Information and Communication Technology-Based Application for Cognitive Behavioral Therapy among Community-Dwelling Older Adults with Insomnia: Development and Validation Study.

This study developed an information and communication technology-based mobile application to administer cognitive behavioral therapy to community-dwelling older adults with insomnia. First, the content of the application was determined through a systematic review and preference survey. Preference data on the perception, needs, and preference for non-face-to-face service content were collected from 15 July 2021 to 31 August 2021 from 100 community-dwelling older adults aged 65 years and older. In the design stage, the structure and function of the application were determined, and an interface was designed. The application was developed in conjunction with design experts and programmers using Android Studio software (Android 9). Usability tests were conducted during the implementation stage, followed by an evaluation stage. The evaluation revealed that the application's structure and functions should comprise sleep information, sleep-habit improvement, sleep assistance, video, real-time counseling, and exercise services. These elements were finalized after receiving the results of a preference analysis and advice from an advisory panel of experts in different fields. The developed application was rated with a score of four or higher in all areas. This study successfully developed, implemented, and evaluated a new mobile application called Smart Sleep for community-dwelling older adults with insomnia.

Effects of preceptors' mentoring function on novice nurses' self-efficacy and organizational commitment: A cross-sectional study.

AIMS: This study investigated novice nurses' perception of the effects of preceptors' mentoring function on their self-efficacy and organizational commitment. BACKGROUND: Nursing mentoring is a mutually beneficial relationship between more and less experienced nurses. In nurse education, mentoring is a powerful tool that can be used for a successful transition from a novice to an experienced nurse. DESIGN: This descriptive study used a cross-sectional design. METHODS: A questionnaire survey was conducted with 160 novice nurses from Korean general hospitals who had been working for less than a year after completing their preceptorship. RESULTS: The preceptors' mentoring function as perceived by the novice nurses was 3.87, self-efficacy of the novice nurses was 3.71 points, and the organizational commitment was 3.46 out of 5 points. The results of the multiple regression analysis showed that mentoring function significantly affected novice nurses' self-efficacy (ß = 0.50, p < 0.01) and organizational commitment (ß = 0.54, p < 0.01). Further, the preceptorship training period had a significant effect on organizational commitment (ß = 0.13, p < 0.05). CONCLUSION: Preceptors' mentoring function, as perceived by novice nurses, affected their self-efficacy and organizational commitment.

Effectiveness of Social Support for Community-Dwelling Elderly with Depression: A Systematic Review and Meta-Analysis.

Depression in the elderly is an important health factor that requires intervention in the form of social support resources. The purpose of this study was to conduct a systematic review, while synthesizing available evidence on what kind of social support, such as social participation and social connection/network, is effective for depression in the elderly. We performed a quality assessment of the included studies using the revised Risk of Bias for Non-randomized Studies tool and a meta-analysis of studies published up to 14 May 2021. Of the 3449 studies, 52 were relevant to this study. The various types of social resource applications reported in these were classified into three types: social support, social participation, and social connection/network. The social support group had significantly lower depression compared to the control group (0.72 [0.65, 0.81], p < 0.00001, I2 = 92%). There was a significant decrease in depression in the social participation group compared to the control group (0.67 [0.56, 0.80], p < 0.00001, I2 = 93%) (2.77 [1.30, 5.91], p = 0.008, I2 = 97%) (0.67 [0.56, 0.80], p < 0.00001, I2 = 93%). Finally, the social connection/network group showed decreased depression compared to the control group (2.40 [1.89, 3.05], p < 0.00001, I2 = 24%) (0.83 [0.76, 0.90], p < 0.00001, I2 = 94%). The results of this systematic review confirmed the effects of various social support interventions in reducing depression among the elderly living in the community.

Nurses' perspectives of the patient care experience assessment items using importance-performance analysis.

