Epidemiology of Accidental Injuries at Home and Related Risk Factors for Mortality among Older Adults in South Korea: A Retrospective Cohort Study.

Background and Objectives: Accidental home injuries among older adults are increasing globally, but reporting is limited. This study aims to establish foundational data for program development and policies to prevent accidental injuries at home in older adults by using data on the occurrence of accidental injuries at home and analyzing the risk factors of mortality due to accidental injuries among adults aged 65 years and older. Materials and Methods: This retrospective study used data from the community-based Severe Trauma Survey in South Korea. This study identified general, injury-related, and treatment-related characteristics of older adults who were transported to the emergency department with accidental injuries at home. Single-variable and multiple logistic regression analyses were used to identify risk factors for mortality after injury. Results: The majority of older adults in this study who experienced accidental injuries at home were aged 75 to 84 (42.8%) and female (52.8%), with 1465 injured from falls and slips (68.0%). Risk factors for mortality included older age (≥85 years) (ORs 2.25, 95% CI 1.47-3.45), male sex (ORs 1.60, 95% CI 1.15-2.20), mechanism of injury (falls or slips vs. contact injury, ORs 6.76, 95% CI 3.39-13.47; airway obstruction vs. contact injury, ORs 13.96, 95% CI 6.35-30.71), higher severity (moderate vs. mild, ORs 2.56, 95% CI 1.45-4.54; severe vs. mild, ORs 12.24, 95% CI 6.48-23.12; very severe vs. mild, ORs 67.95, 95% CI 38.86-118.81), and receiving a blood transfusion (ORs 2.14, 95% CI 1.24-3.67). Conclusions: Based on these findings, the home and community environments where older adults live should be inspected and monitored, and in-home accidental injury prevention strategies should be developed tailored to the characteristics of older adults' risk factors and their injury-related characteristics.

Bowel dysfunction and lower urinary tract symptoms on quality of life after sphincter-preserving surgery for rectal cancer: A cross-sectional study.

OBJECTIVES: This study aimed to investigate the impact of bowel dysfunction and lower urinary tract symptoms on the quality of patients with rectal cancer who underwent sphincter-preserving surgery. METHODS: This cross-sectional study included patients who were followed up after sphincter-preserving surgery in Korea. Data were collected from May 2022 to February 2023. The participants (n = 110) responded to self-reported questionnaires assessing the Low Anterior Resection Syndrome (LARS) score, International Prostate Symptom Score (IPSS), European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-C29 questionnaires. RESULTS: Among the participants, 66.4% had major low anterior resection syndrome, and 39.1% had moderate-to-severe lower urinary tract symptoms. Patients with higher severity of low anterior resection syndrome and lower urinary tract symptoms had a lower quality of life. The IPSS, performance status, duration since the end of the surgery, comorbidities, LARS scores, and tumor location on the anal verge negatively affected the quality of life. CONCLUSION: Patients with more severe bowel dysfunction or lower urinary tract symptoms have a poorer quality of life. Nurses should be made aware of the factors that can reduce the quality of life of patients who have undergone sphincter-preserving surgery. Accordingly, they should plan to address the various nursing problems.

Quiet quitting among healthcare professionals in hospital environments: a concept analysis and scoping review protocol.

INTRODUCTION: The post-COVID-19 pandemic era has seen a rise in 'quiet quitting', with employees limiting their efforts to fulfil assigned tasks without going beyond their designated responsibilities. The occurrence of quiet quitting in hospitals can have detrimental effects not only on organisational culture but also on patient safety and satisfaction. Therefore, the aim of this study is to define quiet quitting among healthcare professionals in hospitals through concept analysis, identify the associated factors and outcomes of quiet quitting, and conduct a scoping review based on this defined concept. METHODS AND ANALYSIS: This study will adopt Walker and Avant method for concept analysis and Aromataris and Munn methodological framework as well as the Joanna Briggs Institute Reviewer's manual for scoping reviews. The concept analysis will follow eight steps: (1) choosing the concept; (2) outlining the objectives of the analysis; (3) recognising the concept's uses; (4) selecting the concept's defining attributes; (5) constructing a model case; (6) constructing additional cases; (7) defining the consequences and antecedents of the concept; and (8) determining empirical referents. This study used databases of PubMed, Embase, PsycINFO, Scopus, ProQuest Dissertations and Theses Global for the English language, and NDSL, KCI, RISS, KISS and DBpia for the Korean language. Additionally, grey literature will be searched. ETHICS AND DISSEMINATION: This concept analysis and scoping review does not require ethical approval. The results of this study will be reported in peer-reviewed publications.

