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Objective@#We aimed to explore whether nursing professionals’ psychological states affect their grief response for a patient’s death in the coronavirus disease-2019 (COVID-19) inpatients’ ward. @*Methods@#Survey was conducted among frontline nursing professionals working in COVID-19 inpatients wards at three tertiary-level affiliated hospitals of the University of Ulsan during April 7–26, 2022. Participants’ information such as age, years of employment, or marital status were collected, and their responses to rating scales including Pandemic Grief Scale (PGS) for healthcare workers, Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), Loneliness and Social Isolation Scale, and Insomnia Severity Scale (ISI) were collected. @*Results@#All 251 responses were analyzed. We observed that 34% reportedly suffered from depression. The linear regression analysis showed that a high PGS score was expected by high SAVE-9 (β=0.12, p=0.040), high PHQ-9 (β=0.25, p<0.001), high loneliness (β=0.17, p=0.006), and high ISI score (β=0.16, p=0.006, F=20.05, p<0.001). The mediation analysis showed that the depression of nursing professionals directly influenced their pandemic grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. @*Conclusion@#We confirm that frontline nursing professionals’ depression directly influenced their grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. We hope to establish a psychological and social support system for the mental health of nurses working in the COVID-19 wards.
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Purpose@#This study aimed to identify levels of perception and performance of end-oflife care among nurses and to investigate correlations between perception and performance. @*Methods@#This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings.A structured questionnaire was utilized to assess their perception and performance of endof-life care. @*Results@#The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses’ perception of end-of-life care and their performance in this area (r=0.78, P＜0.001). @*Conclusion@#It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.
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Background@#This study aimed to identify the self-efficacy and self-care behaviors in patients with an unruptured intracranial aneurysm who have undergone coil embolization. @*Methods@#A cross-sectional study was conducted to 143 patients who were diagnosed with unruptured intracranial aneurysm and visited the outpatient department of radiology for follow-up management after performing coil embolization at a tertiary hospital, Seoul. The self-efficacy and self-care behaviors were measured using self-reported questionnaire. The collected data were analyzed with independent t-test, one-way analysis of variance, Pearson's correlation using the SPSS/win 26.0 statistical programs (IBM Corp, Armonk, NY, USA). @*Results@#The mean score of self-efficacy in patients with an unruptured intracranial aneurysm was 3.49±0.55 out of 5. The mean score of self-care behaviors was 3.69±0.66 out of 5. The self-efficacy exhibited statistically significant differences depending on the size and number of the cerebral aneurysms and the presence of such aneurysms remaining after treatment. There was a positive correlation between self-efficacy and self-care behaviors (r=0.37, P=0.001). Regression analysis revealed that the patient's self-care behaviors of the patients was explained by self-efficacy (β=0.37, P<0.001) and these variables explained 13.3% of the variance in self-care behaviors (F=22.86, P<0.001). @*Conclusions@#In order to increase self-care behaviors, it is necessary to develop self-efficacy interventions so that an unruptured intracranial aneurysm who have undergone coil embolization can effectively cope with various difficulties during treatment course.
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Purpose@#The purpose of this study was to identify the knowledge and attitudes of oncology nurses towards clinical trials and to provide evidence for the development of clinical trial education programs for oncology nurses. @*Methods@#The study was conducted on 142 nurses who had more than six months of nursing experience working with cancer patients at a tertiary hospital in Seoul, Korea. A structured questionnaire was used to measure the knowledge and attitudes of oncology nurses towards clinical trials. @*Results@#The participants scored an average of 15.03±3.52 out of 19 in terms of knowledge about clinical trials. In terms of attitudes towards clinical trials, the participants scored an average of 5.91±1.37 out of 8. There was a significant positive correlation between the knowledge and attitudes of the participants towards clinical trials (r=.23, p=.007). @*Conclusion@#This study found that there was a relationship between the knowledge and attitudes of oncology nurses towards clinical trials. To improve the competency of oncology nurses and provide high-quality care to patients participating in clinical trials, more systematic and sustainable education is needed.
