Nursing Students' Perceptions of Factors Influencing Nursing Intentions toward COVID-19 Patients.

Coronavirus disease (COVID-19) is a pandemic to which nursing students are particularly susceptible. This study aims to comprehensively examine nursing students' knowledge, attitudes, risk perceptions, preventive behaviors related to COVID-19, and nursing intentions toward patients with the virus. A questionnaire was administered to 149 nursing students from two universities. Data on the respondents' general characteristics, knowledge levels, attitudes, perceived risk, preventive behaviors toward COVID-19, and nursing intentions toward COVID-19 patients were collected. The collected data were statistically analyzed using SPSS software (version 26.0). This involved descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analyses. The analyses of the factors affecting nursing students' nursing intentions for COVID-19 patients showed that the most predictive factor was perceived risk (ß = -0.38, p < 0.001), followed by attitudes (ß = 0.29, p < 0.001) and preventive behaviors (ß = 0.17, p = 0.017), which explained 26% of the variance in nursing intentions. Lowering the perceived risk of infectious diseases and cultivating positive attitudes and preventive behaviors can increase nursing students' intentions toward COVID-19 patients. Finally, infection management education programs and research on interventions for nursing students are necessary to enhance the quality of nursing care provided to patients with novel infectious diseases.

The Relationship between Depression and COVID-19 Vaccine Uptake and Intention among Korean Adults: The 2021 Community Health Survey.

Individuals with depressive symptoms are vulnerable to COVID-19 infection and mortality; therefore, their vaccination status must be investigated to reduce these rates. This study investigated the association between depressive symptoms and COVID-19 vaccine uptake and intention and identified the reasons for vaccine avoidance. Data were collected from the 2021 Korea Community Health Survey and analyzed using logistic regression. A statistically significant association was found between the presence of depressive symptoms and no COVID-19 vaccine uptake. Among individuals who reported experiencing depression, 4.6% were unvaccinated and 7.7% reported no intention to get vaccinated. Among the unvaccinated, the adjusted odds ratio (aOR) for depression was 1.53 (95% confidence interval: 1.45-1.61) compared to the vaccinated. Similarly, a significant association was observed between depressive symptoms and no intention to get vaccinated. In the group with no vaccine intention, the aOR for depression was 2.06 (95% CI: 1.86-2.27) compared to the group with vaccine intention. Furthermore, "health-related reasons" and "concerns about side effects or past experience of side effects" accounted for 89% of the reasons for vaccine avoidance among individuals with depression. Therefore, it is important to provide tailored information and develop programs to increase awareness and promote COVID-19 vaccine uptake among these individuals.

Perception and Educational Needs of Developmentally Supportive Care At-Home for Parents of Pre-Term Newborns.

After discharge from neonatal intensive care units (NICUs), the parents of pre-term newborns have to provide developmentally supportive care (DSC) to their children; thus, educational support for parents is essential. This study aimed to explore the lived experiences of parents providing DSC to their children born as pre-term newborns at home and to investigate their parenting-related needs. This study included 10 mothers who were identified through theoretical sampling. In-depth interviews were conducted for data collection. For data analysis, grounded theory was used according to Corbin and Strauss's process. The mother's perception and educational needs were characterized by the phenomena "Coexistence of familiarity and unfamiliarity" and "Desire for expert support". Causal conditions include the "Incomplete education system" and "Gap between expectations and reality". Contextual conditions include the "Fear of developmental disability" and "Lack of good evaluation criteria". Intervening conditions include the "Difficulty in obtaining useful information". Action/interaction strategies include the "Active information seeking" and "Continuing to provide DSC". The consequences were the "Needs for professional educational support". The core category was the "Parenting routine that continues without awareness" and "Hope to establish parenting system supported by multidisciplinary experts". These results may provide the preliminary evidence base for suitable educational programs and for developing a social support system for parents.

Factors Associated with Job Stress and Their Effects on Mental Health among Nurses in COVID-19 Wards in Four Hospitals in Korea.

