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Objective: To analyze duties, tasks, and task elements of health workers in charge of vaccination at public health centers in South Korea. Design: Descriptive study using a survey. Sample: Health workers in charge of vaccination for more than 1 year at 254 public health centers in South Korea. Of 631 health workers, 401 responded to the questionnaire, and 379 responses were included in the analysis after excluding 22 incomplete responses. Measurements: The Developing A Curriculum (DACUM) workshop was conducted to identify the frequency, importance, and difficulty of duties, tasks, and task elements. Results: Four duties (vaccination promotion, vaccination administration and symptom management, execution of vaccination, and vaccination education), 18 tasks, and 81 task elements were identified. "Execution of vaccination" exhibited the highest determinant coefficient. "Implementing the budget" exhibited the highest determinant coefficient among tasks, and "dealing with an emergency in the case of adverse events" exhibited the highest determinant coefficient among task elements. Conclusions: Duty, task, and task elements with high determinant coefficients have high educational needs. Education demands was higher for administrative work than for direct vaccination. Developing an educational curriculum based on DACUM results could contribute to the professional education of vaccine workers. [ABSTRACT FROM AUTHOR]

Background Improving health-related quality of life (HRQOL) has emerged as a priority in the management of nontuberculous mycobacterial pulmonary disease (NTM-PD). We aimed to evaluate HRQOL and its changes after 6 months' treatment in patients with NTM-PD. Methods The NTM-KOREA is a nationwide prospective cohort enrolling patients initiating treatment for NTM-PD in 8 institutions across South Korea. We conducted the Quality of Life–Bronchiectasis (QOL-B) at 6-month intervals and evaluated baseline scores (higher scores indicate better quality of life) and changes after 6 months' treatment. Multivariate logistic regression was performed to identify factors associated with improvement in the QOL-B physical functioning and respiratory symptoms domains. Results Between February 2022 and August 2023, 411 patients were included in the analysis. Baseline scores (95% confidence interval [CI]) for physical functioning and respiratory symptoms were 66.7 (46.7–86.7) and 81.5 (70.4–92.6), respectively. Among 228 patients who completed the QOL-B after 6 months' treatment, improvements in physical functioning and respiratory symptoms were observed in 61 (26.8%) and 71 (31.1%) patients, respectively. A lower score (adjusted odds ratio; 95% CI) for physical functioning (0.93; 0.91–0.96) and respiratory symptoms (0.92; 0.89–0.95) at treatment initiation was associated with a greater likelihood of physical functioning and respiratory symptom improvement, respectively; achieving culture conversion was not associated with improvement in physical functioning (0.62; 0.28–1.39) or respiratory symptoms (1.30; 0.62–2.74). Conclusions After 6 months of antibiotic treatment for NTM-PD, HRQOL improved in almost one-third, especially in patients with severe initial symptoms, regardless of culture conversion. Clinical Trials Registration ClinicalTrials.gov identifier: NCT03934034. [ABSTRACT FROM AUTHOR]

Conventional treatments for allergic rhinitis (AR) exhibit insufficiency and long-term use-related side effects. Considering the reported anti-inflammatory and immunoregulatory effects of Bojungikgi-tang (BJIGT), we aimed to assess its efficacy on persistent AR (PAR). Patients with PAR were randomly assigned in a 1:1:1 ratio into high-dose BJIGT, standard-dose BJIGT, and placebo groups, followed by 1-week run-in and 4-week treatment periods. The primary outcome included the mean change in Total Nasal Symptom Score (TNSS), with secondary outcomes encompassing the Korean Allergic Rhinitis-Specific Quality of Life Questionnaire, biomarkers, overall assessment, TNSS by AR pattern identification, and the Sasang constitution. The mean TNSS change was more improved in the BJIGT group than in the placebo group; however, no statistically significant differences were observed. Additional interaction effect analysis revealed a statistically significant improvement in the high-dose BJIGT group compared with the placebo group from weeks 1–2 to weeks 3–4. Regarding secondary outcomes, the BJIGT group exhibited similar or improved results compared with the placebo group, showing no statistically significant differences. No serious adverse effects or clinically significant changes in safety assessments were observed. Given that this study validated clinical improvement and safety, it serves as potential groundwork for pertinent future studies. [ABSTRACT FROM AUTHOR]

Over the past several decades, significant criticism of the categorical classification system for personality disorders has highlighted the need to transition to a dimensional classification system. This study reviewed key issues involved in the potential conversion of the diagnostic system of personality disorders from a categorical to a dimensional model. The result suggests that Kernberg's concept of personality organization can be used to indicate the overall severity of personality pathology. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the reliability and validity of the Advance Care Planning Engagement Survey-9 Korean version in patients with cardiovascular diseases or metabolic syndrome. In this cross-sectional study, data on advance care planning engagement, registration of advance directives and the intention, and sociodemographic characteristics were collected from 105 patients (mean age, 66.3 years) at 4 medical institutions. Cronbach α was used to test the reliability. Confirmatory factor analysis and independent t tests were used to test the validity. Cronbach αs for the total scale and the self-efficacy and readiness dimensions were .93, . 82, and .97, respectively. In confirmatory factor analysis with 2 factors, all indices of model fit were acceptable: comparative fit index, 0.995; Tucker-Lewis index, 0.989; standardized root-mean-square residual, 0.024; rootmean-square error of approximation, 0.059; and factor loadings > 0.65. Patients who registered advance directives ( P < .001) or had the intention ( P < .001) had higher scores of the Advance Care Planning Engagement Survey-9 Korean version than their counterparts. The findings demonstrate that the Advance Care Planning Engagement Survey-9 Korean version was a reliable and valid instrument. Health care providers, including nurses, can use this instrument to assess and manage advance care planning engagement in Korean patients with cardiovascular diseases or metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objectives: The prognostic significance of CDC42 effector protein 2 (CDC42EP2) and its association with tumor-infiltrating immune cells (TIICs) have not been explored in liver hepatocellular carcinoma (LIHC). This study aims to assess the potential prognostic value of CDC42EP2 by conducting a comprehensive analysis of online databases pertaining to LIHC. Methods: We evaluated the potential of CDC42EP2 as a prognostic biomarker by utilizing online databases such as TIMER, GEPIA2, KM, OSlihc, HPA, and LinkedOmics. Results: In LIHC, we observed that the mRNA and protein expression of CDC42EP2 were upregulated compared to normal tissues. Upregulated CDC42EP2 expression was associated with a worse prognosis based on the clinicopathological characteristics of patients with LIHC. Furthermore, CDC42EP2 was positively associated with TIICs. In the co-expression and functional enrichment analyses of CDC42EP2, 11,416 genes showed positive associations with CDC42EP2 while 8,008 genes showed negative associations. CDC42EP2-related co-expression genes were involved in protein localization to the endoplasmic reticulum, translational initiation, and RNA catabolic processes in gene set enrichment analysis-Gene Ontology (GSEAGO), and regulated the ribosome, spliceosome, and primary immune deficiency in the GSEAKyoto Encyclopedia of Genes and Genomes (KEGG) pathway. In a survival map, 23 and 17 genes that exhibited positive associations with CDC42EP2 showed a significant hazard ratio (HR) for overall survival and disease-free survival, respectively. Conclusion: Our findings demonstrated that CDC42EP2 is a novel prognostic biomarker and a potential tumor immune therapeutic target in patients with LIHC. [ABSTRACT FROM AUTHOR]