Falls, fear of falling, and related factors in patients with diabetic foot disease.

BACKGROUND: Falls and fear of falling (FOF) are common in patients with diabetic foot disease (DFD). PURPOSE: To understand the relationship between falls, FOF, and related factors in patients with DFD. METHOD: We recruited 70 patients being treated for DFD at two hospitals in Korea. A structured questionnaire was used in investigating fall experience, FOF, and related factors. RESULTS: Among the participants, 42.8 % fell in the past year, and FOF was reported in 57.1 %. Rates of "no caregiver," "DFD duration (>1 year)," and "burning pain" were higher in fallers than non-fallers. The rates of "older adults (≥65 years of age)," "unemployed," "not using assistive devices," "visual impairment," and "hearing impairment" were higher in patients with FOF than in those without FOF. However, the level of balance confidence was lower in patients with FOF. CONCLUSIONS: The fall experience of patients with DFD was associated with the presence of their caregiver, disease-related factors, and foot pain symptoms, while FOF was related to age and fall-related factors.

Changed Digital Technology Perceptions and Influencing Factors among Older Adults during the COVID-19 Pandemic.

This correlational study aimed to identify factors that contribute to changes in perceptions of digital technology among older adults during the COVID-19 pandemic. This study utilized raw data from "The 2021 Report on the Digital Divide," a nationwide survey conducted in South Korea. Data were collected from 1171 older adults (aged ≥ 65 years) from September to December 2021. Multiple regression analyses were performed to examine the factors influencing changes in the perception of digital technology. Over one-third of the participants reported positive changes in their perceptions of digital technology during the pandemic. Key factors included self-efficacy for digital devices (ß = 0.35, p < 0.001), digital networking (ß = 0.11, p < 0.001), accessibility to digital devices (ß = 0.10, p = 0.002), and perceived health (ß = 0.08, p = 0.003). The expansion of digital technology owing to the pandemic has served as a catalyst for changes in older adults' perceptions. Healthcare providers and caregivers should consider digital technology perceptions and influencing factors when providing digital healthcare services. The results can be utilized to identify vulnerable older adults with negative perceptions of digital technology, thus minimizing disparities in access to digital healthcare services.

"Untold and unexpected clinical practice stress," nursing students' experience of disgust: A phenomenological approach.

BACKGROUND: In the clinical learning environment, nursing students often face situations that cause physical disgust. Previous studies have shown that more than half of the students experienced disgust, and that high disgust sensitivity in students was related to negative results in terms of academic and caring behavior. OBJECTIVES: This study aims to understand the experience of disgust felt by nursing students in a clinical learning environment. DESIGN: A qualitative study using phenomenological method. METHODS: In-depth, one-on-one interviews were conducted with 18 nursing students at a university in South Korea. The data obtained through the interviews were used to explore the essential structure and meaning of disgust using phenomenological analysis. RESULTS: This study derived four categories, nine theme clusters, and twenty-one themes. The four categories were "fear that stimulates the senses," "untold and unexpected clinical practice stress," "ambivalence towards myself and patients," and "struggling to become a nursing professional." CONCLUSIONS: Nurse educators must be aware that nursing students may feel disgust in clinical settings and are therefore under stress. They must also assist students so that their concerns caused by emotions that they cannot easily reveal do not affect their nursing careers.

Perceived Eye-Related Symptoms and Influencing Factors in Hospital Nurses.

Nurses are at risk of eye discomfort due to the increasing use of visual display terminals and wearing masks, which may worsen eye-related symptoms. This study was conducted in South Korea to identify the factors influencing eye-related symptoms among hospital nurses on/off duty. The study included 154 nurses who completed a self-reported questionnaire that assessed demographic characteristics, perceived health status, dry-eye symptoms, occupational stress, and eye-related symptoms. The results showed that nurses complained of more eye-related symptoms on duty than off duty, with female sex and dry-eye symptoms being the factors influencing eye-related symptoms on duty. On the other hand, computer use time (≥4 h) and dry-eye symptoms were the factors influencing eye-related symptoms off duty. The study suggests that assessing dry-eye symptoms can facilitate early interventions to relieve eye-related symptoms in hospital nurses, and they should pay attention to eye health during working hours as well as off hours.

