Understanding of Dense Breast and Perception of Breast Cancer Risk of Nurses with or without Dense Breast Notification

Purpose@#This study was conducted to identify nurses’ understanding of dense breast and their perception of breast cancer risk based on their status of dense breast notification. @*Methods@#Data were collected between September 13 and November 2, 2021, using self-report questionnaires from 220 female nurses in their 40s or 50s who are currently working at hospitals and have had mammogram experiences. @*Results@#Only 44.5% (n=98) of participants reported receiving dense breast notification; the remaining participants either did not receive the notification (n=106, 48.2%) or did not remember receiving it (n=16, 7.3%). Nurses’ status of dense breast notification was significantly associated with their understanding of dense breast, but not with their perception of breast cancer risk. @*Conclusion@#Future studies should focus on improving the notification process since nurses play a key role in educating clients about breast cancer prevention in relation to dense breast.

The Relationship between 5-year Overall Survival Rate, Socioeconomic Status and SEER Stage for Four Target Cancers of the National Cancer Screening Program in Korea:Results from the Gwangju-Jeonnam Cancer Registry

Purpose@#The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. @*Methods@#A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox’s proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. @*Results@#Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical= 4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. @*Conclusion@#In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

Concept Analysis of Self-stigma in Patients with Tuberculosis

Purpose@#Tuberculosis is an infectious condition with a high disease burden, and the stigma in patients with tuberculosis causes negative health outcomes. The purpose of this study was to define and clarify the concept of self-stigma among patients with tuberculosis. @*Methods@#The analysis was conducted using Walker and Avant’s conceptual approach. Twenty-seven studies met the selection criteria. @*Results@#Self-stigma in patients with tuberculosis can be defined by the following attributes: 1) self-esteem decrement; 2) fear; 3) negative emotions to oneself; 4) social withdrawal; and 5) discrimination. The antecedents identified were 1) inappropriate knowledge of tuberculosis, 2) spread of improper health information through media and social communications, 3) stereotypes and prejudices, 4) visibility due to symptoms appearing, 5) recognizing the risk of infection, and 6) low financial status.The consequences were 1) concealing the disease, 2) treatment delay, 3) poor treatment adherence, 4) poor quality of life, and 5) deterioration in or lack of social activities. Conclusion: The definition and attributes of self-stigma identified by this study can be applied to enhance the understanding of stigma in tuberculosis patients and to improve communications between healthcare providers and researchers. It can also be used to develop theories and measurements related to stigma in patients with tuberculosis.

The Relationship between Unmet Healthcare Needs Due to Financial Reasons and the Experience of Catastrophic Health Expenditures

Purpose@#The purpose of this study is to investigate the association between unmet healthcare needs due to financial reasons and catastrophic health expenditures. @*Methods@#This study used secondary data from the 2014~2015 Korean Health Panel survey. The subjects of this study were 21,495 people aged 20 or older, and of them, there were 16,227 people aged 20 to 64 and 5,268 people aged 65 or older, which were surveyed between 2014 and 2015. The association between unmet healthcare needs due to financial reasons and catastrophic health expenditures was analyzed through logistic regression. @*Results@#In 2015, 1.7% of people aged 20~64 years and 7.9% of those aged 65 or older experienced unmet healthcare needs due to financial reasons. In the 20~64 age group, people who repeatedly experienced catastrophic health expenditures (=10%,=20%) were less likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=0.50, OR=0.41). However, in the 65-or-older group, people who repeatedly experienced catastrophic health expenditures (=20%) were more likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=1.68). @*Conclusion@#A greater percentage of the elderly repeatedly faced both catastrophic health expenditures and unmet healthcare needs due to financial reasons compared to the non-elderly.