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Purpose@#The purpose of this study was to identify the relationship between cancer coping, family support, and degree of posttraumatic growth in female genital cancer patients receiving chemotherapy and provide evidence for nursing intervention to enhance posttraumatic growth. @*Methods@#A cross-sectional study was conducted to 114 participants. The cancer coping, family support, and posttraumatic growth were measured using a self-reported questionnaire. The collected data were analyzed with independent t-test, one-way ANOVA, and Pearson correlation using the SPSS/win 28.0 statistical programs. @*Results@#The mean score of cancer coping was 62.65±13.53, that of intrapersonal coping 38.32±8.34, and that of interpersonal coping was 24.32±6.56. The mean score of family support was 49.06±7.32 and posttraumatic growth was 59.66±17.92. Posttraumatic growth showed a statistically significant positive correlation among intrapersonal coping (r=.80), interpersonal coping (r=.61), and family support (r=.42, p<.001). @*Conclusion@#To increase posttraumatic growth, it is necessary to develop coping interventions so that cancer patients can effectively and positively cope with various difficulties and problems in the process of chemotherapy.
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Purpose@#This study aimed to investigate the level of the relationship between skin toxicities and skin-related quality of life (QoL) in patients with lung cancer taking oral targeted agents. @*Methods@#This cross-sectional study surveyed 152 lung cancer patients receiving oral targeted agents. The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PROCTCAE) was used to assess skin toxicity. The Dermatology Life Quality Index (DLQI) was used to evaluate skin-related QoL. Collected data were analyzed with independent t-test, one-way ANOVA, and Pearson correlation using the SPSS 27.0 statistical analysis software for Windows. @*Results@#Skin toxicity was the highest among patients who reported skin dryness 2.07±1.20, followed by itching 1.91±1.25, rash 1.48±1.32, skin darkening 1.39±1.16, hives 1.38±1.25, acne 1.37±1.36, nail (finger or toe) ulceration 1.34±1.34, nail ridging 1.20±1.14, sensitivity to sunlight 1.10±1.07, stretch marks 0.95±1.13, hair loss 0.91±1.14 and nail discoloration 0.83±1.07.The subjects' mean skin-related QoL of the participants was 7.29±6.11 out of 30. Skin-related QoL showed a statistically significant positive correlation with skin toxicity. @*Conclusion@#Skin toxicities correlated significantly with poor skin-related QoL. Skin toxicity levels in lung cancer patients receiving oral targeted therapies need to be closely monitored, and strategies to enhance skin-related QoL must be developed.
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Purpose@#The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). @*Methods@#We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. @*Results@#Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. onclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a nonmalignant lung disease, because the characteristics of the respective diseases differ, end-oflife care practices and hospice approaches must be considered differently.
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Purpose@#This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). @*Methods@#Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. @*Results@#The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. @*Conclusion@#To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.
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Purpose@#: The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals. @*Methods@#: The participants were 137 advanced practice nurses. The assessment tools were clinical decisionmaking in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods. @*Results@#: There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043). @*Conclusion@#: Therefore, to reduce advanced practice nurses’ job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.
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Objectives@#It is important that inflammatory bowel disease (IBD) patients adhere to their prescribed medication regimens to avoid the repeat exacerbations, complications, or surgeries associated with this disorder. However, there are few studies on medication adherence in patients with IBD, especially in Asian populations. So, we analyzed the factors associated with medication adherence in Korean IBD patients. @*Methods@#Patients who had been diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) more than 6 months previously and receiving oral medications for IBD were enrolled. Medication adherence was measured using the Medical Adherence Reporting Scale (MARS-5), a self-reported medication adherence measurement tool. @*Results@#Among 207 patients in the final study population, 125 (60.4%) had CD and 134 (64.7%) were men. The mean age was 39.63 years (SD, 13.16 years) and the mean disease duration was 10.09 years (SD, 6.33 years). The mean medication adherence score was 22.46 (SD, 2.86) out of 25, and 181 (87.4%) patients had score of 20 or higher.In multiple linear regression analysis, self-efficacy (β=0.341, P<0.001) and ≥3 dosing per day (β=–0.192 P=0.016) were revealed to be significant factors associated with medication adherence. Additionally, there was a positive correlation between self-efficacy and medication adherence (r=0.312, P<0.001). However, disease related knowledge, depression, and anxiety were not significantly associated with medication adherence. @*Conclusion@#To improve medication adherence among patients with IBD, a reduction in the number of doses per day and an improved self-efficacy will be helpful.