Increased workload during the COVID-19 pandemic has threatened nurses' mental health. This study aimed to identify factors associated with job stress in COVID-19 nurses compared to other nurses. Nurses were recruited from four hospitals in Republic of Korea in November 2020. The general sociodemographic questionnaire, job stress, anxiety (GAD-7), and depression (PHQ-9) were used to conduct an online survey. Stepwise multiple regression analysis was used to identify the factors associated with job stress. A total of 290 participants were analyzed: 122 in the dedicated ward and 168 in the nondedicated ward nurse groups. Job stress, anxiety, and depression were higher in nurses dedicated to COVID-19 (4.19 ± 0.59, 5.98 ± 3.92, and 6.97 ± 4.47, respectively) than in the nondedicated group (3.92 ± 0.72 (p = 0.001), 4.98 ± 4.20 (p = 0.042), and 5.92 ± 4.36 (p = 0.047), respectively). Among COVID-19 nurses, job stress levels were higher in 30-39 year olds than in 20-29 year olds (3.71 ± 0.43 vs. 4.04 ± 0.54, p = 0.006) and in non-smokers compared with smokers (3.85 ± 0.49 vs. 3.38 ± 0.53, p = 0.24). Anxiety (ß = 0.34, standard error (SE) = 0.01, p < 0.001) and clinical experience of 5-10 years (ß = 0.23, SE = 0.10, p = 0.004) were associated with job stress. These findings can be applied when devising response strategies for infectious diseases and developing psychological and organizational intervention programs for alleviating job stress in nurses.

Prevalence and methodological quality of systematic reviews in Korean medical journals.

This study aimed to assess and evaluate the prevalence and methodological quality of systematic reviews (SRs) published in major Korean medical journals (KMJs). The top 15 journals with the highest Korean Medical Citation Index, published between 2018 to 2021, were selected. We assessed the methodological quality of SRs using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). In total, 126 SRs were included, with an average of 32 SRs being reported annually. The overall prevalence of SRs in KMJs was 2.8%, with an increase from 2.6% in 2018 to 3.4% in 2021. Overall, the methodological quality of SRs was low (9.5% low, 90.5% critically low). More than 80% of the studies adhered to critical domain items such as a comprehensive literature search and risk of bias assessment, but for items such as protocol registration and listing excluded studies and the justification for exclusion, the adherence rate was less than 15%. While the number of SRs in KMJs steadily increased, the overall confidence in the methodological quality was low to critically low. Therefore, in order to provide the best evidence for decision-making in clinical and public health areas, editors, reviewers, and authors need to pay more attention to improving the quality of SRs.

The impact of fear of COVID-19 on the impact of event and indirect trauma.

This study investigated the mediating effect of fear of COVID-19 on the relationship between the impact of an event and indirect trauma during the pandemic. The study was conducted online from February 8 to 18, 2021, with 215 participants who had never been diagnosed with COVID-19. The collected data were analyzed using SPSS and PROCESS macro software. It was confirmed that fear of COVID-19 partially mediates the relationship between the impact of an event and indirect trauma. This means that the greater the degree of impact of COVID-19, the higher the level of indirect trauma. Additionally, the greater the fear of COVID-19, the higher the level of indirect trauma. These results indicate that the prolonged spread of COVID-19 may vary depending on the country's quarantine systems. Overall, the findings of this study can assist in understanding the psychological problems of people who have experienced COVID-19 and in preparing relevant countermeasures for emotional problems.

Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey.

