Influence of anxiety and resilience on depression among hospital nurses: A comparison of nurses working with confirmed and suspected patients in the COVID-19 and non-COVID-19 units.

AIMS AND OBJECTIVES: This study aimed to compare anxiety, resilience, and depression between COVID-19 unit (confirmed patients and suspected patients) and non-COVID-19 unit nurses and assess their effects on depression. BACKGROUND: Nurses working during the global pandemic are known to be physically and psychologically exhausted, and experience severe anxiety and depression. However, there is a lack of studies comparing anxiety and depression between COVID-19 and non-COVID-19 unit nurses. DESIGN: Descriptive research study. METHODS: This study was conducted on 64 nurses who directly worked for more than a month in a COVID-19 unit of a general hospital with nationally designated negative-pressure isolation beds and 64 nurses working in a non-COVID-19 unit. Data were collected through questionnaires and were analysed using SPSS 25.0. Reporting of this research adheres to the STROBE guidelines. RESULTS: Anxiety and depression were significantly higher in nurses working with patients suspected to have COVID-19 rather than nurses working with confirmed COVID-19 patients and non-COVID-19 patients. Resilience was significantly lower in suspected patient unit nurses than in COVID-19 unit nurses. Anxiety was the major factor predicting depression in both COVID-19 unit (confirmed patients and suspected patients) and non-COVID-19 unit nurses with 76.6%, 80.7%, and 63.6% explanatory power, respectively. CONCLUSIONS: Among nurses working in COVID-19 units, suspected patients unit nurses had higher depression than confirmed patients unit nurses due to an unsafe facility environment, insufficient personal protective equipment, and unknown conditions of the patients. Thus, interventions which have a high impact on depression need to be provided to relieve anxiety. RELEVANCE TO CLINICAL PRACTICE: The nursing organisation must provide comprehensive support including coordinated shifts, internal motivation, incentives, up-to-date information, and clear infection prevention guidelines to relieve anxiety caused by exhaustive workload, uncertainty of infectious diseases, and lack of human and material resources.

Effects of horizontal violence among nurses on patient safety: Mediation of organisational communication satisfaction and moderated mediation of organisational silence.

AIMS: This study aimed to investigate the effect of nurses' horizontal violence on patient safety as mediated by organisational communication satisfaction and to examine the moderated mediation effect of organisational silence. BACKGROUND: Patient safety is a worldwide concern in health care, but patients still experience adverse events. Among factors affecting patient safety, organisational silence must be examined in relation to organisational communication satisfaction and horizontal violence. METHOD: A total of 301 nurses working at four general hospitals with over 500 beds in Gyeonggi-do were recruited from October to November 2018. Data were collected through questionnaires and analysed using SPSS 25.0 and SPSS PROCESS macro. RESULTS: Horizontal violence directly affected patient safety and indirectly affected patient safety via mediation by organisational communication satisfaction. Organisational communication satisfaction had a partial mediation effect, and organisational silence had a significant moderated mediation effect in the path from horizontal violence to organisational communication. CONCLUSION: To enhance patient safety, educational programmes and strategies that improve organisational silence and organisational communication satisfaction should be developed at an organisational level. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators should be aware of the pivotal impact of organisational silence among nurses on patient safety.

Effects of hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication on patient safety.

Recent studies have identified common problems with patient safety in hospitals and medical institutions have responded, prioritizing service quality and performance, including patient safety. However, the factors influencing safety for hospital patients are still being examined and clarified. We aimed to investigate how hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication satisfaction can affect patient safety and to construct and verify a hypothetical model describing the relationships between these factors. The participant sample included 301 hospital nurses from four large (≥500 beds) general hospitals in Gyeonggi-do, South Korea. Data were collected through questionnaires from October to November 2018 and analyzed using SPSS 25.0 and AMOS 22.0. Factors that had direct effects on patient safety were organizational silence (ß = -.130, p < .05) and organizational communication satisfaction (ß = .209, p < .001). Factors that had indirect effects on patient safety were internalized dominant values and horizontal violence. The explanatory power of these variables for patient safety was 7.9%. The results indicate that organizational silence, horizontal violence, and organizational communication satisfaction fully mediated the relationship between nurses' internalized dominant values and patient safety. Our findings may be useful to hospital administrators and managers in identifying and analyzing these organizational characteristics in their institutions. Further, the model described in the results may be used to inform the development of educational programs and strategies to improve patient safety by reducing organizational silence and horizontal violence and improving organizational communication.

Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program.

BACKGROUND & AIMS: The optimal training method for endoscopic characterization of colorectal polyps using narrow-band imaging is uncertain, and sessile serrated lesions (SSLs) optical diagnosis data are lacking. We aimed to evaluate a comprehensive training program for real-time optical diagnosis of colorectal polyps, including SSLs. METHODS: We performed a single-institution prospective study of 15 endoscopists trained with the Workgroup Serrated Polyps and Polyposis classification system. After the first phase of in vivo optical diagnosis, their performances were evaluated. After re-education for insufficient competency, they began the second phase. The learning curves and performance on 2 preservation and incorporation of valuable endoscopic innovations benchmarks were assessed. RESULTS: A total of 7294 polyps, including 486 SSLs, were diagnosed in real-time. The overall accuracy improved from 73.5% in the first phase to 77.1% in the second. The accuracy with high confidence was 79.4% and 85.1% in the first and second phases, respectively. In the first and second phases, the negative predictive values for diminutive neoplastic polyps were 82.1% and 92.5%, respectively, and concordances of the surveillance intervals were 80.7% and 89.7%, respectively. Eight endoscopists achieved the preservation and incorporation of valuable endoscopic innovations benchmarks after the second phase compared with none after the first. In contrast, the high confidence rate decreased from 74.6% to 70.2% as training progressed. CONCLUSION: A comprehensive training program for real-time optical diagnosis significantly improved performance and reduced individual variability in less-experienced endoscopists. ClinicalTrials.gov no: NCT02516748.

Effect of Nurses' Work Experiences in a COVID-19 Unit on Depression: Mediation Effect of Resilience and Moderated Mediation Effect of Organizational Trust.

Aim: Nurses work with a lack of organizational support and perceive an unsafe environment from their organizations, which has been related to depression. This study aimed to investigate the effect of nurses' work experiences in a COVID-19 unit on their depression, the mediation effect of resilience, and the moderated mediation effect of organizational trust. Methods: Participants were 132 nurses working at a general hospital. Through questionnaires, data were collected during the COVID-19 pandemic and analyzed using SPSS 25.0 and SPSS PROCESS macro. Results: Mean resilience was 2.15 ± 0.76; mean organizational trust was 3.03 ± 0.74; mean depression was 0.76 ± 0.63. 65.6% nurses with work experience in a COVID-19 unit had depression. Of the 27.2% nurses who showed moderate or higher levels of depression. Nurses' work experiences in a COVID-19 unit had a direct effect on depression and indirectly affected depression via resilience as a mediator. Resilience had a partial mediation effect, and organizational trust had a significant moderated mediation effect in the path from nurses' work experiences in a COVID-19 unit to depression mediated by resilience. Conclusions: This study emphasizes the key role that healthcare organizations play in providing sufficient support to nursing staff to protect them from depression by improving nurses' resilience and organizational trust during the pandemic. Healthcare organizations need to develop a systematic structure to provide organizational support to nurses so that the organizational trust and resilience of nurses can be maximized.

Parental smartphone addiction and adolescent smartphone addiction by negative parenting attitude and adolescent aggression: A cross-sectional study.

