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BackgroundOnline misinformation proliferation during the COVID-19 pandemic has become a major public health concern. ObjectiveWe aimed to assess the prevalence of COVID-19 misinformation exposure and beliefs, associated factors including psychological distress with misinformation exposure, and the associations between COVID-19 knowledge and number of preventive behaviors. MethodsA cross-sectional online survey was conducted with 1049 South Korean adults in April 2020. Respondents were asked about receiving COVID-19 misinformation using 12 items identified by the World Health Organization. Logistic regression was used to compute adjusted odds ratios (aORs) for the association of receiving misinformation with sociodemographic characteristics, source of information, COVID-19 misinformation belief, and psychological distress, as well as the associations of COVID-19 misinformation belief with COVID-19 knowledge and the number of COVID-19 preventive behaviors among those who received the misinformation. All data were weighted according to the Korea census data in 2018. ResultsOverall, 67.78% (n=711) of respondents reported exposure to at least one COVID-19 misinformation item. Misinformation exposure was associated with younger age, higher education levels, and lower income. Sources of information associated with misinformation exposure were social networking services (aOR 1.67, 95% CI 1.20-2.32) and instant messaging (aOR 1.79, 1.27-2.51). Misinformation exposure was also associated with psychological distress including anxiety (aOR 1.80, 1.24-2.61), depressive (aOR 1.47, 1.09-2.00), and posttraumatic stress disorder symptoms (aOR 1.97, 1.42-2.73), as well as misinformation belief (aOR 7.33, 5.17-10.38). Misinformation belief was associated with poorer COVID-19 knowledge (high: aOR 0.62, 0.45-0.84) and fewer preventive behaviors (≥7 behaviors: aOR 0.54, 0.39-0.74). ConclusionsCOVID-19 misinformation exposure was associated with misinformation belief, while misinformation belief was associated with fewer preventive behaviors. Given the potential of misinformation to undermine global efforts in COVID-19 disease control, up-to-date public health strategies are required to counter the proliferation of misinformation.

Purpose: The purpose of this study was to confirm the factor structure of the McGill Quality of Life Questionnaire-Revised (MQOL-R) in the context of Korean culture and to verify its reliability and validity., Methods: The participants comprised terminal cancer patients aged 25 or older, and data from 164 participants were analyzed. The study was conducted in the following order translation, expert review, reverse translation, preliminary investigation and interviews, and completion of the final version. Confirmatory factor analysis was applied to evaluate the validity of the instrument, and the Beck Depression Inventory, Korean version (K-BDI) was applied to confirm the criterion validity of the MQOL-R Korean version. The Cronbach's alpha coefficient, representing internal consistency, was measured to evaluate reliability., Results: Cronbach's alpha for all 14 questions was 0.862. The model fit indices for confirmatory factor analysis were within the acceptance criteria. The factor loadings of all four factors were over 0.50, and convergent validity and discriminant validity were confirmed. Regarding criterion validity, a negative correlation was found between the four factors of MQOL-R Korean version and the K-BDI., Conclusion: The MQOL-R Korean version, the reliability and validity of which were verified in this study, is a 15-item tool consisting of 14 items dealing with four physical, psychological, existential, and social factors and a single item evaluating the overall quality of life. The MQOL-R Korean version is an instrument that can more concisely and effectively measure the quality of life of patients with life-threatening diseases., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2022 by Korean Society for Hospice and Palliative Care.)

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC)., Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open- ended questions and analyzed with topic modeling techniques., Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC., Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2022 by Korean Society for Hospice and Palliative Care.)

Purpose: This study attempted to develop clinical guidelines to help patients use hospice and palliative care (HPC) at an appropriate time after writing physician orders for life-sustaining treatment (POLST) by identifying the characteristics of HPC use of patients with terminal cancer., Methods: This retrospective study was conducted to understand the characteristics of HPC use of patients with terminal cancer through decision tree analysis. The participants were 394 terminal cancer patients who were hospitalized at a cancer-specialized hospital in Seoul, South Korea and wrote POLST from January 1, 2019 to March 31, 2021., Results: The predictive model for the characteristics of HPC use showed three main nodes (living together, pain control, and period to death after writing POLST). The decision tree analysis of HPC use by terminal cancer patients showed that the most likely group to use HPC use was terminal cancer patients who had a cohabitant, received pain control, and died 2 months or more after writing a POLST. The probability of HPC usage rate in this group was 87.5%. The next most likely group to use HPC had a cohabitant and received pain control; 64.8% of this group used HPC. Finally, 55.1% of participants who had a cohabitant used HPC, which was a significantly higher proportion than that of participants who did not have a cohabitant (1.7%)., Conclusion: This study provides meaningful clinical evidence to help make decisions on HPC use more easily at an appropriate time., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2021 by Korean Society for Hospice and Palliative Care.)

