Effects of Handover Education Using the Outcome-Present State Test (OPT) Model and SBAR in Nursing Students: A Quasi-Experimental Design.

Background: Since most of nursing students lack clinical reasoning competency, for effective handover education, it is necessary to include a strategy to improve the clinical reasoning competency in the practical training course of the nursing department. Methods: This study used a quasi-experimental research design using a non-equivalent control group pretestposttest design to verify the effectiveness of the practice education program using the OPT model and SBAR. The subjects were 73 third-year students participating in clinical practice or clinical alternative practice in Korea. Results: The experimental group showed significantly better communication clarity (t=-12.262, P<.001), communication confidence (t=-12.486, P<.001), problem-solving processes (t=-13.100, P<.001), and team efficacy (t=-6.197, P<.001) compared to before the intervention. However, there was no significant difference between the pre- and post-intervention scores of the control group. Conclusion: In a situation where clinical practice is difficult for nursing students, the handover education program using the OPT model and SBAR can helps improve their communication clarity, communication confidence, problem-solving process, and team efficacy.

Health-related quality of life in older women with injuries: a nationwide study.

Objectives: This study aims to describe the health-related quality of life (HRQoL) and influencing factors of older women who experienced injuries. Methods: This study is a secondary analysis of data from 4,217 women aged 65 years or older sampled from the Korea National Health and Nutrition Examination Survey (KNHANES) (2016-2020) database. Two-way analysis of variance was used to analyze the data. Results: The mean HRQoL scores of older women with and without injuries were 0.81 ± 0.19 (n = 328) and 0.85 ± 0.17 (n = 3,889), respectively, which were significantly different (p < 0.001). The results of multiple regression analysis revealed that working, physical activity, BMI, osteoarthritis, stress, and subjective health status significantly affected the HRQoL of older women with injuries, and the explanatory power of the model was 29%. Conclusion: The results of this study on factors affecting HRQoL can contribute to the understanding of the experience of older women with injuries and can be used as a reference to develop health promotion programs.

Factors associated with self-care behavior in patients with pre-dialysis or dialysis-dependent chronic kidney disease.

Self-care behavior plays a pivotal role in the management of chronic kidney disease. Improved self-care behavior in patients with chronic kidney disease is a key factor in health management and treatment adherence. This study aimed to evaluate the participants' general and medical condition-related characteristics, physiological indices and the level of health literacy affecting self-care behavior in patients with chronic kidney disease in South Korea. The data of 278 participants were analyzed using t-test, analysis of variance, correlation coefficient, and linear multiple regression analysis. There were significant differences in self-care behavior scores depending on participants' age and cohabitation status, employment, and smoking status as well as having dialysis due to end-stage kidney disease; number of comorbidities; levels of serum hemoglobin, calcium, and creatinine; and estimated glomerular filtration rate. The results of regression analysis revealed that not currently working, non-smoker, end-stage kidney disease, and positive response to the "actively managing my health" scale of the Health Literacy Questionnaire significantly affected self-care behavior in patients with chronic kidney disease, and the explanatory power of the model was 32.7%. Therefore, it is necessary to identify each patient's barriers or needs according to individual characteristics, such as age, cohabitation and employment status, and daily life circumstances, including smoking habits, comorbidities, social support, and level of health literacy to develop efficient support strategies for promoting adequate self-care behavior with CKD.

Health Risk Behaviors Affecting Internet Usage in Adolescents: Evidence from the 2018 Korea Youth Risk Behavior Web-Based Survey.