This study aimed to confirm the relationship between resilience, meaning in life, and post-traumatic growth (PTG) among nurses during the COVID-19 pandemic. In particular, the mediating effect of meaning in life on the relationship between resilience and PTG was examined. A cross-sectional descriptive research design was used. The participants were 220 nurses at COVID-19-designated hospitals in Seoul. Descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficient analysis, hierarchical regression, and SPSS PROCESS macro (Model 4) were used for data analyses. As a result of the study, resilience and meaning in life each had a significant positive effect on PTG. In addition, the indirect effect of meaning in life was significant, suggesting that meaning in life partially mediated the relationship between resilience and PTG. The results indicate that nurses' resilience directly contributes to the improvement of PTG, and this relationship is further strengthened indirectly through the presence of meaning in life. Therefore, it is suggested that strategies should be developed to enhance resilience and promote a sense of meaning in the profession in order to support the mental health and foster growth among nurses. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 (β = 0.34, standard error (SE) = 0.01, p < 0.001) and clinical experience of 5–10 years (β = 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. [ABSTRACT FROM AUTHOR]

Background: In an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence. Methods: This cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model. Results: The mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs. Conclusions: Cultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs. [ABSTRACT FROM AUTHOR]

Background: The relationships of patient factors and caregiver contribution to patients' self-care to different types of self-care have been rarely examined in Korean patients with heart failure. Objective: The aim of this study was to examine patient (ie, age, depressive symptoms, and self-care confidence) and caregiver (ie, caregiver contribution to self-care maintenance and self-care management, and caregiver confidence in contributing to self-care) factors related to different types of self-care (ie, self-care maintenance, symptom perception, and self-care management) and self-care confidence in Korean patients with heart failure. Methods: In this cross-sectional, correlational study, data from 41 pairs of patients (mean age, 68.0 years) and caregivers (mean age, 54.1 years) were collected and analyzed using multiple regression. Results: Higher levels of self-care confidence in patients were related to higher levels of self-care maintenance in patients. Higher levels of self-care confidence in patients were related to higher levels of symptom perception. Higher levels of self-care confidence in patients and caregiver contribution to self-care maintenance were related to higher levels of self-care management. Less severe depressive symptoms in patients and higher levels of caregiver confidence in contributing to self-care were related to higher levels of self-care confidence. Conclusion: Different patient and caregiver factors were related to different types of self-care and self-care confidence in Korean patients, but patients' self-care confidence was related to all types of self-care. Clinicians and researchers need to develop and deliver effective interventions to both patients and their caregivers to improve patients' self-care confidence and, in turn, self-care, considering different factors associated with each type of self-care. [ABSTRACT FROM AUTHOR]

The birth prevalence of symptomatic congenital cytomegalovirus (cCMV) disease among live birth in Korea from a multicenter study was 0.06% during 2001–2015 with increasing frequency. The administrative prevalence of cCMV infection by big-data analysis from the national health insurance system was 0.01% and the average healthcare cost was US$2010 per person. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency poses a global public health burden; however, there are limited studies on the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) concentration in Koreans with a special focus on seasonal variables. We hypothesized that the relationship between serum 25(OH)D and vitamin D intake levels in Korean adults would change with the seasons, and that the distribution of food sources for vitamin D would vary according to sex and age. We established a new version of the food vitamin D database, analyzed the Korean National Health and Nutrition Examination Survey 2013 to 2014 data (n = 3257), and calculated the vitamin D intake of Koreans using a complex sample model. We found that the daily vitamin D intakes of men and women were 4.09 ± 0.26 µg and 2.87 ± 0.17 µg and their 25(OH)D levels were 16.98 ± 0.24 ng/mL and 15.62 ± 0.21 ng/mL, respectively. A significant positive correlation was observed between vitamin D intake and serum 25(OH)D levels in all participants. Serum 25(OH)D levels in the spring and winter (low ultraviolet irradiation seasons) were significantly higher in the 3rd tertile of vitamin D intake than in the first tertile. Fish and shellfish were the main sources of vitamin D for Koreans, the consumption of which was the least in the 19- to 29-year-old group; additionally, their serum 25(OH)D level was the lowest. In conclusion, insufficient vitamin D intake during low ultraviolet irradiation seasons is associated with lower levels of serum 25(OH)D. Serum 25-hydroxyvitamin D levels in the spring and winter (low ultraviolet irradiation seasons) were significantly higher in the third tertile of vitamin D intake than in the first tertile. However, the summer and fall (high ultraviolet irradiation seasons) were not significant. In this case, the median value of vitamin D intake was 0.97 to 2.59 µg/d. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective. Functional dyspepsia (FD) is a common gastrointestinal disorder that significantly affects sufferers' quality of life and increases the economic burden on society. Saam acupuncture, a form of traditional Korean acupuncture, is frequently used to treat FD in Korean medicine clinical settings. This study aimed to evaluate the feasibility and preliminary effectiveness and safety of Saam acupuncture for treating FD. Methods. We conducted a pilot, pragmatic, assessor-blinded randomized controlled trial. Patients with FD according to the ROME III criteria were randomly allocated to an acupuncture plus usual care group or a usual care group. Saam acupuncture based on individualized FD and systemic symptoms was conducted in the acupuncture group three times per week for 4 weeks. Study feasibility outcomes, including recruitment, completion, and acupuncture adherence rates, were calculated. In addition, preliminary evaluation of participant responses to the intervention was tested using the gastrointestinal symptom (GIS), FD-related quality of life (FD-QoL), visual analog scale (VAS), patient global assessment (PGA), and EuroQol-5 Dimensions (EQ-5D) scores. Results. Twenty-four participants who met the eligibility criteria were included. The recruitment and completion rates of the clinical trials were 60% and 79.2%, and the acupuncture adherence rate was 83.3%. Although there was no significant difference between the two groups in the dyspepsia symptoms as measured by GIS, VAS, and PGA at Week 4, significant differences were found between the two groups at the follow-up assessments (Weeks 8 and 12). In particular, the early satiety subscore of GIS was significantly improved in the Saam acupuncture group compared with the usual care group at Week 4. The quality of life measured by FD-QoL and EQ-5D improved only in the Saam acupuncture group, although there were no significant differences between the two groups. No adverse events related to Saam acupuncture were reported. Conclusions. Saam acupuncture can be a feasible, preliminarily effective, and safe treatment for FD. Further confirmatory trials with a larger sample size are needed to confirm its effectiveness and safety. The trail is registered with CRIS-KCT0000164, URL: https://cris.nih.go.kr/cris/search/detailSearch.do/2098. [ABSTRACT FROM AUTHOR]