Effects of self-management education on COVID-19 prevention in patients undergoing hemodialysis.

Aim: To develop self-management education for preventing coronavirus disease 2019 (COVID-19) in patients on hemodialysis and to verify its effects. Background: During the current pandemic, studies on various areas, such as infection control in dialysis units, infection rates, clinical characteristics, treatment progress, and the emotional and psychological states of dialysis patients, have been actively reported. However, experimental research verifying the effects of interventions on infection prevention in hemodialysis patients is very rare. Methods: This study included 34 patients on hemodialysis in a South Korean general hospital (18 in the experimental group and 16 in the control group). Data were collected from September to October 2021. The experimental group was provided with self-care behavior for infection prevention education for 8 weeks, and the control group was provided with usual nursing care. Results: The patients on hemodialysis showed moderate fear of COVID-19, good compliance with patient role behavior and self-management efficacy, and poor handwashing practice. After the intervention, there were no significant differences concerning fear of COVID-19, compliance with patient role behavior, and self-management efficacy between the experimental and control groups. However, confidence in handwashing (subjective norm) and proper handwashing practice improved significantly in the experimental group compared with the control group. Conclusion: The infection prevention education developed in this study positively affected confidence in handwashing and proper handwashing practice in patients undergoing hemodialysis. This intervention can be used in various clinical settings where care is provided for patients with chronic illness, including those on hemodialysis.

Influencing factors of fatigue among public health nurses during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: This study investigated the effects of occupational stress, anxiety, depression, and sleep disturbance on the level of fatigue among public health nurses (PHNs). DESIGN: The study had a cross-sectional, correlational survey design. MEASURES: A total of 198 PHNs were enrolled from 30 public healthcare centers/offices. Data were collected between May and July 2021 using a structured questionnaire to investigate the general characteristics, occupational stress, anxiety, depression, sleep disturbance, and fatigue of the participants. Descriptive statistics and multiple regressions were used to determine fatigue and its influencing factors among PHNs. RESULTS: The participants showed high fatigue and occupational stress levels due to a lack of rewards. The percentage of participants with mild-to-severe anxiety and mild-to-severe depression, and those who identified themselves as poor sleepers were 44.9%, 50.5%, and 70.2%, respectively. High levels of sleep disturbance (ß = .23, p < .001), occupational stress (ß = .21, p < .001), anxiety (ß = .20, p = .016), depression (ß = .17, p = .043), being younger (ß = -.15, p = .004), and being a regular worker (ß = .13, p = .017) were influencing factors of fatigue. CONCLUSIONS: Individual efforts and organizational interventions to enhance sleep quality are needed to relieve fatigue among PHNs. Further, organizational support can be considerate of young nurses and regular workers, and alleviate their occupational stress. Moreover, anxiety and depression should be managed efficiently to reduce fatigue.

Effect of Uncertainty in Illness and Fatigue on Health-Related Quality of Life of Patients on Dialysis: A Cross-Sectional Correlation Study.

This study aimed to determine the effect of uncertainty in illness and fatigue on the health-related quality of life of patients on dialysis. A community-based cross-sectional study was conducted among patients on hemodialysis (n = 80) and peritoneal dialysis (n = 81) in Korea. Data were collated using self-reported structured questionnaires. Multiple regression analysis was used to identify those factors affecting the physical and mental health-related quality of life of patients. Patients on peritoneal dialysis reported higher levels of fatigue (p < 0.001). Factors affecting the physical health-related quality of life of patients on dialysis were fatigue (p < 0.001), employment (p = 0.001), and exercise (p = 0.016), thus explaining the observed variance of 37%. Factors affecting mental health-related quality of life were fatigue (p < 0.001), uncertainty (p = 0.004), educational level (p = 0.005), and smoking (p = 0.035). To improve the health-related quality of life of patients on dialysis, clinicians should assess their fatigue levels and plan multidisciplinary interventions to manage it. In addition, education level and employment status should be considered, and tailored interventions should be provided to acquire positive coping strategies and health promotion behaviors to counter disease uncertainty.

Prevalence and Risk Factors of Depression in Patients with Rheumatic Disease in South Korea during the COVID-19 Pandemic.

