2002, the Immunization Registry Information System (IRIS) has been used nationwide to capture vaccination data. This study reviewed documents related to IRIS's establishment and development. The Republic of Korea legally supports IRIS's construction and data collection, integrating vaccination data with the Ministry of the Interior and Safety's resident registration to minimize errors. This collaboration also facilitates cost reimbursement and digital registration, promoting wider vaccination coverage. IRIS manages expense claims once vaccination details are logged, and authorized medical institutions can access these records in real-time. Since 2015, the Korea Disease Control and Prevention Agency has been compiling annual data on national vaccination coverage. IRIS also sends automated reminders in 12 languages, reports adverse effects, and issues vaccination certificates. However, IRIS lacks integration between vaccine and disease registries, unlike countries such as England, Denmark, and the Netherlands. Improving integration capabilities could enhance IRIS's support for public health through an integrated information system.

Development of an Acute Pain Assessment Tool for Patients in Post-anesthesia Care Units.

BACKGROUND: Post-operative pain is a common form of acute pain. Objective pain assessment in post-anesthesia care units after surgery is useful regardless of the patient's condition. AIMS: This study aimed to develop and evaluate an acute pain assessment tool for patients in post-anesthesia care units. DESIGN: This was a cross-sectional observational study comprising two stages: scale development and psychometric evaluation. SETTINGS:  . PARTICIPANTS/SUBJECTS:  . METHODS: Scale items were developed based on a literature review and content validity by experts. The validity and interrater reliability of the pain scale were evaluated using data from 218 patients admitted to the post-anesthesia care unit at a university hospital. A receiver operating characteristic curve was used to identify the sensitivity and specificity for determining the cutoff point for acute pain. RESULTS: We developed an objective acute pain scale, called the APA5, which ranges from 0-10 and comprises behavioral (facial and verbal expressions and body movement) and physiological (changes in heart rate and blood pressure) responses. The APA5 is valid and reliable for assessing acute pain in the recovery room. Sensitivity and specificity were acceptable when the cutoff was 2 out of 10 points. CONCLUSIONS: The APA5 is an easy and simple tool for measuring pain in patients in post-anesthesia care units who have difficulties with self-reporting.

Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study.

AIM: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND: Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS: This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS: One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.

Core contents for a menopausal health literacy intervention for South Korean middle-aged women: an e-Delphi study.

BACKGROUND: The attention on improving health literacy (HL) for self-management at the population level in many countries has been increasing. Although self-management among middle-aged women in the menopausal transition are important public health issues, few studies have developed the menopausal HL intervention reflecting the multidimensional aspects of HL. We aimed to generate consensus from an expert panel on the core contents of the menopausal HL intervention for middle-aged women based on the HL conceptual framework of the European Health Literacy Survey. METHODS: The panel comprised 20 experts from multiple disciplines (nursing, medicine, public health, and food and nutrition). We conducted the e-Delphi process in three rounds, asking the panel to evaluate and prioritize the appropriateness of the core contents and provide open-ended responses to additional comments about the menopausal HL intervention. The e-Delphi questionnaire was developed based on the HL framework, integrating health and HL domains. RESULTS: The experts reached a consensus on 38 components of the intervention. Among the 19 components of the four health domains, health topics in healthcare and disease prevention were more appropriate than those in health promotion. For the 19 HL competency components, strengthening the ability to access, appraise, and apply health information was more important than strengthening the ability to understand information. Finally, a consensus was achieved on the 12 priorities for intervention content by HL domains integrated with health domains. For example, contents included proper access to reliable information resources, understanding the definition and process of menopause, judging abnormal health symptoms, and performing the health checkups necessary for menopausal women. CONCLUSIONS: Our findings provide evidence for HL skills that nurses and other health professionals can consider when developing interventions to improve self-management among middle-aged women. Future research should focus on incorporating the core contents of multidimensional HL skills into menopausal HL interventions to improve self-management among middle-aged women.