Background. Allergic rhinitis (AR) is a common disease, and conventional medications are often insufficient for treatment. Bojungikgi-tang (BJIGT) is an herbal medicine widely used in traditional medicine and has anti-inflammatory and immunoregulatory effects. We hypothesize that BJIGT would improve nasal symptoms in patients with persistent AR (PAR). Methods. This is a randomized, double-blind, placebo-controlled, phase II trial. A total of 105 patients, identified with perennial allergens, with a history of PAR and a mean total nasal symptom score (TNSS) ≥ 5 during the run-in period will be recruited from Daejeon Korean Medicine Hospital. Participants will be randomly assigned to a high-dose BJIGT group, standard-dose BJIGT group, or control group (placebo) in a 1 : 1 : 1 allocation ratio after a week run-in period. The treatment medication will be taken three times per day for 4 weeks. The primary outcome measure is the mean change in the TNSS before and after medication. The secondary outcome measures include the Korean Allergic Rhinitis-Specific Quality of Life Questionnaire, total IgE and eosinophil count, overall assessment of AR, pattern identification questionnaire for AR, and Sasang constitution. Discussion. The aim of this study is to investigate the efficacy and safety of BJIGT in the treatment of PAR and to determine the suitable dosage of BJIGT. Therefore, we planned a randomized, controlled, phase II trial of two different doses of BJIGT compared with placebo, and the results of this study are expected to provide evidence for the use of BJIGT as a treatment of PAR. Trial Registration. The National Clinical Trial Registry Clinical Research Information Service, CRIS, KCT0006616, https://cris.nih.go.kr/cris/search/detailSearch.do/20706. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to construct and test a predictive model for the quality of life (QOL) in mothers of children with developmental disabilities (DB). The hypothesized model included severity of illness, distress, uncertainty, self-help, and parenting efficacy as influencing factors, QOL as a consequence based on the Braden's Self-Help Model. Methods: The data were collected through a direct and online surveys from 206 mothers in 8 locations, including welfare or daycare centers, developmental treatment centers, and The Parents' Coalition for the Disabled located in two provinces of Korea. Data were analysed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the predictive model satisfied recommended levels; χ² = 165.79 (p < .001), normed χ² (χ²/df) = 2.44, RMR = .04, RMSEA = .08, GFI = .90, AGFI = .85, NFI = .91, TLI = .93, CFI = .95. Among the variables, distress (β = - .46, p < .001), parenting efficacy (β = .22, p < .001), and self-help (β = .17, p = .018) had direct effects on QOL. Severity of illness (β = - .61, p = .010) and uncertainty (β = - .08, p = .014) showed indirect effects. The explanatory power of variables was 61.0%. Conclusion: The study results confirm the utility of Braden's Self-Help Model. They provide a theoretical basis for improving QOL in mothers of children with DB. Nursing intervention strategies that can relieve mothers' distress and uncertainty related to disease and enhance parenting efficacy and self-help behavior should be considered. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the influence of violence on depressive symptoms in women. We analyzed panel data from the Korean Longitudinal Survey of Women and Families (n = 6,632). Exposure to sexual violence was a significant predictor of the onset of depressive symptoms. After adjusting for all covariates, other predictors included the perception of a poor or very poor health status than normal and participants in their 40s and 50s versus participants younger than 40 years. Assessing exposure to sexual violence might be beneficial for evaluating depressive symptoms in women who are newly diagnosed with depression. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Osteosarcoma is the most common malignant bone-forming tumor, wherein most patients with high grade osteosarcomas are treated with chemotherapy. Despite this, survival for metastatic or relapsed osteosarcoma patients has remained at an overall 5-year survival rate of 20%. In particular, the extracts of Corylopsis coreana (Korean winter hazel), a cultivated woody plant in South Korea, have shown beneficial anti-inflammatory, anti-oxidative, anti-osteoclastic, and antihyperuricemic properties. Therefore, this study aimed to demonstrate the antitumor activities and underlying mechanism of 11-O-Galloyl bergenin (OGAL) isolated from Corylopsis coreanas leaves in human osteosarcoma cells. Herein, we found that OGAL inhibited MG63 cell proliferation and induced cellular apoptosis as evidenced by cleaved-PARP, cleaved-caspase 3, TUNEL-positive cells, and Annexin V-positive cells. Specifically, OGAL-induced apoptosis was accompanied by p53 and p21 upregulation, BAX expression, and decreased Bcl-2 and cdk2. Moreover, OGAL induced autophagy via AKT inactivation, LC3II upregulation, and MG63 cell autophagosome formation. OGAL-induced autophagy was also accompanied by increased p38 phosphorylation, whereas JNK and ERK1/2 activities were found to be unaffected upon examining the MAPK signaling pathway. Furthermore, wound healing and Boyden chamber assays showed that OGAL suppressed MG63 cell migration and invasion. Given these findings, this study provided evidence that OGAL has antitumor effects by apoptosis and autophagy enhancement through increased p53, AKT, and p38 signaling, suggesting that OGAL may be a potential therapeutic strategy for osteosarcoma treatment. [ABSTRACT FROM AUTHOR]