AIM: This study aimed to evaluate the importance and performance of hospital nurses for patient experience evaluation items from the perspective of care providers and to identify the items that need improvement. BACKGROUND: Patient experience includes customized treatment and services that focus on patient satisfaction and needs, with healthcare providers participating as partners. METHODS: The study was conducted using a cross-sectional survey design, and data were collected on the importance and performance of 15 out of 24 patient experience evaluation items. The sample population consisted of 193 direct care nurses from two hospitals in South Korea. RESULTS: The results showed the items with significant differences in importance and performance ('concentrate here' areas) such as 'description of a drug' (t = 2.26, p = .025), 'listening to patients' (t = 6.64, p < .001), 'description of adverse drug reactions' (t = 10.19, p < .001), 'clean hospital environment' (t = 2.95, p = .004) and 'easy notification of complaints' (t = 8.37, p < .001). CONCLUSION: The findings highlight the importance of awareness and performance in patient experience evaluation items from the nurses' perspective. While some items were recognized as important but not performing well, others were identified as important and performing well. IMPLICATIONS FOR NURSING MANAGEMENT: As identified in this study, nursing managers should strive to develop nursing practice standards and educational programs for nurses to improve patient experiences. It is crucial that these changes are reflected in policies.

Factors associated with nursing needs and nursing hours in acute care hospital settings: A cross-sectional study.

AIM: The aim of this study was to identify the patient and hospital characteristics related to nursing needs and nursing hours in acute hospital settings. BACKGROUND: To determine appropriate staffing levels, accumulating empirical data through direct observation and surveys reflecting the actual situation is necessary. METHODS: In this cross-sectional study, we conducted direct observations of nurses in acute care hospitals from 1 May to 31 August 2020. Twenty-six hospitals in five cities participated, and 747 nursing personnel collected 1,681 patients' data while performing nursing activities. The data of 1,605 nurses were analysed using descriptive statistics, t tests, analysis of variance and linear regression. RESULTS: Hospital size, admission day, patients' dependence level, high fall risk and disease diagnoses were variables associated with nursing needs (F = 73.49, P < .001) and nursing hours (F = 57.7, P < .001). Comparing the correlates of nursing needs and nursing hours revealed that, unlike nursing needs, nursing hours were not significantly associated with surgery and certain diagnoses. CONCLUSION: This study confirmed the variables associated with nursing needs and nursing hours in acute hospitals; based on this, determining appropriate staffing levels, which is an important step in improving inpatients' health outcomes, is necessary. IMPLICATIONS FOR NURSING MANAGEMENT: In acute hospitals, an increased number of nurse staffing should be employed based on the number of newly hospitalized patients, patients with high dependence levels and specific diagnoses, and those at high risk of falling.

The role of clinical trial nurses: Transitioning from clinicians to clinical research coordinators.

AIMS: This study aimed to explore the role of clinical research coordinators (CRCs) and identify the importance and performance of the role as well as the factors that affect the professional recognition of their role. METHODS: A total of 102 CRCs from 10 hospitals were recruited for a survey. The Clinical Trial Nursing Questionnaire scale developed by Ehrenberger and Lillington was used to collect data for the importance-performance analysis. The importance and performance data were plotted on a two-dimensional grid, and multiple stepwise linear regression analysis was used to determine the influencing factors on the CRC role. RESULTS: The influencing factors on the importance of the CRC role were frequency of protocol assessment, implementation and evaluation and professional nursing role performance. The influencing factors on performance were formal education and training in clinical research, institutional career ladder system for professional development and identification as a principal investigator in research studies. The influencing factor on the professional nursing role perception was the lower component of the 'performance of professional nursing role'. CONCLUSION: Formal educational preparation, identification as a principal investigator in research studies and clear career progression are supportive factors to the professional recognition of CRC as a specialized nursing role.

Effects of Just Culture and Empowerment on Patient Safety Activities of Hospital Nurses.