This study aimed to examine the prevalence and risk factors of depression among patients with rheumatic diseases (RDs) during the coronavirus disease 2019 (COVID-19) pandemic. This study adopted a cross-sectional design, and 160 outpatients with RDs in one university hospital in South Korea were sampled using the convenience sampling method. Data were collected from May to July 2021 using a structured questionnaire. The risk factors of depression were analyzed using descriptive statistics and multiple logistic regression analyses. The prevalence rates of post-traumatic stress disorder (PTSD), insomnia, and depression were 37.5%, 20.0%, and 24.4%, respectively. Multiple logistic regression analyses confirmed that employment status, monthly income, perceived health, PTSD, and insomnia were significant risk factors of depression. The findings highlight the urgent need to assist patients with RDs who are at risk of depression during the COVID-19 pandemic, especially individuals who are unemployed or have low incomes and poor perceived health, individuals with high PTSD, and individuals with severe insomnia. There is a need to provide disease-specific interventions to effectively alleviate depression among these individuals during the COVID-19 pandemic.

Depression and quality of life in older adults with pneumoconiosis: The mediating role of death anxiety.

This study identified factors related to the quality of life of older adults with coal workers' pneumoconiosis and determined the mediating effect of death anxiety on the relationship between depression and quality of life. The participants were 161 older adults who were admitted to five pneumoconiosis hospitals in South Korea. The results showed that higher levels of depression indicated higher levels of death anxiety, and higher levels of depression and death anxiety indicated poorer quality of life. While controlling for general characteristics, death anxiety (ß = 0.47, P < .001) had a complete mediating effect on the relationship between depression (ß = 0.13, P = .075) and quality of life (R2 = 0.70, Adjusted R2 = 0.68, P < .001). To improve the quality of life of older adults with pneumoconiosis, interventions that reduce death anxiety along with depression should be investigated.

Patient safety awareness, knowledge and attitude about fire risk assessment during time-out among perioperative nurses in Korea.

AIM: This study aims to investigate the relationship between patient safety awareness, knowledge (risk-Knowledge) and attitude about fire risk assessment during time-out (risk-Attitude) of perioperative nurses. DESIGN: A cross-sectional study. METHODS: Perioperative nurses (N = 158) from 22 small- and medium-sized hospitals participated in the study. Participants' characteristics, knowledge and attitude about fire risk assessment were investigated using structured questionnaires. RESULTS: Patient safety awareness, risk-Knowledge and risk-Attitude scores were high among nurses who received frequent patient safety education or fire preparedness training, while patient safety awareness partially mediated the effect of risk-Knowledge on risk-Attitude. To increase perioperative nurses' risk-Attitude, it would be effective to increase not only their risk-Knowledge but also overall patient safety awareness.

Intention to Stay in Specialist Trauma Nurses: Relationship With Role Conflict, Stress, and Organizational Support.

BACKGROUND: Specialist trauma nurses contribute to shortening hospital stay, lowering intensive care unit readmission rates, and improving treatment outcomes through early detection and management of health problems in trauma patients. However, Korean specialist trauma nurses have a higher turnover rate than other nurses due to negative factors like unclear job descriptions and inconsistent job activities. OBJECTIVE: This study aimed to examine the levels of and relationships among role conflict, occupational stress, perceived organizational support, and intent to stay in Korean specialist trauma nurses. METHODS: We enrolled 53 specialist trauma nurses from eight regional trauma centers in Korea. Data on role conflict, occupational stress, perceived organizational support, and intent to stay were collected using a structured questionnaire. Mann-Whitney U test, Kruskal-Wallis test, and Bonferroni post hoc tests were conducted to examine differences in intent to stay. Spearman's correlation coefficients were used to examine correlations between the key variables. RESULTS: High intent to stay was associated with periodic job training, job satisfaction, and perceived high workload. Role conflict was positively correlated with occupational stress, whereas both were negatively correlated with perceived organizational support. Intent to stay was negatively correlated with occupational stress and positively correlated with perceived organizational support. CONCLUSIONS: Effective improvement measures that lower occupational stress and increase perceived organizational support will help maintain the positions of specialist trauma nurses. These results highlight the need to specify the scope of practice and implement practical measures like career development programs that enhance professional nursing competencies to retain specialist trauma nurses.

Emotional Labor and Burnout of Public Health Nurses during the COVID-19 Pandemic: Mediating Effects of Perceived Health Status and Perceived Organizational Support.