Background: Although uterine leiomyoma causes many problems, including infertility, there are few studies that have investigated the epidemiologic characteristics of uterine leiomyoma in South Korea. The aim of this study is to estimate the prevalence and incidence of uterine leiomyoma in South Korea and analyze the treatment trends. Materials and Methods: Women of reproductive age (15–54 years) were selected from the Korean National Health Insurance Service (NHIS) sample cohort dataset, which was collected from 2002 to 2013. Patients with uterine leiomyoma were identified by ICD-10 (International Codes of Disease, 10th Edition) and intervention codes. Prevalence and incidence were calculated from the NHIS cohort dataset and the treatment trends were analyzed for diagnosed patients. Results: The prevalence in overall age groups increased from 0.96% in 2002 to 2.43% in 2013, and the 1-year incidences of all age groups increased. The 26–30 age group showed the highest rate of 1-year incidence increase (2.14-folds, 0.33% in 2003 to 0.70% in 2013). The proportion of myomectomy increased from 22% in 2002 to 49% in 2013, whereas the proportion of hysterectomy decreased from 78% to 45%. Conclusions: The prevalence and incidence of uterine leiomyoma are increasing in South Korea as time progresses, and the rate of incidence increase is higher in younger reproductive women. Overall trends in uterine leiomyoma treatment are shifting to the methods of the saving uterus. [ABSTRACT FROM AUTHOR]

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had signifi- cantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles. [ABSTRACT FROM AUTHOR]

Four studies were conducted to develop and validate the South Korean Attitudes Toward Multicultural Minorities Scale (SKAMMS). Exploratory factor analysis (n = 336) identified three factors: Unawareness of South Korean Privilege and Discrimination against Multicultural Minorities, Attitudes Against Multiculturalism, and Attitudes Against Advocacy and Policy for Multicultural Minorities. Confirmatory factor analysis (n = 537) provided cross-validation of the 16-item, three-factor model and identified that a three-factor bifactor model best fit the data. Correlational analyses provided evidence of the discriminant and convergent validities of the SKAMMS. Evidence of incremental validity of the SKAMMS was obtained (n = 165), where the SKAMMS accounted for additional variance in criterion variables (i.e., cognitive, affective, and behavioral reactions toward racism) above other measures of attitudes toward multicultural minorities. The estimated 2-week test-retest reliabilities (n = 53) ranged from.67 to.82. We discuss implications for the use of the SKAMMS for practice, advocacy, education/training, and research. [ABSTRACT FROM AUTHOR]

This study identified changes in blood pressure, blood glucose, and cholesterol levels in frail elderly adults who received home health care nursing over 8 years in Korea. Secondary data extracted from nursing records (2010–2018) of a public health center were analyzed using a mixed model of repeated measure. Study participants were elderly people (n = 499) with a mean age of 81.9 ± 5.56 years. Systolic and diastolic blood pressure decreased by 8.97 and 15.78 mmHg, and by 2.92 and 5.01 mmHg, respectively, at 4-year and 8-year monitoring. This demonstrates that home health care nursing is effective and has both short- and long-term benefits. [ABSTRACT FROM AUTHOR]

Objectives. This study is aimed at developing multidimensional leisure participation assessment tool for the elderly to achieve quantitative and qualitative assessment of leisure participation and leisure exploration. Methods. This study collected preliminary items through literature review, statistical office data, and survey of the elderly's leisure activities and considered the list of leisure activities as assessment items by conducting a Delphi survey. Reliability was verified through internal consistency and test-retest reliability. The assessment tool was finally confirmed using content validity and discriminant validity. Results. A total of 81 leisure items classified into 8 categories and 22 subcategories were obtained through data collection and Delphi survey. Cronbach's α value was 0.939, and Intraclass Correlation Coefficient was 0.941. A content validity test was confirmed by validating that I-CVI was 0.78 or more and the S-CVI was 0.95. According to the result of discriminant validity, there was a difference in the number of participating leisure activities and leisure activities with participation intention by age. Conclusion. The leisure participation assessment tool for the elderly developed in this study can obtain information on the overall view of the leisure of the elderly by measuring leisure exploration, leisure participation, and interference factor affecting leisure participation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study examines the factors influencing runaway experiences among at-risk youth. Using the data of 1,743 at-risk youth from the 2016 survey of Korean adolescents' contact with media usage and harmful environment, a logistic regression analysis was conducted. This study shows that factors associated with the adolescents' experiences of family relationships, violence victimization, and harmful environment influence the occurrence of runaway behavior in at-risk adolescents. A significant outcome of this study is the identification of a harmful environment as a factor affecting runaway behavior. The factors identified need to be considered in the development of prevention programs targeting runway behavior among at-risk youth. School nurses are uniquely positioned to review and revise educational strategies to raise adolescents' awareness regarding the effects of harmful environments and to promote violence prevention. This framework provides school nurses with systematic methods for early identification and management of risk factors among at-risk youth runway behavior. [ABSTRACT FROM AUTHOR]

