Factors associated with post-traumatic stress disorder in nurses after directly caring for COVID-19 patients: a cross-sectional study.

BACKGROUND: Nurses are particularly at risk of suffering from post-traumatic stress disorder (PTSD) owing to their overwhelming workload, risk of infection, and lack of knowledge about the coronavirus disease 2019 (COVID-19). PTSD negatively affects an individual's health, work performance, and patient safety. This study aims to assess factors related to PTSD among nurses after providing direct care to COVID-19 patients. METHODS: This study is a secondary analysis aimed at identifying factors influencing PTSD among nurses who provided direct care to COVID-19 patients. Data from 168 nurses, collected between October and November 2020, were analyzed. The independent variables were personal, interpersonal, and organizational and COVID-19-related factors (experience of quarantine and direct care of COVID-19 patients), and the dependent variables were PTSD symptoms evaluated based on the PTSD Checklist-5. The nurses' experience of direct care for COVID-19 patients in the designated COVID-19 isolation wards during the first wave of the pandemic (February 2020 to May 2020) was included. RESULTS: Among the nurses, 18.5% exhibited symptoms of PTSD. When providing direct care to a patient in the designated COVID-19 isolation ward, nurses witnessing the death of a patient (p = .001), low level of nurse staffing (p = .008), and inconvenience of electronic health records programs (p = .034) were associated with PTSD symptoms. The experience of quarantine owing to COVID-19 was also associated with PTSD symptoms (p = .034). Additionally, the higher the nurse managers' ability, leadership, and support of nurses in the current ward, the higher the possibility of lowering nurses' PTSD symptoms (p = .006). CONCLUSIONS: Governments and hospitals should prepare and implement organizational intervention programs to improve nurse managers' leadership, nurse staffing levels, and electronic health records programs. Additionally, because nurses who have witnessed the death of a COVID-19 patient or are self-isolating are vulnerable to PTSD, psychological support should be provided.

The Effect of Nurse Staffing on Patient Outcomes in Acute Care Hospitals in Korea.

Nurse staffing is an important factor influencing patient health outcomes. This study aimed to analyze the effects of nurse staffing on patient health outcomes, such as length of stay, mortality within 30 days of hospitalization, and readmission within 7 days of discharge, in acute care hospitals in Korea. Data from the first quarter of 2018 were collected using public and inpatient sample data from the Health Insurance Review and Assessment Service. The data of 46,196 patients admitted to 536 general wards of acute care hospitals were analyzed. A multilevel logistic analysis was performed for the patients' mortality and early readmission, and a multilevel zero-truncated negative binomial analysis was performed for the length of stay. The average length of stay in acute care hospitals was 6.54 ± 6.03 days, the mortality rate was 1.1%, and the early readmission rate was 7.1%. As the nurse staffing level increased, the length of stay and number of early readmissions were likely to decrease. It can be concluded that interventions to improve nurse staffing are required; for example, a policy that compels medical institutions to comply with Korea's medical law standards should be implemented. Additionally, continuous research and interventions are needed to establish an appropriate nurse staffing level according to patient severity.

Posttraumatic stress disorder and related factors among nurses working during the COVID-19 pandemic.

AIM: To analyse the prevalence of posttraumatic stress disorder (PTSD) and examine its related factors among nurses who worked during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea. BACKGROUND: Nurses are a high-risk population for PTSD, especially during the COVID-19 pandemic. This study was conducted to identify the nursing work environmental factors that should be addressed to reduce PTSD. METHODS: Using a cross-sectional design, 365 nurses were enrolled. Their characteristics (intrapersonal, interpersonal, organizational, and COVID-19-related) and PTSD Checklist-5 scores were analysed. RESULTS: The average PTSD score was 14.98 ± 15.94, and 16.5% of the participants had a high risk of PTSD. Nurses were more likely to have PTSD if they were married (odds ratio = 3.02, p = .013) and when nurse managers' abilities, leadership, and support of nurses were low (odds ratio = 3.81, p < .001). CONCLUSIONS: The nursing work environment was found to be associated with PTSD. Therefore, interventions are necessary to increase nurse managers' abilities, leadership, and support for nurses to reduce the risk of PTSD among nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Effective professional and social support and interventions to improve nurse managers' abilities, leadership, and support of nurses are needed to reduce PTSD.

