Determinants of positive orientations of adolescents in Korean multicultural families based on the socio-ecological model.

The number of multicultural adolescents has been increasing globally, and their psychological well-being has received keen attention. The present study aimed to identify the factors affecting the positive orientations (i.e., self-esteem, optimism, and life satisfaction) of Korean adolescents from multicultural families based on the socio-ecological model. This study comprised a cross-sectional survey that used data from the Multicultural Adolescents Panel Study by the National Youth Policy Institute in South Korea. In total, 1260 adolescents from Korean multicultural families participated. To assess how the factors contributed to positive orientations, we performed a hierarchical linear regression analysis. Of the individual-level factors, gender, appearance satisfaction, social withdrawal, bicultural and multicultural attitudes, and academic achievement satisfaction affected the positive orientations of the adolescents. Among the relationship-level factors, their family support, relationships with their friends, and relationships with their teachers influenced their positive orientations; in particular, family support was the most influential factor. The study identified influential factors on the positive orientations among multicultural adolescents. These findings can help healthcare, educational, and social service professionals develop programs to enhance the positive orientations of adolescents from multicultural families.

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review.

BACKGROUND: The COVID-19 pandemic radically changed nursing education. PURPOSE: To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces. METHOD: Eligible articles were reviewed using the Joanna Briggs framework. RESULTS: The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects. CONCLUSIONS: The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

Training Priority for Managerial Competence of Nurse Managers in Small and Medium-Sized Hospitals: Focusing on the Management Level.

Introduction: The managerial competence of nurse managers varies according to their management level. Objectives: This study aims to explore the training priority of managerial competence for nurse managers in small- and medium-sized hospitals based on their management level. Methods: Nurse managers (122 front-line and 65 middle-level nurse managers and chief nurse executives (CNEs)) from 21 small- and medium-sized hospitals with less than 300 beds participated in a survey. T-test and Borich Priority were analyzed. Results: Nurse managers identified control competence as the most significant management function in both groups. The training priority for front-line nurse managers was motivation in directing, while it was human resource development in human resource management for middle-level nurse managers and, CNEs. Conclusion: Five management strategies were reported, which will be the basis for future systematic nursing management in nursing organizations.

Psychosocial factors associated with health behaviors in pregnant women of advanced maternal age in Korea.

Objectives: To determine the association between psychosocial factors and health-promoting and health-impairing behaviors in pregnant women of advanced maternal age (AMA) in Korea. Design: A cross-sectional survey study. Setting: Online survey. Samples: A total of 217 pregnant women aged 35 and older agreed to participate in the study, with 207 participants completing the self-report questionnaires. Methods: We collected self-reported data on demographic, obstetric, and psychosocial factors and prenatal health behaviors using standardized measures. We conducted a descriptive analysis of the collected data and a linear regression to identify significant associations with health-promoting and health-impairing behaviors. Results: We found that maternal-fetal attachment (ß = 0.43, p < 0.001) and "social atmosphere" of pregnancy stress (ß = 0.13, p = 0.047) were positively associated with prenatal health-promoting behaviors. We found that artificial conception (ß =-0.16, p = 0.011) was negatively associated with prenatal health-impairing behaviors and that multiparity (ß = 0.23, p = 0.001) and "maternal role" of pregnancy stress (ß = 0.27, p = 0.003) positively associated with prenatal health-impairing behaviors. Conclusion: Health-impairing behaviors of pregnant AMA women need assessment and the importance of health-promoting behaviors for maternal and infant health need reinforcing. We recommend pregnancy stress assessments at prenatal checkups and stress relief interventions that consider cultural differences and contexts rather than standardized interventions.

Review of Ecological Approach Factors Affecting Physical Activity among Older People.