Objectives: Maternal attachment to promote role development in mothers of preterm infants is critical for babies' optimal growth and development. However, few models specify how neonatal intensive care units (NICUs) and their environments work to foster postpartum attachment (PPA) after preterm birth. We investigated relationships of quality of family-centered care and NICU environmental stressors with maternal PPA, to determine whether these are mediated by mothers' psycho-emotional response and whether pathways to PPA are moderated by developmental immaturity (gestation, birthweight). Methods: A cross-sectional study using structural equation modeling was conducted on 294 mothers of premature infants with experience in NICUs in over 49 tertiary hospitals in 12 cities or provinces of South Korea. Data were collected using Korean versions of instruments including the Quality of Family-centered Care, Parental Stressor Scale: NICU, and Maternal Postpartum Attachment Scale. Results: Maternal self-representation was a key predictor of PPA (β =.68), accounting for 42.2% of variance. Multi-group analysis indicated that NICU environmental stressor sensitivity (β =.26) and maternal self-representation (β =.67) were predictive of PPA in mothers of moderately preterm and low birthweight (32–36 weeks' gestation, 1500–2499 g birthweight) infants. Quality of family-centered developmental care (β =.11) and NICU environmental stressor sensitivity (β = −.16) had significant indirect effects on PPA through psycho-emotional responses. Conclusions for Practice: Healthcare professionals should be aware of the importance of family-centered interventions focusing on psychosocial support and family participation in baby care, based on their environmental role in promoting PPA. [ABSTRACT FROM AUTHOR]

Aim: Volunteers play a key role in hospice and palliative service. This study was performed to investigate the motivations of Korean hospice volunteers and to identify the predictors that affect their service period. Materials and Methods: The accomplished questionnaire sheets of 93 subjects were included in the analysis. Inventory of Motivations for Hospice Palliative Care Volunteerism to measure the motivations of the hospice volunteers was used. The collected data were subjected to a statistical analysis of the mean and standard deviation, a t-test, and multinomial logistic regression analysis. Results: The motivation score of the hospice volunteers in South Korea is 75.57 ± 10.97, and the top three in the motivation list were altruism, civic responsibility, and self-promotion. Among the subdomains, altruism, 1-4-year working experience (B = 0.79, standard error (SE) = 0.26, P = 0.002, Exp (B) =0.45), and more than 10-year working experience (B = 1.00, SE = 0.30, P = 0.001, Exp (B) =0.36) had statistically significant influences. Conclusions: The finding of this study can be used as basic information for the recruitment and management of hospice volunteers in South Korea. [ABSTRACT FROM AUTHOR]

Background/Objectives: The purpose is to find out utilization and necessity of public support related to the physical and mental health experienced by the middle-aged and elderly people. Method/Statistical Analysis: In distribution of 28 cities and 3 Guns of Gyeonggi-Do, 8,653 subjects are middle-aged people between 50 to 64 years old, and 6,547 subjects are the group under 49 years old and 11,953 subjects are the group over 65 years old. This study examined the differences in physical and mental health characteristics of the middle-aged and comparative groups through χ² validation and one-way ANOVA analysis by SPSS 21.0 program. Findings: The middle-aged showed relatively low level of difficulty than the group over 65 years old in all areas of physical health problems, physical health care difficulty, mental health problems, and mental health care difficulty. However, it showed a significantly higher level of difficulty than the group under 49 years old. The 6,731 people (77.8%) had no intention of using the social services provided to alleviate physical health problems, and 266 people (3.1%) are currently using related services. Among those who are willing to use the service, 1,135 people (13.1%) did not know the related service, the next highest rate, and 377 (4.4%) who knew the service but did not apply, 114 people (1.3%) applied for the application but could not use it. In the analysis of social service use to alleviate the difficulties of mental health, 7,165 (82.8%) of the middle-aged group had no intention of using it. Improvements/Applications: The results showed that the physical and mental difficulties experienced by the elderly and the level of difficulty were lower than normal, but higher than those under the age of 49. [ABSTRACT FROM AUTHOR]

Background/Objectives: The purpose of this study is to analyze the factors affecting internet game addiction in middle school students. Method/Statistical Analysis: The survey was conducted among 304 middle school students in G metropolitan city of Korea. The data were analyzed using frequency and percentage, mean and standard deviation, t-test, ANOVA, and hierarchical regression analysis. Findings: The results for the degree of middle school students' internet game addiction showed that 67.1% were average users, 23.4% were potential risk users, and 9.5% were high risk users. The variables affecting internet game addiction were found to be anxiety, ego-resilience and gender. These three variables explained 15.9% of the internet game addiction in middle school students. Improvements/Applications: To prevent middle school students from being addicted to internet games, intervention strategies that focus on male students for reduction of anxiety and strengthening of ego-resilience are needed. [ABSTRACT FROM AUTHOR]

Background/Objectives: In present nursing education, educators worked to apply new educational strategies that made use of technological development. Evidence emerged for the effectiveness of video-recording and self-evaluating to motivate students' self-directed learning. Method/Statistical Analysis: This study evaluated the effectiveness of a skill-training program using video recording and self-evaluation. A quasi-experimental design was used such that 43 students were allocated into experimental (n = 22) and control groups (n = 21). Prior to the intervention, confidence to practice and problem-solving ability were assessed and actual performance of each core nursing skill added to the post experimental evaluation. For statistical data analysis, paired t-test, independent t-test, X2-test/Fisher's exact test and Mann-Whitney U test were conducted. SPSS was used and statistical significance was determined at the p < .05 level. Findings: Comparing posttest scores, study results showed statistically significantly better performance in nursing skills (p< .001) and confidence to practice (t = 2.95, p = .003) in the experimental group. The change of scores in the experimental group on confidence to practice statistically significantly improved in the experimental group compared to changed scores in the control group. No statistically significant difference emerged in problem-solving ability. Improvements/Applications: Based on the study findings, video recording and self-evaluation provided effective training on core nursing skills. However, caution is needed as no clear evidence emerged for problem solving, which is a critical element in nursing education. Thus, we recommend the use of these strategies as a supplement to clinical placement. Future interventions need to provide additional strategies with robust study designs using randomized controlled trials. [ABSTRACT FROM AUTHOR]