A Double-Blind, Randomized, Placebo-Controlled, Phase II Clinical Study To Evaluate the Efficacy and Safety of Camostat Mesylate (DWJ1248) in Adult Patients with Mild to Moderate COVID-19.

Although several antiviral agents have become available for coronavirus disease 2019 (COVID-19) treatment, oral drugs are still limited. Camostat mesylate, an orally bioavailable serine protease inhibitor, has been used to treat chronic pancreatitis in South Korea, and it has an in vitro inhibitory potential against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study was a double-blind, randomized, placebo-controlled, multicenter, phase 2 clinical trial in mild to moderate COVID-19 patients. We randomly assigned patients to receive either camostat mesylate (DWJ1248) or placebo orally for 14 days. The primary endpoint was time to clinical improvement of subject symptoms within 14 days, measured using a subjective 4-point Likert scale. Three hundred forty-two patients were randomized. The primary endpoint was nonsignificant, where the median times to clinical improvement were 7 and 8 days in the camostat mesylate group and the placebo group, respectively (hazard ratio [HR] = 1.09; 95% confidence interval [CI], 0.84 to 1.43; P = 0.50). A post hoc analysis showed that the difference was greatest at day 7, without reaching significance. In the high-risk group, the proportions of patients with clinical improvement up to 7 days were 45.8% (50/109) in the camostat group and 38.4% (40/104) in the placebo group (odds ratio [OR] = 1.33; 95% CI, 0.77 to 2.31; P = 0.31); the ordinal scale score at day 7 improved in 20.0% (18/90) of the camostat group and 13.3% (12/90) of the placebo group (OR = 1.68; 95% CI, 0.75 to 3.78; P = 0.21). Adverse events were similar in the two groups. Camostat mesylate was safe in the treatment of COVID-19. Although this study did not show clinical benefit in patients with mild to moderate COVID-19, further clinical studies for high-risk patients are needed. (This trial was registered with ClinicalTrials.gov under registration no. NCT04521296).

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea.

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

Role of alcohol media literacy in alcohol use among children and adolescents: a systematic review.

Enhancing alcohol media literacy (AML) is a critical strategy to attenuate negative effects of alcohol-related media messages. We aimed to systematically review previous studies on AML in children and adolescents. Through database and hand searches, we identified four non-experimental and 13 experimental studies. From the 17 studies, we extracted data on theoretical framework, AML measures, intervention contents and main findings. Our review revealed the following. First, nine and four studies used a single theory and at least two theories, respectively. The most frequently used theory was the Message Interpretation Process model. Second, 13 studies assessed AML using participant self-reporting or evaluators' ratings of participant performance, but no study reported validities of AML measures. Eight studies assessed tobacco or general media literacy as well as AML. Third, all experimental studies used three to five media literacy core concepts proposed by the Center for Media Literacy in AML interventions. Finally, all non-experimental studies found strong cross-sectional associations between higher AML and improved drinking outcomes; all experimental studies found strong intervention effects, such as an increase in AML or improvement in drinking outcomes. In addition, intervention effects differed across participants' gender and drinking experiences. Given our review, health professionals should implement strategies to enhance children and adolescents' AML. Future research should investigate (i) causal inferences in non-experimental studies, (ii) long-term intervention effects in experimental studies and (iii) differences in intervention effects across participants' characteristics, while using solid theoretical frameworks and multidimensional AML concepts.

Currently, alcohol consumption and great exposure to alcohol-related media messages in youth are significant public health concerns. After systematically reviewing non-experimental studies on alcohol media literacy (AML) in children and adolescents, we found that high AML levels were associated with improved drinking-related characteristics: a decrease in positive alcohol expectancies, intention to drink and risk of alcohol consumption. Additionally, we found that AML education targeting children and adolescents was effective in enhancing AML and improving the aforementioned drinking-related characteristics. Given our findings, we strongly recommend providing AML education to children and adolescents in order to attenuate negative effects of alcohol-related media messages on drinking-related characteristics.

Instructional design and educational satisfaction for virtual environment simulation in undergraduate nursing education: the mediating effect of learning immersion.

