RESUMEN
Previous studies have shown that tricuspid regurgitation (TR) can be developed in patients with atrial fibrillation (AF) due to annular dilatation. This study aimed to investigate the incidence and predictors of the progression of TR in patients with persistent AF. A total of 397 patients (66.9±11.4 years, 247 men; 62.2%) with persistent AF were enrolled between 2006 and 2016 in a tertiary hospital, and 287 eligible patients with follow-up echocardiography were analyzed. They were divided into two groups according to TR progression (progression group [n=68, 70.1±10.7 years, 48.5% men] vs. non-progression group [n=219, 66.0±11.3 years, 64.8% men]). Among 287 patients in the analysis, 68 had worsening TR severity (23.7%). Patients in the TR progression group were older and more likely to be female. Patients with left ventricular ejection fraction ＜50% were less frequent in the progression group than those in the non-progression group (7.4% vs. 19.6%, p=0.018). Patients with mitral valve disease were more frequent in the progression group. Multivariate analysis with COX regression demonstrated independent predictors of TR progression, including left atrial (LA) diameter ＞54 mm (HR 4.85, 95%CI 2.23-10.57, p＜0.001), E/e’ (HR 1.05, 95%CI 1.01-1.10, p=0.027), and no use of antiarrhythmic agents (HR 2.20, 95%CI 1.03-4.72, p=0.041). In patients with persistent AF, worsening TR was not uncommon. The independent predictors of TR progression turned out to be greater LA diameter, higher E/e’, and no use of antiarrhythmic agents.
RESUMEN
Purpose@#The purpose of this study was to examine the level of turnover intention and identify factors affecting turnover intention in nurses working at a tertiary hospital in Korea. @*Methods@#A descriptive study was conducted. A total of 239 clinical nurses were recruited using a convenient sampling method. The standardized questionnaires was used to assess fatigue, nursing professionalism, and compassion satisfaction. Data were analyzed using SPSS software. Descriptive statistics were computed to describe the sample and study variables. Logistic regression analyses was performed to identify factors affecting turnover intention in clinical nurses working at a tertiary hospital. @*Results@#Among the 239 clinical nurses, a mean age of participants was 28.80±5.08 years. Most of participants were female (n=228, 95.4%) and single (n=183, 76.6%) and achieved bachelor’s degree (n=186, 77.8%). Approximately 43.5% of them intended to turnover their current job. The findings showed that turnover intentions were significantly higher among clinical nurses who were younger (OR=0.93, 95% CI=0.86~0.99), worked in ICU or ER (OR=3.64, 95% CI=1.04~12.70), had higher fatigue (OR=1.02, 95% CI=1.01~1.04), and had lower professionalism (OR=0.98, 95% CI=0.96~0.99). It explained 23.7% of the variance in turnover intention. @*Conclusion@#The findings indicated that nurse administrators need to develop and provide customized intervention program to decrease fatigue and increase nursing professionalism to prevent turnover intention in clinical nurses working at a tertiary hospital.