Purpose: Childhood leukemia is a serious trauma affecting both adolescents and their parents, who experience painful process. However, adolescents with leukemia and their parents also experience positive changes, which is referred to as posttraumatic growth. We examined posttraumatic growth, core beliefs, impact of event, and event-related rumination in adolescents within 5 years of a diagnosis of childhood leukemia and their parents. Methods: The participants were 68 adolescents with childhood leukemia (aged 13~18 years) and their parents, who were recruited from C university hospital in Korea from May to September 2016. The Posttraumatic Growth Inventory, Core Belief Inventory, Impact of Event Scale-Revised, and Event-related Rumination Inventory were completed by the adolescents and their parents. The mean scores and correlations between variables were investigated for both set of participants. Results: Parents showed significantly higher levels of posttraumatic growth, disruption of core beliefs, impact of event, and invasive rumination than adolescents. Disruption of core beliefs and deliberate rumination were positively correlated with posttraumatic growth in both groups. Conclusion: Nursing intervention programs that involve modifying core beliefs and inducing a positive thought can help adolescents with leukemia and their parents grow after traumatic events. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study developed a tool to evaluate the quality of mentoring(QOM) for nurses and verified its validity and reliability before implementing a mentoring system as a strategy to manage them. Method/Statistical Analysis: One hundred twelve preliminary questions were derived from literature and the tool included 74 questions with a content validity at 0.75 or higher selected by an expert group. Ninety nine mentees participated in the prior survey and the main survey, respectively. Their general characteristics were analyzed using the SPSS Windows 18.0 program. The tool's construct validity and internal consistency reliability were analyzed using factor analysis and Cronbach's α coefficient, respectively. Findings: The subjects of this study were 99 nurses who had participated in a mentoring system for new nurses as mentees in an advanced general hospital located in Seoul. The general characteristics of the subjects are as follows: The subjects' average age was 24.8. Females accounted for 92.9% of the subject population. The subjects' average clinical experience was 14.4 months. The final version of the tool to evaluate the quality of mentoring consisted of 32 questions. To examine the construct validity of the tool, an exploratory factor analysis was performed. The tool to evaluate the QOM was composed of three factors and five domains: the structure factor (mentoring program domain), the process factor (psychosocial function, career development function, and role model function domains), and the outcome factor (mentoring value domain). Cronbach's α, a measure of the tool's internal consistency reliability, was 0.96. Improvements/Applications: This study developed a tool to comprehensively evaluate the quality of a mentoring program to apply an effective mentoring system and establish an efficient human resource management strategy in nursing. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine the association between each phase of the Life Transition Process (LTP) and depressive symptoms among parents of children with Autism Spectrum Disorder (ASD). Methods: Using a cross-sectional study design, data pertaining to LTP and depressive symptoms were collected from 285 parents of children with ASD (101 fathers and 184 mothers). Participants were recruited through the Autism Society of Korea and a counseling center for families of children with ASD. Results: Using a cut-off point of 5 or higher on the Beck Depression Inventory-Short Form, more than half of the parents (53.4%) were deemed depressed; these parents experienced moderate (27.4%) to severe (11.6%) levels of depressive symptoms. A hierarchical multiple regression using the socio-demographic characteristics of children and parents and each phase of the LTP as predictors, found that lower income (β=-.14, p=.007) and greater scores for the wandering phase (β=.59, p< .001) were significant predictors of greater levels of depressive symptoms. Conclusion: These findings confirm the association between LTP and depressive symptoms for parents of children with ASD, who were found to have a greater risk of depressive symptoms during wandering phase. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To examine the effects of a simulated emergency airway management education program on the self‐efficacy and clinical performance among nurses in intensive care units. Methods: A one‐group, pre‐ and post‐test design was used. Thirty‐five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team‐based practice, and debriefing. Self‐efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t‐test to compare the mean differences between the pre‐test and post‐test. The scores before and after education were compared. Results: After education, there was a significant improvement in the nurses’ self‐efficacy and clinical performance in emergency airway management situations. Conclusion: Simulation education effectively improved the self‐efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. Design and Sample This is a cross-sectional descriptive study that analyzed data from 466 adults. Measures Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. Results Men and women had significantly different beliefs about intimate partner violence ( t = −7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV ( F = 10.50, p = .000). Conclusions In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence. [ABSTRACT FROM AUTHOR]

This study compared and examined the effects of aroma gargling, cold water gargling, and wet gauze application on thirst, halitosis, and sore throat in patients after spine surgery. A quasiexperimental pretest/posttest control group design was employed. Samples were total 70 patients (aroma gargling: 24 samples, cold gargling: 24 samples, and wet gauze: 22 samples) after spine surgery in K Hospital in Seoul, Korea. The aroma gargle solution as an experimental intervention was prepared by blending peppermint, tea tree, and lemon oils at a ratio of 1:2:2. A 60 cc of aroma gargle solution was used 3 times for 15 to 20 seconds. The visual analog scale was used to measure the degrees of thirst and sore throat, and a portable device was used to examine the degree of halitosis. There were significant differences in the degrees of thirst, halitosis, and sore throat according to interaction between group and duration. In the comparison among 3 groups, aroma gargling provided better oral health by decreasing thirst, halitosis, and sore throat for patients with spine surgery. Aroma gargling can be utilized as an effective nursing intervention for decreasing thirst, halitosis, and sore throat for patients with spine surgery in clinical practice. Results suggest, therefore, that health professionals should consider an array of methods including aroma gargling for patients after spine surgery. [ABSTRACT FROM AUTHOR]