BACKGROUND: Schools were closed after the onset of COVID-19, with non-face-to-face practices or distance education in nursing education replacing video learning or simulation classes in nursing education clinical practicum. This led to an increase in interest in virtual environment simulation education. While technology-based teaching methods might feel new and intriguing to learners, it is necessary to evaluate learner satisfaction with such an educational method beyond its novelty value. Therefore, this study examined the mediating effect of learning immersion on the relationships between instructional design and educational satisfaction, for virtual environment simulation. METHODS: A descriptive cross-sectional research design was used. The study sample included students in the third or fourth year of the nursing curriculum in South Korea. The participants were 164 nursing students, who had an experience with virtual environment simulation practices during the past year, prior to September 2021. Data were collected using an online questionnaire. The questionnaire addressed the characteristics of nursing students, instructional design, learning immersion, and educational satisfaction. The collected data were analyzed using path analysis. RESULTS: The indirect effect of the path between instructional design and educational satisfaction, mediated through learning immersion in virtual environment simulation was found to be significant. Furthermore, the direct path was also statistically significant. CONCLUSION: Educational content, based on virtual environment simulation, should be implemented based on instructional design. It is necessary to recognize the importance of instructional design that can promote learning immersion in virtual environment simulation, as well as to prepare consistent standards for such design.

Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A cross-sectional study.

We examined to compare menstruation and body mass index (BMI) in women with and without polycystic ovary syndrome (PCOS) and to explore the effects of BMI on menstruation, facial acne, and hirsutism in women with PCOS of child-bearing age. Data from the Korea Nurses' Health Study were analyzed. The effect of BMI on irregularity of menstruation, acne, and hirsutism in the PCOS group was analyzed by logistic regression. The prevalence of PCOS was 7.1% among 11,866 participants. We found that BMI affects menstrual irregularity, facial acne, and hirsutism in PCOS women. Healthcare providers should consider weight control to improve irregularity of menstruation and hirsutism in PCOS women.

Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study.

BACKGROUND: The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. METHODS: In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants' immersion, preference, and interaction with the VR using a 5-point Likert scale. RESULTS: In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. CONCLUSIONS: The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

Relationships of Smoking Media Literacy with Smoking Behavior, Attitudes, and Susceptibility among Adolescents in the Republic of Korea.

The literature has indicated that higher smoking media literacy (i.e., SML) can buffer adverse effects of exposure to pro-smoking media content (i.e., PMC) on smoking-related outcomes in adolescence. Thus, we aimed to investigate (a) SML levels among Korean adolescents and (b) relationships of SML with smoking behavior, attitudes, and susceptibility. In 2017, we collected cross-sectional data from nine middle or high schools in Korea, using a convenience sampling method (N = 476). For the first aim, we calculated the average score of SML. For the second aim, we conducted multinomial logistic regression (MLR), multiple linear regression, and binary multiple logistic regression. Additionally, we conducted Firth logistic regression and confirmed the robustness of our findings obtained from the MLR. The average SML score was 6.48 out of 10 points, indicating that our respondents' average SML was slightly above the middle level. In addition, after adjusting for factors potentially affecting associations between SML and the three smoking-related outcomes, we found significant protective relationships of SML with all smoking-related outcomes: smoking behavior, attitudes, and susceptibility. Given our findings, the enhancement of SML through education should be considered an important strategy to weaken the link between exposure to PMC and smoking-related outcomes.

Role of Microbiota-Derived Metabolites in Alcoholic and Non-Alcoholic Fatty Liver Diseases.

Chronic liver disease encompasses diseases that have various causes, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Gut microbiota dysregulation plays a key role in the pathogenesis of ALD and NAFLD through the gut-liver axis. The gut microbiota consists of various microorganisms that play a role in maintaining the homeostasis of the host and release a wide number of metabolites, including short-chain fatty acids (SCFAs), peptides, and hormones, continually shaping the host's immunity and metabolism. The integrity of the intestinal mucosal and vascular barriers is crucial to protect liver cells from exposure to harmful metabolites and pathogen-associated molecular pattern molecules. Dysbiosis and increased intestinal permeability may allow the liver to be exposed to abundant harmful metabolites that promote liver inflammation and fibrosis. In this review, we introduce the metabolites and components derived from the gut microbiota and discuss their pathologic effect in the liver alongside recent advances in molecular-based therapeutics and novel mechanistic findings associated with the gut-liver axis in ALD and NAFLD.