Introduction: This study aimed to examine the mediating role of negative parenting attitudes and adolescent aggression in the relationship between parents' and adolescents' smartphone addiction. Methods: This was a cross-sectional descriptive study that used data from the 2018 Korean Children and Youth Panel Survey. The study involved 2,360 adolescents (1,275 boys, 54.0%, mean age 14.52 ± 0.33 years) and their parents (2,148 mothers, 91.0%), who used smartphones. Adolescents completed questionnaires assessing negative parenting attitudes, aggression, and smartphone addiction while parents completed questionnaires assessing their sociodemographic characteristics and smartphone addiction. Results: Parents' smartphone addiction was directly and indirectly related to adolescents' smartphone. Additionally, negative parenting attitudes and adolescent aggression played serial mediating roles in the relationship between parents' smartphone addiction and adolescent smartphone addiction. Conclusion: The findings suggest that it is necessary to consider parental smartphone addiction, parenting attitude, and adolescent aggression, when developing interventions to prevention smartphone addiction among adolescents. Moreover, it highlighted the importance of developing healthy parenting environment that includes parents' healthy smartphone use and positive parenting to prevent adolescents' smartphone addiction.

Process of Diabetes Management in Young Adults with Type 1 Diabetes.

This study investigated diabetes management processes among young adults with type 1 diabetes applying the grounded theory method. A total of 15 young adults, with an average age of 29 years, with type 1 diabetes were selected through theoretical sampling between November 2016 and October 2018. Data collected through in-depth interviews were analyzed using the constant comparative method. The core category of this study was defined as "living in a standardized frame." Participants managed diabetes through the trial-and-error process in addition to selective restriction or selective minimization. They restricted their diet, physical activity, social interactions, and range of thoughts, often following passive and avoidant strategies. Consequently, nurses are in a critical position to assist diabetic individuals via support programs and take the lead in mitigating social prejudice.

Dietary patterns are associated with the prevalence of nonalcoholic fatty liver disease in Korean adults.

OBJECTIVES: There is minimal research on the effect of overall dietary patterns on the development of nonalcoholic fatty liver disease (NAFLD) in the Korean population. The present study investigated the association between dietary patterns and NAFLD. METHODS: A prospective cross-sectional study was performed on participants who visited a health care center for a health checkup. A semiquantitative food frequency questionnaire was administered to the participants to assess their food intake, and factor analysis was used to identify dietary patterns. Relationships between the dietary patterns and the risk of NAFLD were evaluated. RESULTS: A total of 331 of the 1190 participants (27.8%) analyzed were diagnosed with NAFLD. Three factors were generated and defined as the traditional pattern, Western and high-carbohydrate pattern, and simple meal pattern using a factor analysis procedure. The traditional pattern revealed a positive correlation with NAFLD, and the simple meal pattern exhibited an inverse correlation with NAFLD. We adjusted for confounding factors, such as age, sex, waist circumference, smoking status, total energy intake, diabetes, and hypertension, and participants in the highest quartile of the traditional dietary pattern exhibited a higher prevalence of NAFLD (P for trend = 0.0373; odds ratio, 1.85; 95% confidence interval, 1.11-3.08) than participants in the lowest quartile. Participants in highest quintile of the simple meal pattern exhibited a decreased risk of NAFLD compared with the lowest quintile (P for trend = 0.0233; odds ratio 0.59; 95% confidence interval 0.34-1.00). CONCLUSIONS: The traditional dietary pattern was associated with an increased risk of NAFLD, and the simple meal pattern was associated with a decreased risk of NAFLD in the Korean population. This finding supports the use of dietary patterns to predict the risk of NAFLD and potentially serve as a dietary prevention strategy in individuals who are at high risk of developing NAFLD.

Visceral Obesity Predicts Fewer Lymph Node Metastases and Better Overall Survival in Colon Cancer.

BACKGROUND: The relationship between visceral obesity and colon cancer outcome has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node (LN) metastasis and overall survival (OS) in colon cancer. MATERIALS AND METHODS: Metastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T) > 0.29. RESULTS: In a multivariate analysis among 186 patients, there were inverse associations between V/T and MLR (OR = 0.413, 95% CI = 0.216-0.789, P = 0.007). Furthermore, patients with visceral obesity tended to have significantly better OS than patients with non-visceral obesity. CONCLUSIONS: Higher V/T ratios which indicate referring to visceral obesity was significantly associated with decreased MLR and better OS for CRC.