This review aimed to investigate factors affecting physical activity among older people at the individual, social, and environmental levels based on an ecological approach. We searched PubMed, EMBASE, Web of Science, Cochrane Library, and Korean databases to identify all relevant studies that examined physical activity of older people using an ecological approach. Individual factors included socio-demographic characteristics, physical function components, and subjective health perceptions. Social factors included intimate relationships and social support. Environmental factors included physical living conditions, movement-related components, and policies and programs that affect the environment. This review analyzed the factors affecting physical activity of older people in three levels based on the ecological approach. This result provides a basis for managing, preventing, and promoting physical activity in older people based on an ecological approach and highlights the importance of environmental factors for improving physical activity among older people when applying foundational data for health prevention and management.

Differences in Student Brain Activation from Digital Learning Based on Risk of Digital Media Addiction.

Although digital media usage is prevalent among middle school students, the safety of digital media-based learning activities for students at risk of digital media addiction is unknown. The goal of this study was to evaluate the differences in students' brain activity in relation to their risk of digital media addiction. The study was quasi-experimental, with a pre- to post-test control group design. The study participants included 83 middle school students who were engaged in digital learning. We measured their brainwaves to evaluate brain activity using a PolyG-I (LAXTHA Inc.). We found no statistically significant differences in the location of the attention index between the two groups before and after digital learning. However, there were statistically significant differences between the two groups in the P3, P4, and F4 locations of the relaxation index. These results indicate that students at risk of digital media addiction may experience learning difficulties. These results can be used to guide healthcare professionals in developing digital learning programs that are safe for students and to also verify the effects of these programs.

Impact of nurses' compassion competence and transcultural self-efficacy on their global health nursing competency.

AIM: To develop a GHNC scale and verify the effects of nurses' compassion competence (CC) and transcultural self-efficacy (TSE) on GHNC. BACKGROUND: Global health nursing competency (GHNC) is essential for professional nursing care for multicultural populations. METHODS: Using a cross-sectional design, data were collected from 318 nurses of recruited through convenience sampling. Factor analysis and multiple regressions were performed to measure GHNC and determine its influential factors, respectively. RESULTS: The GHNC scale was developed with 15 items in four domains: perception of global society, cultural attitude, nursing practice, and communication skill. The communication factor of CC and cognitive factor of TSE significantly affected GHNC. CONCLUSIONS: The GHNC scale has sufficient validity and reliability for use in nursing practice and research. It can be used to identify the current position of GHNC and develop programs to improve GHNC by enhancing nurses' CC and TSE.

A Scoping Review of Homebound Older People: Definition, Measurement and Determinants.

Being homebound (HB) can affect people's physical and mental health by decreasing movement, which can itself be exacerbated by the deterioration of people's health. To break this vicious cycle of HB and being in poor health, it is necessary to identify and address the factors influencing HB status. Thus, we used a scoping review to identify an HB trend, focusing on the definition, measurements, and determinants of HB status. We analyzed 47 studies according to the five-stage methodological framework for scoping reviews. The common attribute of definitions of HB status was that the boundaries of daily life are limited to the home. However, this varied according to duration and causes of becoming HB; thus, the understanding of HB shifted from the presence or absence of being HB to the continuum of daily activity. Various definitions and measurements have been used to date. Many studies have focused on individual factors to analyze the effect of HB. In the future, it will be necessary to develop a standardized measurement that reflects the multidimensional HB state. In addition, it is necessary to utilize a theoretical framework to explore the social and environmental factors affecting HB.

Factors Affecting the Obesity Levels of Older Koreans Living Alone.

This study investigated factors related to the obesity levels of older Koreans living alone. It used data from the Korean Longitudinal Study of Aging. Its participants comprised 819 people aged 65 years and older, living alone in Korea. Multiple logistic regression was performed to analyze the factors related to managing obesity at the individual, social, and environmental levels. In the obese group, social interaction was a significant factor on social level, whereas in the overweight group, regular exercise, social interaction, and region were the significant factors at the individual, social, and environmental levels, respectively. It was found that different approaches were needed depending on the level of obesity. In addition, this study identified that it was appropriate to approach the obesity management of older people living alone, in terms of individual, social, and environmental systems, based on the ecological perspective.

A systematic review and meta-analysis of the effects of global health competency improvement programs on nurses and nursing students.