Living labs for health: an integrative literature review.

BACKGROUND: Living labs are user-focused experimental environments in which users and producers co-create innovative solutions in real-life settings. The aim of this study was to review and synthesize health-related studies that used the living labs approach. METHODS: An integrative literature review of 15 studies was conducted on the application of living lab principles and their usefulness for investing health problems. Three reviewers independently used methodological assessment tools to evaluate the data quality. RESULTS: Twelve of 15 studies were published during the past 5 years, while 14 of the 15 studies were conducted in Europe. Older adults were the target population in 9 of the 15 studies. The research topics varied, including detecting and monitoring daily life, fall prevention and social support. All the studies applied multi-method approaches and a real-life setting. Use of the living lab approach appeared to improve the quality of life, physical and social health and cognitive function of the target populations. CONCLUSIONS: The results showed that the living lab approach was more commonly used to investigate health problems in older adult populations. Living lab appears to be an appropriate method for developing innovative solutions to improve the health of vulnerable groups.

Immunochromatographic assay to detect α-tubulin in urine for the diagnosis of kidney injury.

BACKGROUNDS: Shortening of primary cilia in kidney epithelial cells is associated with kidney injury and involved with the induced level of α-tubulin in urine. Therefore, rapid detection and quantification of α-tubulin in the urine samples could be used to the preliminary diagnosis of kidney injury. METHODS: Cellulose-based nanobeads modified with α-tubulin were used for the detection probe of competitive immunochromatographic (IC) assay. The concentration of α-tubulin in the urine samples was determined by IC assay and compared with the amount determined by Western blotting analysis. RESULTS: The relationship between α-tubulin concentration and the colorimetric intensity resulted from IC assay was determined by logistic regression, and the correlation coefficient (R2 ) was 0.9948. When compared to the amount determined by Western blotting analysis, there was a linear relationship between the α-tubulin concentrations measured by the two methods and the R2 value was 0.823. CONCLUSIONS: This method is simple, rapid, and adequately sensitive to detect α-tubulin in patient urine samples, which could be used for the clinical diagnosis of kidney injury.

Activity limitation in children with cerebral palsy and parenting stress, depression, and self-esteem: A structural equation model.

BACKGROUND: The challenges associated with the activity limitation and participation constraints of children with cerebral palsy may increase their parents' stress. The present study aims to identify the factors associated with parenting stress in mothers of children with cerebral palsy (CP) and to test the multidimensional assumptions of the condition, focusing on the relationship between stress, self-esteem, and depression among parents and the activity limitation of their children. METHODS: We used structural equation modeling to examine the relationships between activity limitation (gross and fine motor, and communication function) in children with CP and their mothers' depression, self-esteem, and parenting stress. The participants were 217 children with CP (123 boys; 94 girls). The mean age of the children involved in the study was 6.61 (SD = 2.76). The types of CP were spastic (71.0%), dyskinetic / athetotic (7.8%), ataxic (4.6%), and mixed (5.5%). We further used structural equation modeling to investigate the mediating influence of depression and self-esteem on parent-child relationships, and the direct effects on parenting stress. RESULTS: The proposed model showed excellent fit indices. Activity limitation had an indirect effect and depression had a direct effect on self-esteem. Activity limitation and depression had effects on parenting stress both directly and indirectly, whereas self-esteem had only a direct effect on parenting stress. CONCLUSIONS: The results highlight the importance of identifying parental depression and self-esteem as predictive variables for parenting stress among parents of children with CP, as well as children's activity limitation.

Computationally Efficient Cooperative Dynamic Range-Only SLAM Based on Sum of Gaussian Filter.