Background: The purpose of this cross-sectional study was to assess the effects of health risk behaviors on the daily Internet usage of Korean high school students. Methods: The data of 19,830 high school students who responded to the Korea Youth Risk Behavior Web-based Survey were analyzed from June to July 2018. Results: The mean daily Internet usage of high school students was 193.3±125.7 minutes. There were differences in daily Internet usage according to body mass index, grade level, school type, academic achievement, economic status, physical activity, number of physical education classes attended, safety accidents, and safety education (p<.05). Daily Internet usage also differed according to health risk behaviors, including smoking (t=8.32), alcohol consumption (t=9.36), drug use (t=4.51), and risky sexual behaviors (t=5.94). The daily Internet usage of students significantly increased in the absence of physical activity and with health risk behaviors such as smoking, alcohol consumption, drug use, and risky sexual behaviors. Conclusion: It is necessary to develop an intervention program and provide education on increasing physical activity and reducing health risk behaviors for the proper management of health and Internet usage in adolescents.

Nursing students' intent to use AI-based healthcare technology: Path analysis using the unified theory of acceptance and use of technology.

BACKGROUND: Marked advances in artificial intelligence (AI)-based technologies throughout industries, including healthcare, necessitate a broader understanding their use. Particularly, intent to use AI-based healthcare technologies and its predictors among nursing students, who are prospective healthcare professionals, is required to promote the utilization of AI. OBJECTIVE: This study conducted a path analysis to predict nursing students' intent to use AI-based healthcare technologies based on the unified theory of acceptance and use of technology. DESIGN: A cross-sectional survey was performed. PARTICIPANTS: The participants were 210 nursing students from two nursing schools in Korea. METHODS: This study established hypothetical paths for the influence of performance expectancy, effort expectancy, social influence, facilitating conditions, self-efficacy, and anxiety on intent to use AI-based technologies. Mediation of positive and negative attitudes and facilitating conditions' direct effects on intent to use were examined. RESULTS: Positive attitude toward AI (ß = 0.485, p = .009) and facilitating conditions (ß = 0.117, p = .045) predicted intent to use, whereas the path from negative attitude to intent to use was not significant. Performance expectancy, self-efficacy, and effort expectancy predicted positive attitude. Performance expectancy and self-efficacy had a negative effect on the path to negative attitude, whereas anxiety had a positive effect. Facilitating conditions did not significantly predict positive or negative attitude and only directly predicted intent to use. Social influence did not have a significant effect on intent to use. CONCLUSIONS: Intervention programs and other measures should be developed to provide education and information to boost performance expectancy, effort expectancy, facilitating conditions, and self-efficacy regarding the use of AI to lower anxiety and foster positive attitude toward AI-based health technologies.

Influence of AI ethics awareness, attitude, anxiety, and self-efficacy on nursing students' behavioral intentions.

BACKGROUND: Artificial intelligence (AI) technology has recently seen rapid advancement, with an expanding role and scope in nursing education and healthcare. This study identifies the influence of AI ethics awareness, attitude toward AI, anxiety, and self-efficacy on nursing students' behavioral intentions to use AI-based healthcare technology. METHODS: The participants included 189 nursing students in Gyeonggi-do, with data collected from November to December 2021 using self-reported questionnaires. We analyzed the data using the SPSS/WIN 26.0 program, including a t-test, Pearson's correlation coefficient, and hierarchical multiple linear regression. RESULTS: The results revealed that AI ethical awareness (t = - 4.32, p < .001), positive attitude toward AI (t = - 2.60, p = .010), and self-efficacy (t = - 2.65, p = .009) scores of the third and fourth-year nursing students were higher, while their anxiety scores were lower (t = 2.30, p = .022) compared to the scores of the first and second-year nursing students. The factors influencing behavioral intention included a positive attitude toward AI (ß = 0.58) and self-efficacy (ß = 0.22). The adjusted R2 was 0.42. CONCLUSION: It is necessary to inculcate a positive attitude toward AI and self-efficacy by providing educational programs on AI-based technology in healthcare settings.

Effects of a Sociodrama-based Communication Enhancement Program on Mothers of Children with Neurodevelopmental Disorders: A Pilot Study.