Purpose: This study was conducted to examine differences in Spiritual Interests Related to Illness Tool (SpIRIT) scores and the degree of spiritual needs (SNs) between patients with terminal cancer and their primary family caregivers and to compare spiritual needs between them., Methods: The study participants were inpatients with terminal cancer and their primary family caregivers at 40 national hospice centers. The final analysis included 120 SpIRIT surveys from patients and 115 from family members, and 99 SNs questionnaires from patients and 111 from family members. Data analysis was conducted using descriptive statistics, the t-test, one-way analysis of variance, and Pearson correlation coefficients., Results: There were no significant between-group differences in SpIRIT scores or SNs. The SpIRIT sub-dimensions that ranked high for both patients and primary family caregivers were "maintaining positive perspective", "loving others", and "finding meaning". The SNs sub-dimensions were ranked identically in both groups, in the order of "love and connection", "hope and peace", "meaning and purpose", respectively. In both groups, the recognition of the importance of spiritual matters and religion were major factors influencing SpIRIT scores and SNs., Conclusion: The SpIRIT scores and degree of SNs of patients with terminal cancer and their primary family caregivers were found to be very closely related, and the needs for coherence and meaning were greater than religious needs. When providing spiritual care for patients with terminal illness, family members should also be considered, and their prioritization of spiritual needs and the importance of spiritual matters and religion shall be taken into account., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2020 by Korean Society for Hospice and Palliative Care.)

Purpose: The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers., Methods: An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffé test, and multiple regression with dummy variables., Results: The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked sub-dimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking "why?", receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking "why?". The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group., Conclusion: The results of this study may serve as evidence that spiritual care for non-cancer patients' family caregivers should be considered as an important part of hospice and palliative care., (Copyright © 2020 by Korean Society for Hospice and Palliative Care.)

Purpose: The purpose of this study was to test the reliability and validity of an MIL instrument for adolescents., Method: The research design was a three-phase, methodological study. 1) The original 46 items of the Meaning in Life (MIL) Scale were reviewed and corrected partially by 20 adolescents. 2) The content was validated by an expert panel (n=15) and adolescents (n=5). 3) The instrument was validated by survey (n=468). Finally, 33 items were chosen for the adolescents meaning in life(AMIL) scale., Results: Cronbach's alpha coefficient of the 33 items was .92, confirming the high internal consistency of the instrument. 2) Eight factors were extracted through factor analysis: 'experience of love', 'making efforts for goal', 'awareness of essential being', 'awareness of self limitation', 'feeling of satisfaction', 'relation experience', 'positive thinking', and 'hope'. These factors explained 58.26% of the total variance., Conclusion: AMIL Scale was identified as a tool with a high degree of reliability and validity. The tool can therefore be effectively utilized to assess the degree of meaning of life in caring areas for adolescents. Studies on AMIL of different adolescent subjects are needed for further verification.

Purpose: The purpose of this study was to obtain a clearer understanding of spirituality and examine the process of spirituality through defining the meaning and attributes of spirituality., Method: Concept analysis was done in the three phases, theoretical phase, fieldwork phase, and analytical phase suggested in the Hybrid Model. Five people participated in the fieldwork phase., Results: Spirituality is activated through self-awareness which occurs as spirit being activated through self-introspection, and through restoration of the relationship with Supreme Being. This interconnectedness with Supreme Being has an absolute impact on one's harmonious interconnectedness with self and neighbors, thus leads all the critical attributes of spirituality to be revealed. The core energy of this harmonious interconnectedness is love. When activated, it has a great impact on an individual as integrative energy, leads one to go beyond everyday experience as well as to have new perspectives, and to live a satisfactory life in every aspect., Conclusion: The results of this study suggest that promotion of connectedness is the most important element in spiritual nursing interventions. The results can also be used effectively in developing spirituality assessment scales and theory.