AIMS: To identify trends in global health competency improvement programs for nurses and to verify their effects. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Articles published from 2000-2017 in Ovid MEDLINE, Embase, and ProQuest and the Cumulative Index to Nursing and Allied Health Literature database, Cochrane Library, Research Information Sharing Service, DataBase Periodical Information Academic, Korean Studies Information Service System, and National Assembly Library. REVIEW METHODS: Cochrane methods were used to conduct a systematic review, meta-analysis, and sensitivity analysis. RESULTS: Nineteen studies were reviewed. Among them, 12 studies were used for the meta-analysis. The meta-analysis indicated that global health competency improvement programs affected multicultural self-efficacy and cultural competence. CONCLUSION: The findings can be used as the basis for global health competency improvement programs. More studies are needed to clarify their effectiveness. IMPACT: Global health competency improvement programs can be beneficial to improve cultural competence and multicultural self-efficacy for nurses and nursing students.

Sleep quality among shift-work nurses: A systematic review and meta-analysis.

AIM: We systematically reviewed the quality of sleep measurement instruments applied to shift-work nurses and analyzed the effects of intervention research. BACKGROUND: There is a need to test the effects of experimental studies worldwide that conducted interventions to improve the sleep quality of nurses who work shiftwork. METHODS: In this systematic literature review and meta-analysis, we used PICO (Participant, Intervention, Comparison, and Outcome) and searched for papers in Korean and English published up until August 2018. We utilized Cochrane Review Manager Software 5.3. RESULTS: Thirteen articles from 1991 to 2018 were included in the systematic literature review, and 6 of those were used in a meta-analysis. The instrument used most often to asses subjective sleep quality was the Pittsburgh Sleep Quality Index. Additionally, an actigraph and sleep logs were used to collect physiological data about participants' sleep quality. Intervention types were categorized into aroma-inhalation therapy, shift-rotation interventions, physical-activity interventions, and cognitive-behavioral therapy. Ultimately, the effects of the aroma-inhalation therapy intervention significantly improved shift-work nurses' sleep quality. CONCLUSIONS: We established a basic understanding of a strategy to measure and improve participants' sleep quality. Consequently, sleep interventions that can positively promote nurses' health and foster effective job performance should be developed.

Short Sleep Duration as a Risk Factor of Cardiovascular Disease in Korean Adults: Secondary Analysis of the Fifth Korean National Health and Nutrition Examination Survey.

BACKGROUND: Sleep durations shorter or longer than 7 h are associated with cardiovascular diseases. We aimed to investigate the association among sleep duration, risk factors of hypertension, and cardiovascular disease in South Korea using data from a recent large-scale survey. METHODS: Data produced by the Korea National Health and Nutrition Examination Survey (KNHANES) were subjected to multivariate logistic analysis. This cross-sectional, nationally representative survey was conducted from Jan 1 to Dec 31, 2011, by the Korean Center for Disease Control and Prevention. Overall, 6,466 participated. Data were analyzed using STATA version 13.0 (STATA Corp LP). RESULTS: The participants' socioeconomic, physical, and lifestyle factors were statistically different between the two age groups (<65 yr and ≥65 yr). Shorter sleep durations were associated with hypertension in individuals younger than 65 yr of age. On the other hand, in participants aged ≥65 yr, both shorter and longer sleep durations were associated with hypertension, while shorter sleep durations were associated with cardiovascular diseases. CONCLUSION: Unusual sleep durations are associated with an increased prevalence of cardiovascular disease among Korean adults. The effect of sleep duration appears to be more significant in individuals with hypertension, suggesting that the management of hypertension should be prioritized in patients older than 65 year.

Factors affecting the health-related quality of life in community-dwelling elderly people.

OBJECTIVE: The purpose of this study was to investigate the determinants of the health-related quality of life of elderly people in Korea by applying the Andersen model. DESIGN AND SAMPLE: This study was a descriptive survey. Participants were 240 elderly people over 65 years of age living in a community. MEASURES: A hierarchical multiple regression was performed to analyze the factors related to the health-related quality of life, including predisposing, enabling, and need factors, and health behaviors. RESULTS: Need factors, that is, self-reported health status, were the most significant in influencing the health-related quality of life of the elderly people; predisposing factors were age and education level, and enabling factors were income and activities of daily living. CONCLUSION: The findings of this study can be used to develop a community-based intervention program and to establish a policy for improving the quality of life of elderly people.