PURPOSE: The incidence and prevalence of neurodevelopmental disorders have rapidly increased, indicating an urgent need for assistance through parenting interventions. This study aimed to evaluate the effects of a sociodrama-based communication enhancement program on mothers of children with neurodevelopmental disorders. METHOD: A non-randomized controlled experimental study design was employed. The experimental and control groups had 16 and 18 participants, respectively. The once-a-week six-session intervention was conducted from September to November 2017, in South Korea. The effects of group, time, and group-by-time interactions among the groups were verified using generalized estimating equations with an autoregressive correlation structure. RESULTS: There was a significant decrease in the parenting burden, alongside a significant improvement in parent-child communication and parenting competence in the experimental group compared to the control group. CONCLUSION: The sociodrama-based communication enhancement program was found to positively influence the parenting burden, communication, and parenting competence of mothers of children with neurodevelopmental disorders. These findings suggest that sociodrama-based programs may be an effective intervention strategy for parents of children with neurodevelopmental disorders. The sociodrama-based communication enhancement program can be applied to decrease parenting burden and improve parent-child communication and parenting competence. Through continuous parenting interventions, an improvement in expressive language and an increase in the attachment behaviors of children with neurodevelopmental disabilities could be expected.

Impact of Internet usage time on mental health in adolescents: Using the 14th Korea Youth Risk Behavior Web-Based Survey 2018.

Dependency on the Internet in daily life is increasing, and the negative consequences this dependence may have on mental health are not sufficiently understood. The aim of this study was to investigate the relationship between Korean adolescents' Internet usage time and their mental health. This cross-sectional study included 29,811 high school students ages 16-18 from the 2018 Korea Youth Risk Behavior Web-Based Survey. Participants' mean Internet usage time was 193.4±1.6 min/day. Internet usage time was associated with sex, grade level, type of school, living arrangement, economic status, academic achievement, and experience of school violence. With regard to mental health, subjective health status, stress, feelings of sadness, and suicidal ideation were also related to Internet usage time. The group with more than average Internet usage had poorer subjective health, higher level of stress, and had feelings of sadness and suicidal ideation compared to the group with less than average Internet usage. To effectively manage Internet usage time, interventions to lower Internet usage and leisure programs that could replace Internet usage need to be developed.

Development and validation of the Scale for Staff-Family Partnership in Long-term Care (SSFPLC).

BACKGROUND: A partnership between staff and families is crucial to maintain nursing home residents' health and promote quality of care, and currently, there is a need for a measurement tool to assess the partnership. OBJECTIVES: This study aimed to develop a tool for assessing the partnership between staff and the families of older adult nursing home residents from the perspective of staff members and to verify its reliability and validity. METHODS: The instrument was developed in the following four stages: (1) generation of an item pool via literature review and focus group interview, (2) experts' content validity analysis of 32 items, (3) a preliminary survey on 30 staff members and (4) validity and reliability tests of the instrument on 346 staff members in nursing homes between July and October 2018. RESULTS: The final instrument consists of 17-items in four categories (family's trust and support, collaborative relationship and communication, encouragement to participate in care and professional care). Each item was rated on a 4-point Likert scale, and the higher scores indicating better partnership between staff and families of nursing home residents. The reliability of the instrument was 0.90, and the test-retest intra-class correlation coefficient was 0.96. CONCLUSION: The Scale for Staff-Family Partnership in Long-term Care (SSFPLC) showed acceptable reliability and validity as an instrument to assess the partnership between nursing home staff and families. IMPLICATIONS FOR PRACTICE: This tool can be used for evaluating staff and family partnerships within nursing homes.

Model Setting and Interpretation of Results in Research Using Structural Equation Modeling: A Checklist with Guiding Questions for Reporting.

PURPOSE: This study develops a checklist with guidelines for the methods and important factors to consider in research using structural equation modeling (SEM). METHOD: The paper discusses the factors to consider in the process across the three stages of 1) model setting, 2) model evaluation and modification, and 3) interpretation and reporting of SEM-based studies. RESULTS: The authors present a checklist for researchers during the stages of model setting, model evaluation and modification, result analysis, and reporting, along with examples of figures and tables with explanations. CONCLUSION: A checklist will help to improve the reporting quality of SEM-based studies.