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Objective@#We aimed to explore how nursing students’ adherence to physical distancing, sense of belonging, or resilience may be associated with viral anxiety during the coronavirus disease (COVID-19) era in South Korea. @*Methods@#We conducted an online survey among nursing students from December 8–10, 2021. The survey gathered participants’ age, sex, grades, living area, and responses to questions on COVID-19. In addition, responses to Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), adherence to physical distancing, Sense of Belonging Instrument, Calling and Vocation Questionnaire, Patient Health Questionnaire-9 items (PHQ-9), and Connor-Davidson Resilience Scale-2 (CD-RISC2) items were gathered. @*Results@#The SAVE-6 score was significantly correlated with adherence to physical distancing (r=0.29), PHQ-9 (r=0.26), and CD-RISC2 (r=-0.34, all p<0.01) similar to partial correlation analysis adjusting participants’ group (freshmen and sophomores vs. juniors and seniors). A linear regression analysis revealed that viral anxiety of nursing students was predicted by sex (female, β=0.20, p=0.001), adherence to physical distancing (β=0.25, p<0.001), sense of belonging (β=0.16, p=0.014), and CD-RISC2 score (β=-0.32, p<0.001) (adjusted R2=0.24, F=10.01, p<0.001). @*Conclusion@#We observed that adherence to physical distancing, sense of belonging, and their resilience influenced nursing student’s viral anxiety. An appropriate support system to manage viral anxiety is needed for nursing students during the COVID-19 pandemic.
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Purpose@#This study aimed to identify the changes in psychological distress and the quality of life in patients with esophageal cancer from pre-surgery to 3 months after surgery. @*Methods@#We enrolled 49 patients scheduled to undergo esophageal surgery at a tertiary hospital in Seoul, South Korea. Patients’ psychological distress and quality of life were assessed using the Korean scales, such as the Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), and an esophageal cancer-specific questionnaire (QLQ-OES18) at pre-surgery, 1 month, and 3 months post-surgery. @*Results@#Moderate-to-severe anxiety was reported in 12.2% of patients at the pre-surgery evaluation, 57.1% of patients at 1 month post-surgery, and 8.2% at 3 months post-surgery. Moderate-to-severe depression was reported in 12.2% of patients at the pre-surgery evaluation, 63.3% at 1 month post-surgery, and 16.3% of patients at 3 months post-surgery. Clinically significant, moderate changes (10~20 points) in physical functioning, insomnia, nausea and vomiting, and dyspnea (per EORTC QLQ-C30) and dysphagia and taste problems (per QLQ-OES18) were reported from pre-surgery to 1 month post-surgery. @*Conclusion@#One month after esophageal cancer surgery, patients demonstrated severe psychological distress and worsening quality of life. Nursing intervention is needed to relieve psychological distress and improve the quality of life in patients with esophageal cancer in the 1-month early recovery period.
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Purpose@#: The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master’s course professors at a graduate school. @*Methods@#: Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. @*Results@#: Based on the data, we extracted four themes and 14 categories. The themes were “Role and system of APNs started according to healthcare environment changes”, “Optimal healthcare provider to ensure quality of care”, “Confused role and system of APNs due to incomplete medical law”, and “Tasks for the stable operation of the APN system.” @*Conclusion@#: For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs’ scope of practice is required. Finally, a discussion is necessary about the integration of APNs’ 13 fields.
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Purpose@#The purpose of this study was to identify the influence of the nurse’s character on care and the sense of coherence (SOC) on the professional quality of life among oncology nurses. @*Methods@#Data were collected from June 2 to July 1, 2020. The participants were 185 oncology nurses caring for cancer patients. Data were analyzed using independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression with the SPSS/WIN 22.0 program. Nurse’s Character Scale for Care in Clinical Settings (NCS_C) and SOC, Professional Quality Of Life (ProQOL), which is conceptualized with three sub-dimensions (compassion satisfaction, compassion fatigue, burnout, and secondary traumatic stress), along with demographic and work-related variables were measured. @*Results@#The compassion satisfaction and burnout results had a significant correlation with the nurse’ s character for care and SOC. In multiple regression analysis, the meaningfulness of sub-dimension SOC (β=.58) accounted for 67.8% of compassion satisfaction and the meaningfulness of sub-dimension SOC (β=-.37) accounted for 55.4% of burnout. @*Conclusion@#Meaningfulness of sub-dimension SOC was an important factor that could be used to improve the professional quality of life among oncology nurses. Therefore, it is necessary to develop and make available programs for oncology nurses to improve compassion satisfaction, and methods to decrease burnout needs to be developed.