Objective: Several intervention studies have suggested that foot massage and cognitive behavioral therapy (CBT) are beneficial for reducing the stress response. However, no randomized control trials have been conducted to examine these effects in middle-aged women, who are more commonly exposed to stress relative to others. This study aimed to examine the effects of combined self-administered foot massage and CBT on the psychophysiological stress response in Korean middle-aged women. Design: Randomized controlled trial. Setting: Subjects were recruited from the social welfare center in Sahmcheok, Kangwondo, Korea. The subjects performed some of the massage at the center and some at home, and CBT was performed at the center. Subjects: Fifty-three women aged 45-64 years were randomly assigned to Group A (intervention, n = 31) or B (usual care, n = 30). Intervention: Combined self-administered foot massage and CBT. Outcome measures: Depression, anxiety, stress, blood pressure, heart rate, blood glucose (BG), and oxygen saturation were measured at baseline and 3-week follow-up. Results: Mean depression scores ( p = 0.021), stress scores ( p = 0.009), systolic blood pressure (SBP) ( p = 0.035), and BG levels ( p = 0.007) had decreased significantly subsequent to the intervention. Conclusion: Combined self-administered foot massage and CBT led to reductions in depression, stress, SBP, and BG levels. Therefore, the intervention could be an effective means of reducing the stress response in middle-aged women. [ABSTRACT FROM AUTHOR]

Background: Women are more vulnerable to the adverse effects of alcohol than men. The present study aimed to investigate the link between drinking and obesity in pre- and postmenopausal women in Korea. Methods: We performed a cross-sectional study of 4374 premenopausal and 2927 postmenopausal women using a multistage probability cluster survey sample to produce nationally representative estimates. We assessed the subjects' alcohol drinking tendencies rates according to their drinking levels as well as Alcohol Use Disorders Identification Test (AUDIT); obesity was identified based on body mass index (BMI) ≥25 kg/m2, waist circumference (WC) ≥80 cm, and waist-to-height ratio (WHtR) ≥50%. We performed t-tests and chi-square tests to assess the association between drinking and obesity. Results: In premenopausal subjects, obesity indices increased significantly as alcohol consumption rose. Significant correlations between drinking level and obesity factors were found in premenopausal women after adjusting for age (odds ratios [ORs] for BMI, WC, and WHtR were 1.58 [1.08-2.31], 1.94 [1.11-3.00], and 1.80 [1.24-2.61], respectively). Furthermore, an AUDIT score of 20 or higher indicated a significantly higher likelihood of obesity (ORs for BMI, WC, and WHtR were 2.02 [1.18-3.46], 2.75 [1.70-4.87], and 2.86 [1.78-4.59], respectively). There was a significant correlation between AUDIT scores and obesity factors after adjusting for age, energy intake, fat intake, exercise, smoking, education, and income in premenopausal women (ORs for BMI and WHtR were 1.71 [0.85-3.47] and 1.73 [0.97-3.06], respectively). Conclusion: Our results suggest that alcohol is associated with a risk factor for obesity in premenopausal women. [ABSTRACT FROM AUTHOR]

Baicalein is an active flavonoid extracted from the root of Scutellaria baicalensis that has anticancer and anti-inflammatory properties; its effects on osteoblastic and angiogenic potential are controversial. The aim of this study was to investigate the effects of baicalein on odontoblastic differentiation and angiogenesis and the underlying mechanism in human dental pulp cells (HDPCs). Baicalein (1-10M) had no cytotoxic effects and promoted alkaline phosphatase (ALP) activity, mineralization assayed by Alizarin Red-S staining, and the mRNA expression of marker genes, in a concentration-dependent manner. In addition, baicalein upregulated angiogenic factors and increased in vitro capillary-like tube formation. Moreover, baicalein upregulated bone morphogenetic protein (BMP)-2 mRNA and phosphorylation of Smad 1/5/8 and Wnt ligand mRNA, glycogen synthase kinase-3, and nuclear -catenin. The odontogenic and angiogenic effects of baicalein were abolished by the BMP antagonist noggin and the Wnt/-catenin receptor antagonist DKK-1. These results demonstrate that baicalein promoted odontoblastic differentiation and angiogenesis of HDPCs by activating the BMP and Wnt/-catenin signal pathways. Our findings suggest that baicalein may contribute to dental pulp repair and regenerative endodontics. [ABSTRACT FROM AUTHOR]

Introduction. Streptococcus pneumoniae is an important pathogen with high morbidity and mortality rates. The aim of this study was to evaluate the distribution of common serotypes and antimicrobial susceptibility of S. pneumoniae in Korea. Methods. A total of 378 pneumococcal isolates were collected from 2008 through 2014. We analyzed the serotype and antimicrobial susceptibility for both invasive and noninvasive isolates. Results. Over the 7 years, 3 (13.5%), 35 (10.8%), 19A (9.0%), 19F (6.6%), 6A (6.1%), and 34 (5.6%) were common serotypes/serogroups. The vaccine coverage rates of PCV7, PCV10, PCV13, and PPSV23 were 21.4%, 23.3%, 51.9%, and 62.4% in all periods. The proportions of serotypes 19A and 19F decreased and nonvaccine serotypes increased between 2008 and 2010 and 2011 and 2014. Of 378 S. pneumoniae isolates, 131 (34.7%) were multidrug resistant (MDR) and serotypes 19A and 19F were predominant. The resistance rate to levofloxacin was significantly increased (7.2%). Conclusion. We found changes of pneumococcal serotype and antimicrobial susceptibility during the 7 years after introduction of the first pneumococcal vaccine. It is important to continuously monitor pneumococcal serotypes and their susceptibilities. [ABSTRACT FROM AUTHOR]

This study was conducted to increase the frequency and level of thoroughness of hand hygiene practice by nurses, and to assess the influence of the methicillin-resistant Staphylococcus aureus (MRSA) acquired incidence rate and the MRSA colonization pressure in a medical intensive care unit (MICU). A total of 24 MICU nurses received hand hygiene education and individual feedback of hand hygiene frequency and method after a session of education, and two posteducation evaluations were followed. The frequency of hand hygiene (P = 0.001) and the methodology score of hand hygiene increased significantly (P = 0.001). The MRSA acquisition rate decreased significantly, from 11.1% before the education to 0% after (P = 0.014). The MRSA colonization pressure decreased significantly from 39.5% to 8.6% after the education sessions (P = 0.001). This indicates that providing individual feedback after hand hygiene education was very effective in increasing nurses' hand hygiene frequency and improving hand hygiene method; furthermore, it was expected to decrease health care-associated infections. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the effects of case-based learning on communication skills, problem-solving ability, and learning motivation in sophomore nursing students. In this prospective, quasi-experimental study, we compared the pretest and post-test scores of an experimental group and a nonequivalent, nonsynchronized control group. Both groups were selected using convenience sampling, and consisted of students enrolled in a health communication course in the fall semesters of 2011 (control group) and 2012 (experimental group) at a nursing college in Suwon, South Korea. The two courses covered the same material, but in 2011 the course was lecture-based, while in 2012, lectures were replaced by case-based learning comprising five authentic cases of patient-nurse communication. At post-test, the case-based learning group showed significantly greater communication skills, problem-solving ability, and learning motivation than the lecture-based learning group. This finding suggests that case-based learning is an effective learning and teaching method. [ABSTRACT FROM AUTHOR]