A cooperative dynamic range-only simultaneous localization and mapping (CDRO-SLAM) algorithm based on the sum of Gaussian (SoG) filter was recently introduced. The main characteristics of the CDRO-SLAM are (i) the integration of inter-node ranges as well as usual direct robot-node ranges to improve the convergence rate and localization accuracy and (ii) the tracking of any moving nodes under dynamic environments by resetting and updating the SoG variables. In this paper, an efficient implementation of the CDRO-SLAM (eCDRO-SLAM) is proposed to mitigate the high computational burden of the CDRO-SLAM due to the inter-node measurements. Furthermore, a thorough computational analysis is presented, which reveals that the computational efficiency of the eCDRO-SLAM is significantly improved over the CDRO-SLAM. The performance of the proposed eCDRO-SLAM is compared with those of several conventional RO-SLAM algorithms and the results show that the proposed efficient algorithm has a faster convergence rate and a similar map estimation error regardless of the map size. Accordingly, the proposed eCDRO-SLAM can be utilized in various RO-SLAM applications.

Efficient long-term amplification of hepatitis B virus isolates after infection of slow proliferating HepG2-NTCP cells.

BACKGROUND & AIMS: As hepatitis B virus (HBV) spreads through the infected liver it is simultaneously secreted into the blood. HBV-susceptible in vitro infection models do not efficiently amplify viral progeny or support cell-to-cell spread. We sought to establish a cell culture system for the amplification of infectious HBV from clinical specimens. METHODS: An HBV-susceptible sodium-taurocholate cotransporting polypeptide-overexpressing HepG2 cell clone (HepG2-NTCPsec+) producing high titers of infectious progeny was selected. Secreted HBV progeny were characterized by native gel electrophoresis and electron microscopy. Comparative RNA-seq transcriptomics was performed to quantify the expression of host proviral and restriction factors. Viral spread routes were evaluated using HBV entry- or replication inhibitors, visualization of viral cell-to-cell spread in reporter cells, and nearest neighbor infection determination. Amplification kinetics of HBV genotypes B-D were analyzed. RESULTS: Infected HepG2-NTCPsec+ secreted high levels of large HBV surface protein-enveloped infectious HBV progeny with typical appearance under electron microscopy. RNA-seq transcriptomics revealed that HBV does not induce significant gene expression changes in HepG2-NTCPsec+, however, transcription factors favoring HBV amplification were more strongly expressed than in less permissive HepG2-NTCPsec-. Upon inoculation with HBV-containing patient sera, rates of infected cells increased from 10% initially to 70% by viral spread to adjacent cells, and viral progeny and antigens were efficiently secreted. HepG2-NTCPsec+ supported up to 1,300-fold net amplification of HBV genomes depending on the source of virus. Viral spread and amplification were abolished by entry and replication inhibitors; viral rebound was observed after inhibitor discontinuation. CONCLUSIONS: The novel HepG2-NTCPsec+ cells efficiently support the complete HBV life cycle, long-term viral spread and amplification of HBV derived from patients or cell culture, resembling relevant features of HBV-infected patients. LAY SUMMARY: Currently available laboratory systems are unable to reproduce the dynamics of hepatitis B virus (HBV) spread through the infected liver and release into the blood. We developed a slowly dividing liver-derived cell line which multiplies infectious viral particles upon inoculation with patient- or cell culture-derived HBV. This new infection model can improve therapy by measuring, in advance, the sensitivity of a patient's HBV strain to specific antiviral drugs.

The effectiveness of virtual reality for people with mild cognitive impairment or dementia: a meta-analysis.