Effect of Nurses' Preceptorship Experience in Educating New Graduate Nurses and Preceptor Training Courses on Clinical Teaching Behavior.

Only few studies have examined the preceptor training courses and their effects on clinical teaching behaviors (CTBs) of preceptors. This study investigated preceptors' experiences in educating new graduate nurses and the effect they had on clinical teaching behavior (CTB) based on whether they participated in a preceptor training program. A descriptive online survey method was used, and the participants included 180 registered nurses who were preceptors. The Clinical Teaching Behavior Inventory (CTBI-22) was used, and perceptions of teaching experiences were measured by six items. Data were analyzed using multiple linear regression. Preceptors working at general hospitals or hospitals were less likely to have participated in a preceptor training program than those working at tertiary hospitals. The overall mean score of CTB was 89.30, and "guiding inter-professional communication" showed the lowest mean score. Positive perceptions of preceptorship experiences were positively related with CTB, and the number of precepting experiences affected CTB only for nurses having undergone preceptor training courses. The use of role-playing as a method in training courses positively affected preceptors' CTB. These findings suggest that preceptors need support from nurse managers and colleagues, and preceptor training programs should be developed.

Relationships among demands at work, aggression, and verbal abuse among registered nurses in South Korea.

BACKGROUND: In order to improve organizational culture and job outcomes, it is important to characterize and better understand the relationship between aggression and verbal abuse among nurses. PURPOSE: To examine the relationships among demands at work, aggression, and verbal abuse among nurses. METHODS: A cross-sectional study was conducted using survey data from three tertiary hospitals located in South Korea. Sixteen nursing units were selected and 378 nurses' data were used as the final sample. The relationships were examined by multiple linear or logistic regression analyses. FINDINGS: More than 70% of the nurses had experienced at least 1 type of verbal abuse. Higher physical aggression and hostility were significantly related to greater verbal abuse experience. CONCLUSION: To prevent the vicious cycle of victims becoming perpetrators, it is necessary to develop and implement concrete strategies to manage verbal abuse and aggression among nurse colleagues.

Synthesis of 2-Alkoxy/Thioalkoxy Benzo[d]imidazoles and 2-Thione Benzo[d]imidazoles via a Phase-Based, Chemoselective Reaction.

2-Alkoxy/thioalkoxy benzo-[d]-imidazole and 2-thione benzo-[d]-imidazole libraries were constructed in solution phase and on solid phase, respectively. The key step in this work is the phase-based chemoselective reaction of the 2-mercaptobenzo-[d]-imidazole intermediate with benzyl chloride (solution phase) and Merrifield resin (solid phase). In the solution-phase case, benzyl chloride reacted with the thiol group of 2-mercaptobenzo-[d]-imidazole, whereas in the solid-phase case, Merrifield resin was introduced at an internal amine group of benzo-[d]-imidazole. To afford the desired 2-alkoxy/thioalkoxy benzo-[d]-imidazole analogues, we used various alkyl halides, alcohols, and thiols in solution phase, and to obtain 2-thione benzo-[d]-imidazole derivatives on solid phase, we used diverse alkyl halides and boronic acids. Finally, to measure the drug potential to be orally active and the molecular diversity in three-dimensional (3D) space, we calculated physicochemical properties and displayed energy-minimized 3D structures. As a result, the libraries from solution phase and solid phase show distinct features in physicochemical properties and skeletal diversities in 3D space.

Relationships Between Nurse Staffing and Patients' Experiences, and the Mediating Effects of Missed Nursing Care.