This study investigated the relationship among hospital nurses' perceptions of a just culture, empowerment, and patient safety activities. It also determined the factors affecting the patient safety activities of nurses. This cross-sectional study included 189 nurses from four hospitals in South Korea. The survey was conducted from October to December 2019 using self-report questionnaires including items on socio-demographic characteristics, just culture, empowerment, and patient safety activities. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis with SPSS/WIN 25.0. Patient safety activities correlated positively with just culture (r = 0.369, p < 0.000) and empowerment (r = 0.38, p < 0.000). Additionally, empowerment (ß = 0.213, p = 0.001) and just culture (ß = 0.442, p < 0.000) had statistically significant effects on patient safety activities and explained about 19.5% of the variance in patient safety activities (F = 16.170, p < 0.001). The patient safety at medical institutions can be improved by cultivating a work environment that embraces a just culture and empowers nurses.

Information and General Guidance for Healthcare Professionals in the Fourth Wave of COVID-19.

The COVID-19 curve seesawed and reached the fourth pandemic in July 2021. Since the first three waves, the focus has been on achieving herd immunity through vaccination while a lot of manpower is used for quarantine. However, we have not been able to prevent the fourth wave. The causes are thought to be related to people who doubt the safety of the vaccine and refuse it or violate quarantine guidelines such as social distancing. This study examined guidelines for preventing and controlling COVID-19, the accuracy of vaccination-related information, and described quarantine measures including for those who completed vaccination. In conclusion, prevention and vaccination are the most effective countermeasures against COVID-19. We recommend people vaccination with self-quarantine. Also, it is necessary to make large investments to protect and support nurses in future pandemics.

Effectiveness of Information and Communication Technology (ICT) Interventions in Elderly's Sleep Disturbances: A Systematic Review and Meta-Analysis.

Sleep is a crucial factor for human health and is closely related to quality of life. Sleep disturbances constitute a health problem that should be solved, especially when it affects the elderly. This study aims to examine the effectiveness of information and communication technologies (ICT) interventions in managing sleep disturbances in the elderly. The study used a systematic review of three databases: Ovid-Medline, Ovid-EMBASE, and the Cochrane library database for papers published till 15 April 2021. Two authors independently selected and screened relevant studies based on predefined inclusion criteria. The meta-analysis of randomized controlled trials (RCTs) was carried out using Review Manager 5.4. Two authors independently screened the titles and abstracts of 4297 studies considering both inclusion and exclusion criteria. The complete texts of 47 articles were then evaluated, 31 articles were excluded, and finally, 16 articles were selected. Our meta-analysis showed that the cognitive-behavioral therapy for insomnia (CBT-I) group had a significantly reduced Insomnia Severity Index (ISI) compared to the control group (-4.81 [-5.56, -4.06], p < 0.00001, I2 = 83%) in RCTs, with a significant reduction in ISI (3.47 [1.58, 5.35], p = 0.0003) found in quasi-experimental studies. A significant improvement was found in total sleep time in the CBT-I group compared to the control group (29.24 [15.41, 43.07], p <0.0001) in RCTs, while the CBT-I group showed significantly reduced wake time after sleep onset compared to the control group (-20.50 [-26.60, -14.41], p < 0.00001). In addition, a significant reduction in depression was found in the CBT-I group compared to the control group (-2.11 [-2.85, -1.37], p < 0.00001, I2 = 0%) in RCTs. The quality of life-mental component score (5.75 [1.64, 9.87], p = 0.006, I2 = 0%) and the quality of life-physical component score (5.19 [0.76, 9.62], p = 0.02, I2 = 0%) showed significant improvement in the CBT-I group compared to the control group. ICT interventions showed positive effects on sleep disturbances of the elderly, specifically confirming the positive effect on depression and quality of life as well as the indicators directly related to sleep such as ISI and quality of sleep. Thus, the application of ICT in the healthcare sector will be greater in the future, with changes in the nursing education and practice guidelines so that nurses can play a pivotal role in promoting health behaviors such as sleep-related quality of life and daily activities of the elderly.

Big Data Analysis of the Risk of Intracranial Hemorrhage in Korean Populations Taking Low-Dose Aspirin.