Critical care nurses' communication challenges during handovers: A systematic review and qualitative meta-synthesis.

AIMS: To review and synthesize qualitative studies to gain a deeper understanding of critical care nurses' inter-departmental and shift-to-shift handover challenges. BACKGROUND: Good-quality nurse-to-nurse handover promotes patient safety, while poor handover has been associated with medical errors. However, systematic reviews of qualitative approaches for better understanding the handover experiences of critical care nurses are lacking. EVALUATION: Systematic review methods incorporating meta-synthesis were used. A comprehensive search of seven databases was conducted. Two independent reviewers performed data extraction and evaluated ten studies using the Critical Appraisal Screening Program. Findings were analysed and synthesized using thematic analysis. The transactional model of communication was used to guide the analysis. KEY ISSUES: A total of 10 qualitative studies were included. Seven major handover themes were identified: (a) expectations of perfection, (b) need for partnership, (c) unilateral communication, (d) obstacles to information acquisition, (e) lack of pertinent patient information, (f) need for a structured handover and (g) interruptions/distractions. CONCLUSIONS: Handovers should be considered an essential part of patient-centred care for ensuring continuity of care. IMPLICATIONS FOR NURSING MANAGEMENT: Poor communication during a handover could increase the nurse's burden or stress and adversely affect patient care. Therefore, training should be provided on explicit handover communication.

Effects of a Simulation With Team-Based Learning on Knowledge, Team Performance, and Teamwork for Nursing Students.

Simulation and team-based learning are reported as useful strategies in nursing education. However, empirical evidence on the effects of participating in an integrated course of team-based learning and simulation is limited. The aim of this study was to identify the effects of a nursing simulation program with team-based learning on knowledge, team performance, and teamwork among Korean nursing students. A one-group pretest-posttest design was used. Fourth-year students (N = 229) participated in a 32-hour nursing simulation program with team-based learning. Each of the three sessions of the program involved a 3-hour task training with video-assisted learning and skills performance assessment, 1-hour team-based learning, and 4-hour simulation session with a high-fidelity simulator. In addition to the knowledge test and performance assessment, participants completed a self-administered questionnaire on teamwork. Participants achieved higher scores in the Group Readiness Assurance Test than they did in the Individual Readiness Assurance Test. The posttest scores on team performance and teamwork were significantly higher than their pretest scores. The simulation with team-based learning induced favorable effects on participants' knowledge, performance, and teamwork. A curricular integration of simulation program with team-based learning is consistent with achieving outcomes-based learning in nursing education.

Nurses' perspectives on advance directives before the establishment of the new well-dying law in Korea: A mixed methods study.

AIM: This study explored the attitudes, experiences, and perceptions of Korean nurses toward advance directives (ADs) before the establishment of new Well-Dying Law. METHODS: A sequential explanatory mixed method design was applied. We administered a constructed questionnaire on attitudes toward ADs and end-of-life issues and experience related to end-of-life decision-making. A Korean-translated version of the KAESAD [Knowledge-Attitudinal, Experimental Survey on ADs] was administered by 245 nurses. Semi-structured interviews (N = 16) were audio-recorded, transcribed, and coded in a qualitative content analysis. RESULTS: The quantitative results revealed the nurses' perspectives on ADs: that valuing patient's autonomy, authority, or rights is vital to the implementation of ADs and end-of-life decision-making. Also, nurses reported that patients should be knowledgeable and informed about ADs. These responses allowed us to generate an interview, which revealed four themes in adopting the Well-Dying Law, including ADs. Themes with 'benefits' and 'roles of health care providers' mainly supported the quantitative results. Themes with 'ethical issues,' such as disagreement between patients and family members on ADs, and 'preparation,' regarding adopting the new law, should be importantly considered when implementing ADs in clinical settings. CONCLUSIONS: Our study highlights that nurses need to develop sufficient knowledge on the laws, and communication skills to help patients be knowledgeable and make their own decisions regarding ADs. To successfully adopt the Well-Dying Law, our findings suggest that a nationwide public campaign and a continuing education program for nurses to manage ethical issues regarding ADs are required.