The preventive measures against the spread of COVID-19 have negatively impacted the mental health of people with chronic diseases. This cross-sectional study investigated the association between mental health and hand hygiene practices in patients with hypertension (HTN) and diabetes mellitus (DM) (n = 74,296) during the COVID-19 pandemic. Their anxiety about contracting COVID-19 and death, depression, and hand hygiene practices were compared to that of controls. Multiple logistic regression analysis showed that the patients had higher anxiety and depression and poorer hand hygiene practices than controls. Anxiety about contracting COVID-19 was associated with increased handwashing before eating (aOR = 1.59), after using the restroom (aOR = 1.61), after returning from outdoors (aOR = 1.69), for at least 30 s (aOR = 1.45), and with soap or hand sanitizer (aOR = 1.43). However, depression was associated with decreased handwashing before eating (aOR = 0.50), after using the restroom (aOR = 0.51), after returning from outdoors (aOR = 0.51), for at least 30 s (aOR = 0.73), and with soap or hand sanitizer (aOR = 0.63). Anxiety about death showed similar results. Psychological support for people with chronic diseases in crisis situations may promote self-care activities such as hand hygiene for infection control.

Factors influencing medical and nursing students' willingness to care for COVID-19 patients in South Korea: a cross-sectional study.

BACKGROUND: The COVID-19 pandemic has threatened the stability and adequacy of the global healthcare system. In this situation, authorities have considered engaging medical and nursing students to address the shortage of frontline healthcare workers. This study investigated the effect of COVID-19-related knowledge, attitudes, and preventive behaviors on medical and nursing students' willingness to care for COVID-19 patients. METHODS: Medical and nursing students from universities in two regions of South Korea participated in this cross-sectional study. A total of 330 questionnaires were distributed; of them, 99.3% were collected, and 315 questionnaires were analyzed. Data were collected on participants' general characteristics, COVID-19-related knowledge, attitudes, and preventive behaviors, and willingness to care for COVID-19 patients. RESULTS: In total, 66.3% of the participants were willing to care for patients during the COVID-19 pandemic. Students in higher grades and those with more clinical practice experience showed higher levels of willingness to care. Specifically, willingness to care was correlated with the senior year (OR = 3.58, 95% CI = 1.24 - 10.37, p = .019), a high level of COVID-19-related knowledge (OR = 1.03, 95% CI = 1.00 - 1.05, p = .041), an optimistic attitude that COVID-19 can be overcome (OR = 1.63, 95% CI = 1.24 - 2.14, p < .001), and increased engagement in infection prevention behaviors (OR = 1.41, 95% CI = 1.16 - 1.71, p < .001). CONCLUSIONS: The findings indicated that a high level of knowledge regarding the COVID-19 pandemic, having an optimistic attitude, and engaging in preventive behaviors affected students' willingness to care for COVID-19 patients. Integrating disaster preparedness courses in the early years of their curriculum could increase future healthcare providers' willingness to care for patients.

Stress, Depression, and Unhealthy Behavior Changes among Patients with Diabetes during COVID-19 in Korea.

The government ordered various restrictions to limit the spread of coronavirus disease 2019 (COVID-19), thus, affecting the mental health status and lifestyle of people with diabetes. This study identifies COVID-19 effects on mental health problems and unhealthy behavioral changes among patients with diabetes. The subjects of this cross-sectional study were adults aged 19 years or older who participated in the 2020 Korean Community Health Survey. Stress, depression, and changes in unhealthy behavior in diabetic patients (N = 26,839) because of COVID-19 were compared with controls (N = 26,834). The association between stress and depression and unhealthy behaviors among patients with diabetes was investigated. During the COVID-19 pandemic, 20.3% and 4.2% of diabetic patients reported higher levels of stress and depression, respectively, than controls. Diabetic patients showed decreased physical activity and sleep time, and increased smoking. Among diabetic patients, stress and depression are associated with unhealthy behavior changes during COVID-19. Measures to promote healthy lifestyles along with stress and depression management strategies must be implemented for the health care of diabetic patients during the pandemic.

Associations Between Workplace Violence, Mental Health, and Physical Health among Korean Workers: The Fifth Korean Working Conditions Survey.