BACKGROUND: Virtual Reality (VR) is increasingly used in health-related fields and interventions using VR have the potential to be powerful tools in patient management. The aim of this study was to synthesize the effects of VR interventions for people with mild cognitive impairment (MCI) or dementia. METHODS: Electronic databases were searched to identify studies that used an experimental design to investigate VR intervention outcomes for patients with MCI or dementia. Studies were excluded if the intervention did not focus on VR, if relevant quantitative outcomes were not reported, or if the intended study purpose was assessment or diagnosis. Data were extracted and analyzed from studies that met criteria. To synthesize the intervention effect sizes (ES), we used random effects models to accommodate heterogeneity in the main effect and sub-group analyses. To identify the potential reason for heterogeneity and compare ES according to the moderator variables, subgroup analyses were conducted based on study characteristics and intervention outcomes. RESULTS: Data from eleven studies that met eligibility criteria were analyzed. VR intervention delivered to participants with MCI or dementia produced small to medium effects (ES = 0.29, CI = 0.16, 0.42). The ES for studies using semi-immersive technology (ES = 0.37, CI = 0.25, 0.49) was greater than the studies using full-immersive VR (ES = 0.03, CI = -0.14, 0.21). The results showed small-to-medium effects for VR interventions affecting key outcome variables such as cognition (ES = 0.42, CI = 0.24, 0.60) and physical fitness (ES = 0.41, CI = 0.16, 0.65). CONCLUSION: VR interventions, particularly of the semi-immersive type, are useful for people with MCI or dementia. These results should contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.

Psychometric properties of the geriatric quality of life-dementia in older adults with dementia or mild cognitive impairment living in nursing homes.

BACKGROUND: Given the theoretical and methodological limitations, there is insufficient knowledge about the psychometric properties and internal structure of quality of life (QOL) measurements for patients with dementia living in nursing homes. The present study aimed to confirm the validity and reliability of the Geriatric Quality of Life-Dementia scale (GQOL-D) to measure the QOL of patients with dementia in nursing homes and analyze their QOL based on the validated GQOL-D factor structure. METHODS: The GQOL-D was used to assess QOL. A convenience sampling method was used to recruit patients with dementia or mild cognitive impairment from six nursing homes in two cities. In order to confirm the validity and factor structure of the scale, both exploratory factor analysis and confirmatory factor analysis were employed. An independent t-test and a one-way analysis of variance were performed to examine the difference in the QOL across general characteristics. RESULTS: The original factor model was not appropriate to assess the QOL of dementia patients living in nursing homes because the models did not show adequate fit indices. The results support a two-factor structure: environmental and personal factors. Our findings suggest that the internal consistency and construct validity of the proposed two-factor model are adequate, and the GQOL-D is a useful tool for assessing the QOL of dementia patients living in nursing homes. CONCLUSIONS: This factor structure model of environmental and personal aspects is a useful theoretical framework for designing and evaluating interventions for people with dementia and providing integrated person-centered care for people with dementia in nursing homes.

Interprofessional global health competencies of South Korean health professional students: educational needs and strategies.

BACKGROUND: There is growing recognition of the importance of educating health professional students to enhance their competence in collaborating with individuals from other health professions in the area of global health. This study aimed to identify the performance levels in interprofessional global health competencies (IGHC) of health professional students, their educational needs, and the strategies for successfully developing IGHC. METHODS: This study used a mixed methods design involving an online survey followed by focus group interviews. A sample of 325 fourth-year undergraduate students from 14 health-related majors completed a self-report online survey (38.8% response rate). The performance of IGHC was measured on a five-point Likert scale using the IGHC items developed by the Consortium of Universities for Global Health. Additionally, 12 senior students and five professors in global health-related majors participated in focus group interviews. The students' educational needs and priorities were analysed using the Borich needs assessment and the Locus for Focus model. RESULTS: The participants' IGHC mean score was 3.11 (SD = 0.55) and differed by previous global health activity experiences (t = - 2.10, p = .037). Nine competencies in six domains using the Locus for Focus model were identified as a priority for global health education. Suggested strategies to enhance IGHC included establishing IGHC education in formal curricula, developing value-based content and outcomes, and engaging students in learning activities. CONCLUSIONS: It is necessary to design an interprofessional pre-departure course to achieve the priority IGHC and to organise learning activities where there is cooperation in problem solving while applying the expertise of each major within resource-limited settings. This study supports future health professional education that should foster enhanced roles and scopes of practice as changing agents to assure the achievement of sustainable development goals.