Association between Hospital Nurses' Perception of Patient Safety Management and Standard Precaution Adherence: A Cross-Sectional Study.

Standard precautions should be applied to prevent health care-associated infections during every nursing activity. However, adherence to standard precautions was reported to be inadequate. Therefore, this study aimed to identify the rates of standard precaution adherence and the association between perception of patient safety management and standard precaution adherence. In this cross-sectional descriptive study, a convenience sample of nurses was recruited from a university-affiliated teaching hospital in Seoul, Korea. Data were collected using a structured self-report questionnaire. Among the 332 questionnaires returned (response rate: 94.9%), a total of 329 nurses were analyzed. In the present study, the overall standard precaution adherence rate was approximately 53.5%. The multiple linear regression results revealed that participants' perceptions of patient safety management were only significantly associated with standard precaution adherence after adjusting other covariates (ß = 0.412, p < 0.001). Nurse supervisors should focus more on raising awareness about nurses' perception of patient safety management based on the specific work environment, such as the total number of nurses working together and the nurse-to-patient ratio. Nurse educators should develop integrated curricula to help graduate nurses transition smoothly into professional practice and enhance adherence to standard precautions in diverse health care settings.

Factors Affecting Body Image Discordance Amongst Korean Adults Aged 19-39 Years.

OBJECTIVES: This study was designed to investigate factors affecting the discordance between body image and body mass index amongst Korean adults aged 19-39 years. METHODS: Data (N = 59,361) from the 2014 Korean Community Health Survey was analyzed using descriptive analysis, chi-square test, and logistic regression analysis. RESULTS: To examine the factors affecting body image discordance as observed in 43.1% of participants, the group was subdivided into underestimation and overestimation. There were 36.0% of participants that were body image discordant underestimators and 7.1% were overestimators. Multivariate logistic regression analysis showed that the underestimators tended to be men, graduated from high school, married, current/ex-smokers, ex-drinkers, had between 5 to 9 hours sleep (inclusive), had fair to good self-rated health, and demonstrated healthy weight control behavior, relative to the reference group. In comparison, overestimators tended to be in the 19-29 year group and had signs of depression. The OR of individuals who were men, married, and had healthy weight control behavior was significantly lower in the overestimators group. CONCLUSION: These findings show that tailored interventions to promote accurate body awareness should be based on the type of body image discordance. In addition, it is necessary to develop and implement a program of body image improvement that considers the factors affecting body weight discordance.

Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

PURPOSE: This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. METHOD: Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. RESULTS: The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. CONCLUSION: Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved.

[A comparison study using mixed methods on foreign residents' satisfaction with Korean health care services].

PURPOSE: This study was conducted to examine and compare satisfaction with Korean health care services for Americans, Chinese and Russians who resided in Korea. METHODS: A questionnaire was distributed to 252 participants (81 Americans, 89 Chinese, 82 Russians). Three focus group interviews were subsequently conducted in order to obtain a greater understanding of participants' experience and perspectives. RESULTS: The average satisfaction score was 3.09, with Americans and Russians showing significantly higher scores than Chinese. Overall, participants reported higher satisfaction in 'Facility', 'Quality of care' and 'Nursing services' as opposed to 'Information/education'. 'Care with cultural respect' as well as communication related services. Data from the focus group interviews were categorized into 12 sub-categories, 7 categories and 2 themes. The two themes were common experience and contrasting experience. Common experience included 4 categories, 'Quality of care', 'Hospital facility and health care system', 'Language barrier' and 'Information and education'. Contrasting experience included 3 categories, 'Medical cost', 'Health care personnel' and 'Accessibility'. CONCLUSION: Results of this study provide basic knowledge on foreign residents' satisfaction and experience with Korean health care services. Further research is needed with foreigners from different cultural backgrounds. Administrative and educational efforts are required to improve communication skills and cultural competency.