BACKGROUND: Workplace violence (WPV) is a global public health problem and a threat to the health of Korean workers. This study assessed the prevalence and risk factors of WPV and its association with mental and physical health among Korean workers. METHODS: Data obtained for 50,205 respondents to the Fifth Korean Working Conditions Survey were utilized for this study. Verbal abuse, threats, physical violence, and sexual harassment were assessed individually and as a composite for "any WPV." Workers were characterized by education, income, shift work status, access to a health and safety education program, work sector and overall health. Descriptive analyses and multiple logistic regression analyses were used to estimate the prevalence of WPV and its association with mental and physical health. FINDINGS: Overall, 5.6% of workers reported experiencing one of four forms of WPV. The prevalence of verbal abuse, threats, physical violence, and sexual harassment were 4.9%, 0.7%, 0.2%, and 1.1%, respectively. Most perpetrators were customers. Prevalence of WPV was associated with lower education level, poor health status, long working hours, shift work, and no experience of health and safety education; 9.0% of service workers experienced violence. Workers who had experienced WPV were more likely to experience anxiety, sleep-related problems, depressive symptoms, back pain, headache/eye strain, and overall fatigue. CONCLUSIONS/APPLICATIONS TO PRACTICE: Workplace violence is a serious occupational and public health concern in Korea. These results suggest managing WPV may improve workers' well-being and that violence-prevention strategies, policies, and regulations should be implemented across most industries.

Smoking Behavior Changes during COVID-19 among Korean Adults.

OBJECTIVES: In this study, we investigated the changes in smoking behavior during the COVID-19 outbreak in Korea in 2020. We also examined the influence of general characteristics and mental health problems due to COVID-19 on changes in smoking behavior. METHODS: We collected data from August to October 2020 from adults aged 19 years and older from the Korea Community Health Survey (N=229,269). RESULTS: Among current smokers (N=39,534), 11.0% reported an increase in smoking, and 12.8% reported a decrease in smoking. Overall, 33.3% reported perceived stress and 3.7% reported depression. Participants reported COVID-related anxiety about infecting family (83.0%), economic damage (76.3%), blame or harm from others (66.5%), infection (60.6%), and death (31.3%). Lower education level, living alone, and poor subjective health status were associated with increased smoking. Being a woman and being of older age were associated with decreased smoking. Stress, depression, and anxiety about economic damage due to COVID-19 were more likely to result in increased smoking. Anxiety related to death due to COVID-19 was more likely to result in decreased smoking. CONCLUSION: These findings provide insight into the changes in smoking behavior caused by COVID-19.

Factors Associated with Mental Health among International Students during the COVID-19 Pandemic in South Korea.

The purpose of this study was to investigate mental health problems among international students in South Korean universities during the COVID-19 pandemic, as well as to identify the factors that affect their mental health. A total of 488 international students living in South Korea participated in a web-based survey. The questionnaire was created using the Google Forms platform, and a link to the questionnaire was shared through social media. Multiple logistic regression analysis was conducted to analyze the data. The prevalence rates of sleep problems, anxiety, and depression among international students were 47.1%, 39.6%, and 49%, respectively. The prevalence of mental health problems was higher among participants who were male, living with someone, residents of a rural area, and earning a higher income. The following variables were found to contribute to the prevalence of mental health problems: undergraduate student status, good understanding of the Korean language, longer hours of media usage, and experiences related to COVID-19 infection. A collaborative effort between the government and universities to manage the mental health of international students could promote the mental health of these students.

Development of a Web-Based Korean Triage and Acuity Scale Learning Program for Emergency Department Nurses.

The Korean Triage and Acuity Scale is a tool developed to classify severity and urgency of emergency department patients, focusing on their symptoms. Considering the importance of the Korean Triage and Acuity Scale, learning for emergency department nurses who perform the Korean Triage and Acuity Scale must be structured to ensure that the knowledge they gain can be applied to various clinical situations of the emergency department. Moreover, Web-based learning is considered appropriate in this situation. This is a methodological research study that was conducted to develop a Web-based Korean Triage and Acuity Scale learning program for emergency department nurses. The learning program was developed using each of the five phases of the "analysis, design, development, implementation, and evaluation" model, that is, analysis, design, development, implementation, and evaluation. The learning program was composed of 22 cases of emergency situations based on the Korean Triage and Acuity Scale teaching material with an approval from the Korean Triage and Acuity Scale committee in the Korean Society of Emergency Medicine. The developed program was delivered in 4-hour sessions over 4 weeks. Emergency department nurses who were given the Web-based Korean Triage and Acuity Scale learning program showed improvement in work-site transfer and reported satisfactory learning. The findings indicate that the Web-based learning program for nurses can be used as an effective tool that is easily accessible and provides multiple learning opportunities.