A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools.

BACKGROUND: There are advantages to using digital textbooks, but also health concerns yet to be evaluated. OBJECTIVE: This study examines the use of digital textbooks' effects on carpal tunnel, considered one of the potential health risks in students using digital textbooks. METHODS: Data were obtained from 43 elementary school students in the sixth grade, selected from two groups who had used digital and paper textbooks, respectively. To assess carpal tunnel function, this study performed median motor nerve and median sensory nerve conduction studies. RESULTS: There were no statistically significant differences between the groups, indicating that there were no functional differences related to carpal tunnel syndrome between the groups. CONCLUSION: Usage of digital textbook is expanding nationwide in the Republic of Korea. There is no short-term risk of carpal tunnel syndrome in this population of elementary school students.

[Development and Application of a Performance Prediction Model for Home Care Nursing Based on a Balanced Scorecard using the Bayesian Belief Network].

PURPOSE: This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN). METHODS: This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0. RESULTS: We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit. CONCLUSION: KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.

Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique.

PURPOSE: The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. METHODS: Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. RESULTS: After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. CONCLUSIONS: The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurses.

Key components of financial-analysis education for clinical nurses.

In this study, we identified key components of financial-analysis education for clinical nurses. We used a literature review, focus group discussions, and a content validity index survey to develop key components of financial-analysis education. First, a wide range of references were reviewed, and 55 financial-analysis education components were gathered. Second, two focus group discussions were performed; the participants were 11 nurses who had worked for more than 3 years in a hospital, and nine components were agreed upon. Third, 12 professionals, including professors, nurse executive, nurse managers, and an accountant, participated in the content validity index. Finally, six key components of financial-analysis education were selected. These key components were as follows: understanding the need for financial analysis, introduction to financial analysis, reading and implementing balance sheets, reading and implementing income statements, understanding the concepts of financial ratios, and interpretation and practice of financial ratio analysis. The results of this study will be used to develop an education program to increase financial-management competency among clinical nurses.

A review of the present state and future policy alternatives for home visit nursing services in Korea.

OBJECTIVES: The aim of this study was to describe the current state of home visit nursing services in the Korean context and to suggest future policy directions. DESIGN: First, the three home visit nursing services that have developed in Korea are compared using the analytic framework provided by Gilbert and Terrell in 2012. The framework is based on four dimensions of social welfare: users, services, source of funds, and service delivery process. Second, we perform a strength, weakness, opportunity, and threat analysis to suggest comprehensive and constructive home visit nursing service policies for the future. RESULTS: Specifically, we advocate the creation of an organization that steers the central government to operate an integrated management organization to distribute services and reduce redundancy for preventing the waste of both medical and state financial resources. This study also recommends the development of educational programs to improve the quality of services and service evaluation criteria for the objective assessment of those services. CONCLUSIONS: These policy guidelines may prove useful both for Korea and for other countries that intend to prepare or revise their home visit nursing service systems.

Descriptive study of electromagnetic wave distribution for various seating positions: using digital textbooks.

To better understand environmental electromagnetic wave exposure during the use of digital textbooks by elementary school students, we measured numeric values of the electromagnetic fields produced by tablet personal computers (TPCs). Specifically, we examined the distribution of the electromagnetic waves for various students' seating positions in an elementary school that uses digital textbooks. Electric and magnetic fields from TPCs were measured using the HI-3603 Visual Display Terminal/ Very Low Frequency (VDT/VLF) radiation measurement system. Electromagnetic field values from TPCs measured at a student's seat and at a teacher's computer were deemed not harmful to health. However, electromagnetic field values varied based on the distance between students, other electronic devices such as a desktop computers, and student posture while using a TPC. Based on these results, it is necessary to guide students to observe proper posture and to arrange seats at an appropriate distance in the classroom.