Background This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction ( LVSD) after aortic valve surgery in patients with chronic aortic regurgitation ( AR). Methods We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery. Results Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m2) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD. Conclusion Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD. [ABSTRACT FROM AUTHOR]

The article presents a study which showed that neurocognitive impairmentss were evident in ultra-high-risk individuals for psychosis prior to the onset of overt psychosis. Topics include the tests for five separate neurocognitive domains applied to UHR individuals and patients with first-episode schizophrenia (FES), how testing for spatial memory significantly predicted the transition to overt psychosis, and findings that support the neurodevelopmental model of schizophrenia.

Background: To investigate whether laughter therapy lowers total mood disturbance scores and improves self-esteem scores in patients with cancer. Design/Setting: Randomized controlled trial in a radio-oncology outpatient setting. Patients: Sixty-two patients were enrolled and randomly assigned to the experimental group ( n=33) or the wait list control group ( n=29). Interventions: Three laughter therapy sessions lasting 60 minutes each. Outcome measures: Mood state and self-esteem. Results: The intention-to-treat analysis revealed a significant main effect of group: Experimental group participants reported a 14.12-point reduction in total mood disturbance, while the wait list control group showed a 1.21-point reduction ( p=0.001). The per-protocol analysis showed a significant main effect of group: The experimental group reported a 18.86-point decrease in total mood disturbance, while controls showed a 0.19-point reduction ( p<0.001). The self-esteem of experimental group was significantly greater than that of the wait list control group ( p=0.044). Conclusions: These results indicate that laughter therapy can improve mood state and self-esteem and can be a beneficial, noninvasive intervention for patients with cancer in clinical settings. [ABSTRACT FROM AUTHOR]

This research was conducted to examine the relationships among mobile phone use, anxiety, and parental attitudes toward child-rearing in a convenience sample of 351 Grade 6 elementary school students. There were 157 boys and 194 girls. A mobile phone overuse questionnaire, the State-Trait Anxiety Inventory, and the Parental Attitude Inventory were used for data collection. The data were analyzed by the ttest, analysis of variance, hierarchical regression, and descriptive analysis using SPSS WIN 18.0. Mobile phone use was greater in girls than in boys, and the difference was statistically significant. Mobile phone use was positively correlated with anxiety, and it was negatively correlated with parental child-raising attitudes. Mobile phone use in girls was mainly affected by anxiety, and in boys, it was significantly affected by the maternal child-raising attitude. This research provides basic data for parent education, school policy, and prevention programs about mobile phone overuse that support mental health improvement in the individual, family, and community. [ABSTRACT FROM AUTHOR]

This pilot study was performed to investigate the effects of a community-based intervention ( CBI) on cardio-metabolic risk and self-care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi-experimental design was used. The older adults in the intervention group participated in an 8-week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by −1.35 cm ( P < 0.001) and improved self-care behaviour (+ 5.17 score, P < 0.05) and self-efficacy (+ 4.84 score, P < 0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Purpose: The Purpose of this study was to investigate relationships between maternal fetal attachment and state anxiety for pregnant women in preterm labor. Methods: The subjects consisted of 56 pregnant women in preterm labor on C hospital. The data were analyzed using SPSS computer program that includes descriptive statistics, mean, standard deviation, t-test, ANOVA, Scheffe? test and Pearson correlation coefficient. Results: Age distribution was 30~39 years of age. Mean score of maternal fetal attachment was 91.50. The group whose planned pregnancy was highest showed higher maternal fetal attachment. The primigravida group showed high maternal fetal attachment. Most frequently practiced attachment item was: ”I'm really looking forward to seeing what the baby looks like”. The next was was: ”I enjoy watching my tummy jiggle as the baby kicks inside”. There was no difference in degree of anxiety by general and obstetrical characteristics. There was statistically significant of negative correlation between maternal fetal attachment and state anxiety for pregnant women with preterm labor. Conclusion: Findings provide useful information for further studies in reducing anxiety and intervention programs relating to pregnancy and preterm labor. To increase maternal fetal attachment of pregnant women with preterm labor, it is necessary to standardize prenatal education program. [ABSTRACT FROM AUTHOR]

This study aimed to explore the current status of advance directives (ADs) and preferences for care near the end of life (PCEOL) of patients with chronic diseases in South Korea. A descriptive cross-sectional design was used. A total of 303 participants were recruited by convenience sampling from 3 hospitals in Korea. All participants completed a questionnaire on perception of ADs and the PCEOL-K (Lee and Kim. Korean J Med Ethics. 2009;12(1):29-42), the Korean version of a tool originally developed by Gauthier and Froman (Res Nurs Health. 2001 ;24(4):298-306). Most participants reported that they had no living wills (96.4%) and had not heard of ADs (91.4%). They preferred that their spouse (41.6%) or their son/daughter (27.2%) make health care decisions when they could no longer make those decisions. There were relatively positive preferences toward end of life pain control, family input in decision making, decision making by health care providers, and spirituality: There was a negative preference for the autonomous physiological decision-making dimension of the PCEOL-K. The PCEOL-K scores displayed statistically significant differences depending on marital status, age, religion, and perceived stage of treatment. Based on the study findings, it appears that wide promotion and awareness about ADs may assist Korean patients with chronic diseases to make informed decisions regarding their end of life care. [ABSTRACT FROM AUTHOR]