OBJECTIVES: Aspirin has traditionally been used as an analgesic and anti-inflammatory drug; however, low-dose aspirin is known to increase the risk of gastrointestinal and intracranial hemorrhage. In this study, the risk of intracranial hemorrhage in patients taking low-dose aspirin was assessed. MATERIALS AND METHODS: We used the Standard Sample Cohort DB dataset from the National Health Insurance Sharing Service of Korea. This dataset includes details of medical care and prescriptions for patients who used hospital services during a 14-year period throughout Korea. Of approximately 1 million total patients, data from 746,703 adults over the age of 30 years were included for analysis. An Χ2 test was performed to assess the effect of low-dose aspirin on intracranial hemorrhage. In addition, the relationship between use of low-dose aspirin and intracranial hemorrhage was analyzed using multiple logistic regression with consideration of all confounding variables. RESULTS: The results revealed no significant positive correlations between the use of low-dose aspirin and intracranial hemorrhage requiring hospitalization. CONCLUSIONS: Big data analysis of 746,703 patients in Korea over a period of 14 years showed that serious intracranial hemorrhage requiring hospitalization was unrelated to low-dose aspirin use. Moreover, low-dose aspirin use reduced the risk of intracranial hemorrhage in Korean populations.

Evaluating the Correlation Between Nursing Practice and Electronic Nursing Records Using Importance-Performance Analysis.

This study aimed to analyze the importance and performance of nursing task items in the standard guidelines for comprehensive nursing services and confirm whether they are reflected in the nursing records. A total of 120 nurses from three hospitals were surveyed for the importance-performance analysis of standard nursing services and their correlation with nursing records. The average scores for importance, performance, and correlation to nursing records were 3.65, 3.31, and 3.08, respectively, demonstrating a significant positive correlation. Regarding the correlation between nursing tasks and nursing records, spiritual and emotional assessment, mobilization, education and counseling, and escaping and suicide prevention items had moderately low scores. In the importance correlation to the nursing records of the task items matrix, 10 items in quadrant 1 were strengths. Conversely, in quadrant 2, suicide and escape prevention require critical areas for improvement. The other six items were low-priority items in quadrant 3, and the three items in quadrant 4 were hygiene, elimination, and nutrition, which required excessive effort. It is necessary to evaluate the electronic nursing records system periodically according to the nursing environment and modify and supplement the records if required.

Effects of nursing power and organizational trust on nurse's responsiveness and orientation to patient needs.

Aim: To assess the relationship among perceived nursing group power, organizational trust and patient orientation and identify patient orientation predictors. Background: Nurses and nursing organizations should use all resources to give care. Methods: Survey data were collected from 193 nurses at six acute care hospitals in South Korea. Characteristics of hospitals and nurses were analysed using t tests, one-way ANOVAs and regression models. Results: The means for perceived nursing group power, organizational trust and patient orientation were 3.71 (SD± 0.58), 3.22 (SD± 0.83) and 3.94 (SD± 0.53), respectively. Multiple regression analysis revealed that 40% of the variance in patient orientation was explained by perceived nursing group power, organizational trust and work experience. Conclusion: Hospitals should increase nursing group power and improve organizational trust to enhance patient orientation. Hospital executives and nurse managers should work to enhance nursing group power and positive perceptions of organizational trust, which could contribute to patient orientation.

Analysis of Research Topics and Trends in the Journal of Korean Academy of Nursing to Improve Its International Influence.

PURPOSE: The purpose of this study was to analyze articles published in the Journal of the Korean Academy of Nursing (JKAN) between 2010 and 2019, along with those published in three international nursing journals, to improve JKAN's international reputation. METHODS: The overall characteristics of JKAN's published papers and keywords, study participants, types of nursing interventions and dependent variables, citations, and cited journals were analyzed. Additionally, the keywords and study designs, publication-related characteristics, journal impact factors (JIF), and Eigenfactor scores of International Journal of Nursing Studies (IJNS), International Nursing Review (INR), Nursing & Health Sciences (NHS), and JKAN were analyzed and compared. RESULTS: Among the four journals, JKAN's score was the lowest in both the journal impact factor and Eigenfactor score. In particular, while the JIF of INR and NHS has been continuously increasing; JKAN's JIF has remained static for almost 10 years. The journals which had cited JKAN and those which JKAN had cited were mainly published in Korean. CONCLUSION: JKAN still has a low IF and a low ranking among Social Citation Index (E) journals during the past 10 years, as compared to that of four international journals. To enhance JKAN's status as an international journal, it is necessary to consider publishing it in English and to continuously improve the conditions of other publications.