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Purpose@#This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. @*Methods@#In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. @*Results@#The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. @*Conclusion@#It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency.
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Purpose@#The purposes of this study were to develop a case-based video education program for oncology nursing based on clinical reasoning and to identify the clinical reasoning competence and satisfaction with the education of students in an oncology advanced practice nursing program after applying the video education. @*Methods@#This study was a single group before and after designed experiment for identifying the clinical reasoning competence and satisfaction with education after a case-based video education program for oncology nursing based on clinical reasoning. Eight experts developed a case-based video education program based on clinical reasoning. Fifty-seven students from an oncology advanced practice nursing program participated in this education format.The clinical reasoning competence and satisfaction with education were measured with online self-reporting questionnaires. @*Results@#The overall education satisfaction was 4.21±0.67 points (out of 5). The clinical reasoning competence increased from 55.25±6.54 points to 61.18±7.13 points (out of 75) after completing the education program and there was a statistically significant difference (t=-6.52, p<.001). @*Conclusion@#The case-based video education for oncology nursing based on clinical reasoning was effective in improving the students’ clinical reasoning competence. Various education programs should be developed and applied to improve the clinical reasoning competence of students in an oncology advanced practice nursing program.
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Purpose@#: The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master’s course professors at a graduate school. @*Methods@#: Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. @*Results@#: Based on the data, we extracted four themes and 14 categories. The themes were “Role and system of APNs started according to healthcare environment changes”, “Optimal healthcare provider to ensure quality of care”, “Confused role and system of APNs due to incomplete medical law”, and “Tasks for the stable operation of the APN system.” @*Conclusion@#: For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs’ scope of practice is required. Finally, a discussion is necessary about the integration of APNs’ 13 fields.
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Purpose@#The purpose of this study was to identify the influence of the nurse’s character on care and the sense of coherence (SOC) on the professional quality of life among oncology nurses. @*Methods@#Data were collected from June 2 to July 1, 2020. The participants were 185 oncology nurses caring for cancer patients. Data were analyzed using independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression with the SPSS/WIN 22.0 program. Nurse’s Character Scale for Care in Clinical Settings (NCS_C) and SOC, Professional Quality Of Life (ProQOL), which is conceptualized with three sub-dimensions (compassion satisfaction, compassion fatigue, burnout, and secondary traumatic stress), along with demographic and work-related variables were measured. @*Results@#The compassion satisfaction and burnout results had a significant correlation with the nurse’ s character for care and SOC. In multiple regression analysis, the meaningfulness of sub-dimension SOC (β=.58) accounted for 67.8% of compassion satisfaction and the meaningfulness of sub-dimension SOC (β=-.37) accounted for 55.4% of burnout. @*Conclusion@#Meaningfulness of sub-dimension SOC was an important factor that could be used to improve the professional quality of life among oncology nurses. Therefore, it is necessary to develop and make available programs for oncology nurses to improve compassion satisfaction, and methods to decrease burnout needs to be developed.
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Purpose@#This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. @*Methods@#In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. @*Results@#The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. @*Conclusion@#It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency.
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Purpose@#The purposes of this study were to develop a case-based video education program for oncology nursing based on clinical reasoning and to identify the clinical reasoning competence and satisfaction with the education of students in an oncology advanced practice nursing program after applying the video education. @*Methods@#This study was a single group before and after designed experiment for identifying the clinical reasoning competence and satisfaction with education after a case-based video education program for oncology nursing based on clinical reasoning. Eight experts developed a case-based video education program based on clinical reasoning. Fifty-seven students from an oncology advanced practice nursing program participated in this education format.The clinical reasoning competence and satisfaction with education were measured with online self-reporting questionnaires. @*Results@#The overall education satisfaction was 4.21±0.67 points (out of 5). The clinical reasoning competence increased from 55.25±6.54 points to 61.18±7.13 points (out of 75) after completing the education program and there was a statistically significant difference (t=-6.52, p<.001). @*Conclusion@#The case-based video education for oncology nursing based on clinical reasoning was effective in improving the students’ clinical reasoning competence. Various education programs should be developed and applied to improve the clinical reasoning competence of students in an oncology advanced practice nursing program.