Nursing students’ confidence in clinical competency and job readiness during the COVID-19 pandemic era / 한국간호교육학회지

Purpose@#This study explored nursing students’ experiences of attending clinical practicum courses in 2020 during the COVID-19 pandemic era, focusing on their confidence in clinical competency and job readiness. @*Methods@#The data for this study were collected using online questionnaires that were uploaded to a free online survey website and distributed via a link to the survey to 334 nursing students attending four-year nursing colleges at four national universities. Data analysis was done with descriptive statistics, independent t-tests, and ANOVA. @*Results@#The participants were mostly female (83.2%) college seniors (78.1%). About 60% of the participants practiced between 40% to 100% of their clinical practicum hours in alternative ways. Almost a third of the participants reported that they were not ready for a job (30.2%). However, participants’ confidence in clinical competency and job readiness was not related to the rate of alternative practice, but rather to both achievement of educational outcomes and satisfaction in the nursing practicum. @*Conclusion@#Due to COVID-19, it is evident that effective and efficient materials and ways of delivering clinical courses are constantly to be sought and developed. In particular, recently graduated nurses who experienced abrupt and considerable alterations in their clinical practicum courses due to COVID-19 are in need of attention while they strive to make clinical adaptations.

Symptom Clusters and Quality of Life Changes according to Recovery Period of Patients with Heart Valve Surgery / 중환자간호학회지

PURPOSE: It is widely accepted that addressing multiple symptoms together is the preferred approach in assessment and intervention and results in reduced negative patient outcomes. Yet, there are few studies examining symptom clusters and their impacts on quality of life longitudinally in patients after heart valve surgery.METHODS: A total of 101 patients were recruited from a tertiary hospital and were administered questionnaires (at 3, 6, and 10 weeks after the surgery) assessing participants' characteristics, cardiac symptoms, and quality of life. Factor analysis was used to identify symptom clusters. Hierarchical multiple linear regression was used to predict quality of life.RESULTS: Participants were predominantly 70-years old or more with a mean age of 64.34. The two symptom clusters at 3 weeks after the surgery with education, gender, and occupation accounted for 76.3% of variance in quality of life.CONCLUSION: Symptom clusters containing various physical and psychological symptoms in patients after the surgery affected quality of life, and the relationship was significant at 3 weeks after the surgery. Because symptom clusters were identified in all three recovery periods, nurses need to acknowledge these clusters, rather than each symptom separately, and to utilize these in providing care and education and in promoting quality of life in these patients.

A Frame Analysis of Nurse-related Articles from Korean Daily Newspapers / 한국간호교육학회지

PURPOSE: This study analyzed how the four nurse-related news items ‘talent show,’‘neonatal death,’‘nurse's death,’ and ‘sexual harassment’ were portrayed in Korean daily newspaper articles. METHODS: A total of 392 newspaper articles published from November 2017 to May 2018 were retrieved through the internet homepages of three newspapers, the Chosun Ilbo, the Dong-a Ilbo, and the JoongAng Ilbo and through a database for 13 other newspapers. Articles were analyzed for their views on nurses and their structural and contextual frames. RESULTS: Articles with the highest frequency of mentioning nurses' death appeared in the JoongAng Ilbo; these were written as straight news articles. In the analyzed articles, nurses were portrayed mostly as victims, troublemakers, passive, or selfish. Articles were written mostly in episodic, incident notice, or attribution of responsibility frames. CONCLUSION: It was not uncommon to read articles with negative views on nurses; most of these articles focused only the four major incidents as straight news type stories. Future efforts are needed to study the implications of newspaper articles with negative views on nurses and the frames most commonly used.

Study on Recipients' Experience of Adapting to Permanent Pacemakers / 중환자간호학회지

PURPOSE: This study develops a substantive theory on the recipients' experience of adapting to a permanent pacemaker.METHOD: The study used the grounded theory method developed by Strauss and Corbin (1998). The participants of the study were 13 adults who had received a permanent pacemaker during the previous year. The study addressed the research question “what is the experience of adaptation in people who had received permanent pacemakers?” From October 2016 to March 2017, data were collected from the participants through in-depth interviews.RESULTS: The core category indicating the essence of the adaptation experience was shown to be “accepting the pacemaker as part of my body and living in line with it.”CONCLUSION: In nursing practice, the results of this study will assist nurses in improving their communications with and developing guidelines or interventions for their clients who have received permanent pacemakers. In the field of nursing education, this study is expected to provide a framework to understand the experiences of future nurses and other healthcare workers working with permanent pacemaker recipients.