PURPOSE: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences. DESIGN: The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea. METHODS: Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy. Patients' experiences included adverse events, communication with nurses, and overall hospital rating. Patient-reported missed care was measured using the MISSCARE Survey-Patient with three domains: communication, basic care, and timely response. FINDINGS: Lower nurse-perceived staffing adequacy was associated with more patient-reported missed communication. Lower patient-perceived staffing adequacy was associated with more missed care and adverse events, and a lower likelihood of experiencing good communication with nurses and of giving a high overall rating to the hospital. Patient-reported missed care mediated the relationship between nurse staffing and patients' experiences. CONCLUSIONS: Nurse staffing adequacy, particularly as perceived by patients, was significantly associated with patient-reported missed communication and basic care, as well as patients' experiences. CLINICAL RELEVANCE: Appropriate nurse staffing is required to reduce missed care and to improve patients' experiences.

Genome-wide profiling in melatonin-exposed human breast cancer cell lines identifies differentially methylated genes involved in the anticancer effect of melatonin.

Epigenetic alterations have emerged as an important mechanism involved in tumorigenesis. The epigenetic impact of DNA methylation in various types of human cancer is not completely understood. Previously, we observed melatonin-induced differential expression of miRNA and miRNA-related genes in human breast cancer cell lines that indicated an anticancer effect of melatonin. In this report, we further characterized epigenetic changes in melatonin-exposed MCF-7 cells through the analysis of DNA methylation profiles in breast cancer cells to provide new insights into the potential mechanisms of the anticancer effect of melatonin. Microarray-based DNA methylation and gene expression profiling were carried out using human breast cancer cell lines. We further identified a number of mRNAs whose expression levels show an inverse correlation with DNA methylation levels. The mRNA expression levels and methylation status of candidate genes in melatonin-exposed cells were confirmed by real-time quantitative PCR and bisulfite PCR. This approach led to the detection of cancer-related genes, which were oncogenic genes, including EGR3 and POU4F2/Brn-3b were down-regulated, while the tumor suppressor gene, GPC3, was up-regulated by 1 nm melatonin-treated MCF-7 cells. Our results provide detailed insights into the DNA methylation patterns induced by melatonin and suggest a potential mechanism of the anticancer effect of aberrant DNA methylation in melatonin-treated breast cancer cells.

Genetic and pathogenic characterization of Akabane viruses isolated from cattle with encephalomyelitis in Korea.

A large-scale outbreak of Akabane viral encephalomyelitis in cattle was reported in the southern part of Korea in 2010. Fifteen Akabane virus (AKAV) strains were isolated from the brain and spinal cord samples by using BHK-21 and/or HmLu-1 cells. To examine the genetic relationships and characteristics of the isolates, nucleotide sequences of the S, M, and L segments of the 15 isolates were determined and analyzed. Complete sequence analysis of the 15 AKAV isolates showed 99.9-100% amino acid identities, indicating that the 15 isolates originated from a single strain. The S and M RNA segments of a representative isolate (AKAV-7/SKR/2010) were also compared with the segments of representative reference sequences. This AKAV-7/SKR/2010 strain showed the highest identity with the Iriki and KM-1/Br/06 strains. Neighbor-joining phylogenetic trees of S and M RNA segments were constructed. Four representative AKAV isolates were classified into subgroup Ia, which contains the Iriki and KM-1/Br/06 strains recognized to cause encephalomyelitis in calves and adult cattle in Japan. Moreover, experimental intraperitoneal infection was performed using the AKAV-7/SKR/2010 and AKAV-17/SKR/2010 strains to assess pathogenesis in suckling mice. The 2 isolates, genetically related to the Iriki strain, were neurovirulent and caused neurological signs in suckling mice. In contrast, the 93FMX strain and the K0505 strain, related to the OBE-1 strain, were avirulent in mice. The present results indicate that these isolates most likely had originated from the Iriki strain and are closely related to the Iriki strain both genetically and pathogenically.