The purpose of this study was to identify the mediating effects of perceived health status (PHS) and perceived organizational support (POS) in the association between emotional labor and burnout in public health nurses (PHNs). The participants were 207 PHNs convenience sampled from 30 public health centers and offices in Jeju, Korea. Data regarding emotional labor, PHS, POS, and burnout were collected between February and March 2021 using a structured questionnaire. Collected data were analyzed by Pearson's correlation coefficient and multiple regression analysis. Burnout of PHNs was positively correlated with emotional labor (r = 0.64, p < 0.001) and negatively correlated with PHS (r = -0.51, p < 0.001) and POS (r = -0.51, p < 0.001). In the association between emotional labor and burnout, PHS (B = -1.36, p < 0.001) and POS (B = -0.42, p = 0.001) had a partial mediating effect. Reduction of burnout among PHNs requires not only effective management of emotional labor but also personal and organizational efforts to improve PHS and POS.

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit.

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

Fear of falling and related factors during everyday activities in patients with chronic stroke.

The aim of this study was to examine the impact of physical function, anxiety, and depression on the fear of falling associated with everyday activities in patients with stroke. This was a cross-sectional descriptive survey. Convenience sampling was used to select 127 patients with stroke who were undergoing rehabilitative therapy at a single rehabilitation hospital in South Korea. Fear of falling, anxiety, and depression were assessed using structured questionnaires. Physical parameters, including lower extremity function, functional mobility, balance ability, and lower extremity muscle strength, were measured using objective methods. A multiple regression analysis was used to identify the predictors of fear of falling. Female patients had a higher fear of falling associated with walking outdoors compared to male patients. Lower extremity strength was the only significant predictor of fear of falling when adjusting for age, sex, Mini Mental State Examination scores, and fall experience. Lower extremity strength was identified as the most important factor affecting the fear of falling associated with everyday activities in patients with stroke. Preventing muscle weakness in the lower extremities and providing education and support to improve patients' self-efficacy in outdoor activities are strategies that can be used to reduce the fear of falling in patients with stroke.

Burden, Depression, and Awareness of Information on Safety Behavior in Korean Hemodialysis Patients during the COVID-19 Pandemic.

The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in Korea between January and February 2021. A structured questionnaire was used to survey their levels of burden, depression, AIC, adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). The study results showed that the influencing factors of ASB for COVID-19 were AIC (ß = 0.265, p < 0.001), the burden of "not receiving hemodialysis on time" (ß = 0.233, p = 0.008), and the burden of "social exclusion of hemodialysis patients" (ß = 0.186, p = 0.032). The influencing factors of DSB were the burden of "social exclusion of hemodialysis patients" (ß = 0.258, p = 0.003) and AIC (ß = 0.217, p = 0.004). As the COVID-19 pandemic continues, the latest evidence-based information must be provided to hemodialysis patients to promote self-care and prevention behavior that encourages ASB and discourages DSB.

Association between sleep quality, anxiety and depression among Korean breast cancer survivors.

AIM: This study aimed to examine the sleep pattern of breast cancer survivors and anxiety and depression associated with sleep quality to provide evidence-based information for the development of interventions to improve sleep disorders in these survivors. DESIGN: A cross-sectional study. METHODS: The subjects were 266 breast cancer survivors in South Korea. Structured questionnaires regarding sleep quality, anxiety and depression were used. The data were analysed using t test, ANOVA and multiple regression analysis. RESULTS: Sleep duration and sleep disturbance were found to affect anxiety, whereas sleep latency and subjective sleep quality were found to affect depression. These results suggest that various factors affecting sleep quality should be considered when providing care for anxiety and depression in breast cancer survivors.

Effects of Home-and-Workplace Combined Exercise for Patients with Ankylosing Spondylitis.

PURPOSE: The purpose of this study was to investigate the effects of home-and-workplace combined exercise on physical function, depression, and work-related disability in patients with ankylosing spondylitis. METHODS: This study adopted a non-randomized quasi-experimental design. Fifty-two patients were recruited: home-and-workplace combined exercise (n = 17), home exercise (n = 18), and control group (n = 17). RESULTS: The home-and-workplace combined exercise group showed improvement in spinal mobility and pulmonary function and significantly lower absenteeism and overwork impact than the home-exercise group and control group. The home-and-workplace combined exercise and home exercise groups showed a higher level of activity improvement than the control group. CONCLUSION: home-and-workplace combined exercise can be recommended to patients with ankylosing spondylitis to enhance their physical function, including spinal mobility and pulmonary function, and reduce work-related disability.