Relationship Between Catastrophic Health Expenditures and Income Quintile Decline

OBJECTIVES: The aims of this study were to investigate the proportion of households facing catastrophic health expenditures based on household income quintiles, and to analyze the relationship between expenditures and household income quintile decline. METHODS: Study data were obtained from an annually conducted survey of the 2012–2013 Korean health panel. There were 12,909 subjects aged 20–64 years from economically active households, whose income quintile remained unchanged or declined by more than one quintile from 2012 to 2013. Logistic regression analysis was performed to determine whether catastrophic health expenditures in 2012 were related to more than one quintile income decline in 2013. RESULTS: Households facing catastrophic health expenditures of ≥ 40%, ≥ 30%, and ≥ 10% of a household's capacity to pay, were 1.58 times (p < 0.003), 1.75 times (p < 0.000), and 1.23 times (p < 0.001) more likely to face a decline in income quintile, respectively. CONCLUSION: Over a 1 year period, the proportion of households facing more than one quintile income decline was 16.4%, while 2.1% to 2.5% of households in Korea faced catastrophic health expenditures. Catastrophic health expenditure experienced in 2012 was significantly associated with income quintile decline 1 year later. Therefore, lowering the proportion of households with catastrophic health expenditure may reduce the proportion of households with income quintiles decline.

Factors Affecting Smoking Cessation Success during 4-week Smoking Cessation Program for University Students

PURPOSE: Smoking cessation interventions are important because university students are vulnerable to smoking and good health practices during their university lives greatly affects their health status. The purpose of this study is to investigate the factors affecting smoking cessation success among the university students who participated in the 4-week smoking cessation program. METHODS: This study was conducted with 101 university student smokers. To identify the factors affecting the success of smoking cessation, a logistic regression analysis was performed. RESULTS: In Model 1, without the smoking cessation aids variable, when the frequency of face-to-face counseling was greater, the success rate of smoking cessation was 1.70 times higher. In Model 2, including the smoking cessation aids variable, when the nicotine dependence score was higher, the success rate of smoking cessation was 0.72 times lower, and when the number of smoking cessation aids used was greater, the success rate of smoking cessation was 1.40 times higher. CONCLUSION: Smoking cessation aids are essential to increase the success of short-term smoking cessation, and face-to-face counseling and telephone counseling should be provided continuously to maintain long-term smoking cessation.

Dental Care Utilization for Examination and Regional Deprivation / 예방의학회지

OBJECTIVES: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. METHODS: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). RESULTS: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. CONCLUSIONS: This study's findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

Unmet dental care needs according to employment status / 대한구강보건학회지

OBJECTIVES: This study aimed to investigate differences in unmet dental care needs according to employment status and if factors have relevance to unmet dental care needs due to "economic burden" and "no time to spare for visiting". METHODS: Multivariate logistic regression analysis was performed to examine the factors that affected the prevalence of unmet dental care needs due to "economic burden" and "no time to spare for visiting" in an economically active population comprised of subjects aged 20-64 years. RESULTS: Compared to regular workers, part-time workers experienced 1.28-times more unmet dental care needs, while students experienced 0.64-times fewer unmet dental care needs. With regard to reasons related to "economic burden", the rate of experiencing unmet dental care needs was 1.37-times higher for part-time workers than for regular workers. Regarding reasons related to "no time to spare for visiting", the rate of experiencing unmet dental care needs was 0.51-times lower in part-time workers compared with regular workers. In economically inactive people, these values were 0.51-times lower in the unemployed, 0.37-times lower in students, 0.23-times lower in house workers, 0.20-times lower in subjects with disease and injury, and 0.20-times lower in early retirees compared to regular workers. CONCLUSIONS: Part-time workers experienced more unmet dental care needs compared with regular workers. With regard to "economic burden", a significant difference in unmet dental care needs was observed between regular workers and part-time workers. Additionally, regarding "no time to spare for visiting", people who were economically inactive because of unemployment, student or house-worker status, diseases and injury, and retirement experienced fewer unmet dental care needs compared with regular workers.

Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy

PURPOSE: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. METHODS: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. RESULTS: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. CONCLUSION: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.

Intensive Care Unit Nurses' Knowledge and Nursing Practices regarding Bedside Electrocardiograph Monitoring / 한국간호교육학회지

PURPOSE: Bedside electrocardiograph (ECG) monitoring is continuously used for assessing patients' cardiac status in intensive care units. However, it has not been explored whether it is used with proper knowledge and nursing practices; if not, its usage will be limited and the risk for compromised patient safety might be significant. This study, therefore, explored knowledge and nursing practices regarding bedside ECG monitoring in nurses working at intensive care units. METHODS: Participants in this survey research were a convenience sample of 156 nurses from 25 intensive care units distributed in five hospitals with more than 1,000 beds each in Seoul, South Korea. RESULTS: Participants showed limited and incorrect knowledge and nursing practices. Only 4 (2.6%) participants correctly answered to all electrode placement sites of RA, LA, LL, and V1. Lead II was the most frequently monitored unit regardless of the main purpose of ECG monitoring, and nursing practices to manage noisy signals did not include skin care at the top priorities. CONCLUSION: Educators and clinicians alike need to make an effort to ensure that a safe level of knowledge and practices for the monitoring is maintained in order to make sure that patient outcomes are not compromised.

Effects of Type D Personality on Compassion Fatigue, Burnout, Compassion Satisfaction, and Job Stress in Clinical Nurses / 간호행정학회지

PURPOSE: This study was done to identify the effects of Type D personality on compassion fatigue, burnout, compassion satisfaction, and job stress in clinical nurses. METHODS: A descriptive cross-sectional design was used. Data were collected from a convenience sample of 172 clinical nurses working in two tertiary hospitals. The structured questionnaires included Type D personality scale, compassion fatigue, burnout, compassion satisfaction, and job stress scales. RESULTS: About 79.7% of participants were classified as Type D personality group. The Type D personality was not related to general characteristics of clinical nurses. The Type D personality group showed statistically significant higher compassion fatigue, burnout, and job stress and lower compassion satisfaction compared to the non-Type D personality group. In addition, compassion fatigue and burnout were positively correlated with job stress and compassion fatigue was positively correlated with burnout. However, compassion satisfaction was negatively correlated with burnout. CONCLUSION: As the prevalence of Type D personality is high in clinical nurses, it is necessary to assess stress-related personality. In addition, management for the nurse with Type D personality is required to alleviate compassion fatigue, burnout, and job stress and to improve compassion satisfaction.

Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention / 예방의학회지

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.

Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention / 예방의학회지

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment / 예방의학회지

OBJECTIVES: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. METHODS: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. RESULTS: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician- nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. CONCLUSIONS: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment / 예방의학회지

OBJECTIVES: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. METHODS: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. RESULTS: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician- nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. CONCLUSIONS: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

Insulin pump therapy in transient neonatal diabetes mellitus

Neonatal diabetes mellitus (NDM) is a rare disease requiring insulin treatment. Its treatment is primarily focused on maintaining adequate glycemic control and avoiding hypoglycemia. Although insulin pump therapy is frequently administered to adults and children, there is no consensus on the use of insulin pumps in NDM. A 10 day-old female infant was referred to us with intrauterine growth retardation and poor weight gain. Hyperglycemia was noted, and continuous intravenous insulin infusion was initiated. However, the patient's serum glucose levels fluctuated widely, and maintaining the intravenous route became difficult within the following weeks. Continuous subcutaneous insulin infusion with an insulin pump was introduced on the twenty-fifth day of life, and good glycemic control was achieved without any notable adverse effects including hypoglycemia. We suggest that the insulin pump is a safe and effective mode for treating NDM and its early adoption may shorten the length of hospital stays in patients with NDM.