Impact of South Korea's Comprehensive Nursing Service Policy on Nurse and Patient Outcomes.

In some Asian and African countries, caregivers of patients are permitted to reside in hospital rooms and support the daily tasks of patient care. To solve the various problems that this system could cause, the Korean government has established a comprehensive nursing service, whereby caregivers are no longer permitted in the hospital and, instead, nurses provide all the patient care. This study aimed to identify and evaluate the effectiveness of the comprehensive nursing service, by surveying 1348 nurses to evaluate nursing outcomes-specifically, the Nurses' Assessment of Quality Scale, job satisfaction, and turnover intention. A total of 396 patients were also surveyed to determine patient outcome, in particular patient satisfaction. In the comprehensive nursing service ward, the total score on the Nurses' Assessment of Quality Scale, job satisfaction, and patient satisfaction scores were higher than in the non-comprehensive nursing service ward. Moreover, turnover intention was lower. All differences were statistically significant. The results of this study demonstrate that the decision to implement policy-based comprehensive nursing services has thus far been beneficial. In the future, the government should revise and supplement its policies through various socioeconomic assessments.

Development of Caring as a Human Science: 50 Years of History of the Korean Society of Nursing Science.

PURPOSE: This year 2020 marks the 50th anniversary of the founding of the Korean Society of Nursing Science (KSNS). This study was aimed to explore development of caring and describe the 50 years of history of KSNS within the sociocultural context of Korea regarding academic footsteps, meanings, and implications for the future. METHODS: This study used a historical research methodology using a literature review and bibliometric analysis. Relevant literature was reviewed and the published abstracts in the Journal of Korean Academy of Nursing (JKAN) were analyzed using VOSviewer. RESULTS: Birth control and family planning in the 1970s was the main research topic. In the 1980s, the development of nursing concepts, theories, and philosophies was the mission of KSNS to extend the disciplinary boundary. In the 1990s, the progress of KSNS to become one of the woman-dominant healthcare professionals was the mission in the given period. Expanding the frontiers of KSNS to the extent of global standards was the undertaking of the nursing scholars in the 2000s. Lastly, in the 2010s, the quality and quantity improvement of KSNS and JKAN is expected to make our future even prosperous. The map visualization of the 50 years of research accumulation showed the comparable opposition of quantitative vs. qualitative research methodologies, equation modeling, and instrument development. CONCLUSION: These clusters of research demonstrates the efforts to make nursing evidence by Korean nursing scholars for the last five decades. The growth in the slope of KSNS and outcomes of JKAN are to carry on to an unimaginable extent in the future.

Effectiveness of multifactorial interventions in preventing falls among older adults in the community: A systematic review and meta-analysis.