Impact of blended learning on learning outcomes in the public healthcare education course: a review of flipped classroom with team-based learning.

BACKGROUND: A flipped classroom with team-based learning is a blended educational strategy that guides active learning inside and outside the classroom. This study aimed to verify the effects of this innovative blended educational strategy on knowledge, problem-solving ability, and learning satisfaction of undergraduate nursing students undergoing public healthcare education. METHODS: The subjects were undergraduate nursing students enrolled in H University in South Korea. The experiment was conducted over a period of 8 weeks in the public healthcare course. Two groups, blended learning (A flipped classroom with team-based learning) which was the experimental group and traditional lecture-based classroom group, the control group, were assessed. In the blended learning group, the students had pre-class, in-class (including team-based learning elements), and post-class learning elements. The two groups were compared on the following learning outcomes: knowledge, problem-solving ability, and learning satisfaction. RESULTS: Results showed that the blended learning instructional methods, in comparison with traditional lectures, enhanced the students' knowledge, problem-solving ability, and learning satisfaction in the public healthcare course. CONCLUSIONS: This study supports the feasibility of the flipped classroom with team-based learning as a blended learning strategy, able to produce improvements in nursing students' learning outcomes. Blended learning approaches may be an effective alternative to conventional approaches in nursing education.

Associations Between Secondhand Smoke and Mental Health in Korean Adolescents.

This study assessed secondhand smoke exposure among nonsmokers and examined its association with mental health in Korean adolescents. We used the 14th Korea Youth Risk Behavior Survey in 2018 to extract data and analyzed 60 040 adolescents through three secondhand smoke exposure categories: home, school, and public places. Mental health included stress, insufficient sleep, depressive symptoms, and suicidal ideation. Secondhand smoke exposure was reported at 23.0% for home, 20.0% for school, and 51.4% for public places. Secondhand smoke exposures were associated with stress insufficient sleep, depressive symptoms, and suicidal ideation. Furthermore, in the stratified analysis, secondhand smoke exposure was related to poor mental health in both nonsmokers and smokers. Based on the results, we concluded that Korean adolescents may experience poor mental health symptoms from being exposed to secondhand smoke.

Associations between Problematic Smartphone Use, Unhealthy Behaviors, and Mental Health Status in Korean Adolescents: Based on Data from the 13th Korea Youth Risk Behavior Survey (2017).

OBJECTIVE: We aimed to assess the associations between problematic smartphone use, unhealthy behaviors, and mental health status among adolescents. METHODS: The data for this cross-sectional study were obtained from the 13th Korea Youth Risk Behavior Survey (2017). From among the 62,276 adolescents who participated in this nationwide web-based survey, 54,603 (87.7%) who used smartphones were selected as the study population. Unhealthy behaviors included smoking, drinking, physical inactivity, skipping breakfast, and fast food consumption. For the examination of mental health status, we considered sleep disturbances, stress, depressive symptoms, suicidal ideation, and suicide attempts. The associations between problematic smartphone use, unhealthy behaviors, and mental health were analyzed using multiple logistic regression analyses. RESULTS: More than four hours of use on weekdays (31.3%) and weekends (61.3%) and the use of smartphones for communication (46.9%) were associated with unhealthy behaviors and mental health problems. Furthermore, adolescents who experienced conflicts with family (22.3%) and friends (25.8%) and academic problems (3.4%) were likely to have health problems. CONCLUSION: The results suggest that problematic smartphone use may disrupt adolescents' health. Therefore, there is a need for prevention programs for problematic smartphone use at home and at school to improve adolescents' health.