BACKGROUND: Falls often cause unexpected injuries that older adults find difficult to recover from (e.g., hip and other major fractures, intracranial bleeding); therefore, fall prevention and interventions are of particular significance. OBJECTIVES: This study aimed to examine the effectiveness of multifactorial fall prevention interventions among community-dwelling older adults and compare subgroups that differed in terms of their degree of fall risk and the intensity and components of interventions. METHODS: An exhaustive systematic literature search was undertaken using the following databases: Ovid-Medline, Ovid-Embase, and the Cochrane Central Register of Controlled Trials (Central). Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias. We conducted a meta-analysis of randomized controlled trials that had been published up to March 31st, 2019, using Review Manager. RESULTS: Of 1,328 studies, 45 articles were relevant to this study. In total, 29 studies included participants in the high-risk group, 3 in the frail group, and 13 in the healthy older adult group. Additionally, 28 and 17 studies used active and referral multifactorial interventions, respectively. Multifactorial interventions included the following components: exercise, education, environmental modification, medication, mobility aids, and vision and psychological management. Multifactorial interventions significantly reduced fall rates in the high-risk (risk ratio 0.66; 95% confidence interval 0.52-0.84) and healthy groups (risk ratio 0.72; 95% confidence interval 0.58-0.89), when compared to the control group. Active multifactorial interventions (risk ratio 0.64; 95% confidence interval 0.51-0.80) and those featuring exercise (risk ratio 0.66; 95% confidence interval 0.54-0.80) and environmental modification also showed significantly reduced fall rates (risk ratio 0.65; 95% confidence interval 0.54-0.79) compared to usual care. Multifactorial interventions had a significantly lower number of people who experienced falls during the study period compared to usual care in the healthy group (risk ratio 0.77; 95% confidence interval 0.62-0.95). Active multifactorial interventions (risk ratio 0.73; 95% confidence interval 0.60-0.89) and those featuring exercise (risk ratio 0.79; 95% confidence interval 0.66-0.95) and environmental modification (risk ratio 0.80; 95% confidence interval 0.68-0.95) had a significantly lower number of people who experienced falls compared to those receiving usual care. CONCLUSIONS: Active multifactorial interventions had positive effects on fall rates and the number of people experiencing falls. Thus, healthcare workers, including nurses, should be involved in planning fall prevention programs so that older adults can be provided with optimal care; multifactorial interventions that include exercise and environmental modification are particularly effective in reducing falls.

Assessing How Well Electronic Nursing Records Reflect Changes in the Nursing Profession's Scope of Practice in Korea.

Electronic health records, a source of key administrative data for patient care, have been used in Korea for the past 13 years. In recent years, there have been significant changes in the Korean hospital nursing care delivery system. "Comprehensive nursing service," in which nurses provide direct care to patients, including activities of daily living without a family member, is one of the changes in the nursing profession's scope of practice. Accordingly, this study attempts to determine how well the electronic nursing record reveals nursing services that are being used differently. This study analyzed 19 372 nursing records of a total of 200 patients using the random sampling method in two comprehensive nursing service wards and two noncomprehensive nursing service wards. The number of nursing activity records for all items in the comprehensive nursing service ward was higher; only three items showed significant differences. Five nursing diagnoses including "anxiety" and "pain" were more significantly used in the records of the comprehensive nursing service ward. This study found that there were significant differences in nursing records based on the nursing services provided and that the current electronic nursing recording system adequately reflects changes in nursing practice.

Core nursing competency assessment tool for graduates of outcome-based nursing education in South Korea: A validation study.

AIM: To develop a competency assessment instrument for nurses who have completed an outcome-based educational program based on national standards and to assess the content-, construct-, and criterion-related validity of that instrument. METHODS: In the development stage, the competencies of nurses with 1-3 years' clinical experience after the completion of nursing education and training programs, based on national standards, were identified. A systematic literature review was conducted to derive the competencies in addition to the 12 national standard competencies. In the evaluation stage, the content-, construct-, and criterion-related validity of the developed tool were verified. For verification of the content validity at each stage, the participants were 10 nurse managers of general hospitals and 10 nurse professors. A factor analysis was conducted to assess the construct validity and the Cronbach's alpha coefficients and item-total correlation were used to assess the reliability of the developed scale. For the factor analysis, the participants were 141 nurses with 1-3 years' clinical experience who were recruited from four general hospitals. In order to evaluate the construct- and criterion-related validity, the correlations between a nursing performance measurement scale, a self-leadership tool, and the developed scale were examined. RESULTS: A competency assessment instrument, consisting of 19 items on a 4-point scale, was developed and validated for assessing the competencies among nurses with 1-3 years' experience. CONCLUSIONS: Nursing research, policy awareness, and leadership competencies were required by the Korean Accreditation Board of Nursing Education for nursing college graduates, but were removed due to poor content validity, indicating a need for nursing professionals to bridge the gap between educational standards in nursing colleges and clinical settings.