Association between Serum Liver Enzymes and Metabolic Syndrome in Korean Adults.

The purpose of this study was to evaluate the association between alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and metabolic syndrome (MS) in the Korean population. A total of 11,587 adults ≥30 years of age and with complete data were selected from Korea National Health and Nutrition Examination Survey VI conducted from 2013 to 2015. Normal ALT and AST levels were divided into quartiles, and their associations with MS were assessed by logistic regression analysis. Elevated levels of ALT [adjusted odds ratio (aOR) = 7.90, 95% confidence interval (CI) = 6.50⁻9.60] and AST (aOR = 3.81, 95% CI = 3.10⁻4.74) were both significantly associated with a higher prevalence of MS. The quartile group containing the highest levels of ALT and AST within the normal range also showed an increased risk of MS and its components. Elevated levels of ALT and AST, even within the normal range, were associated with prevalence of MS.

Effects of team-based learning on problem-solving, knowledge and clinical performance of Korean nursing students.

BACKGROUND: Team-based learning (TBL) has been used as a learner-centered teaching strategy in efforts to improve students' problem-solving, knowledge and practice performance. Although TBL has been used in nursing education in Korea for a decade, few studies have studied its effects on Korean nursing students' learning outcomes. OBJECTIVES: To examine the effects of TBL on problem-solving ability and learning outcomes (knowledge and clinical performance) of Korean nursing students. DESIGN: Randomized controlled trial. PARTICIPANTS: 63 third-year undergraduate nursing students attending a single university were randomly assigned to the TBL group (n=32), or a control group (n=31). METHODS: The TBL and control groups attended 2h of class weekly for 3weeks. Three scenarios with pulmonary disease content were employed in both groups. However, the control group received lectures and traditional case study teaching/learning strategies instead of TBL. A questionnaire of problem-solving ability was administered at baseline, prior to students' exposure to the teaching strategies. Students' problem-solving ability, knowledge of pulmonary nursing care, and clinical performance were assessed following completion of the three-week pulmonary unit. RESULTS: After the three-week educational interventions, the scores on problem-solving ability in the TBL group were significantly improved relative to that of the control group (t=10.89, p<.001). In addition, there were significant differences in knowledge, and in clinical performance with standardized patients between the two groups (t=2.48, p=.016, t=12.22, p<.001). CONCLUSION: This study demonstrated that TBL is an effective teaching strategy to enhance problem-solving ability, knowledge and clinical performance. More research on other specific learning outcomes of TBL for nursing students is recommended.

Evaluation of antidiabetic, antihyperlipidemic and antioxidant effects of Boehmeria nivea (L.) Gaudich., Urticaceae, root extract in streptozotocin-induced diabetic rats

The potential role of 80 percent methanolic extract of Boehmeria nivea (L.) Gaudich., Urticaceae, root in the treatment of diabetes, along with its antihyperlipidemic and antioxidant effects, was studied in streptozotocin-induced diabetic male Wistar rats. Preliminary screening of the extract revealed the presence of polyphenolics and flavonoids. The animal study was conducted with variable doses of 125, 250 and 500 mg/kg of extract for 21 days in diabetic rats. A significant effect was observed at a dose of 500 mg/kg, which was comparable to the standard drug, glibenclamide. Administration of the extract at a 500 mg/kg dose resulted in a significant reduction of fasting blood glucose, total cholesterol, triglycerides, blood urea, alanine aminotransferase, aspartate aminotransferase, urine sugar and urine ketone levels in diabetic rats in comparison with the diabetic control group. Additionally, this dose significantly increased body weight, hemoglobin, plasma total protein, high density lipoprotein cholesterol, liver glycogen content, superoxide dismutase, reduced glutathione and catalase levels in diabetic rats at the end of 21 days of treatment. Therefore, dietary supplementation with Boehmeria nivea root extract could be beneficial for correcting hyperglycemia, hyperlipidemia and enhancing the antioxidant defense system.