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Background@#The purpose of this study was to describe the distinct cognitive trajectories for 8 years according to living arrangement among community-dwelling older adults using the Korean longitudinal study of ageing. @*Methods@#We analyzed data from a final sample of 3,049 community-dwelling older adults aged 65 years or older who participated in at least three cognitive function measures in an 8-year period (2012-2020). Cognitive function was assessed by Korean mini mental state examination. Latent class growth model analysis was applied to determine the number and shape of trajectories of older adults according to living arrangement.Multinomial logistic regression analysis was used to determine risk factors for cognitive function trajectories. @*Results@#We identified five trajectory patterns in cognitive function among older adults living alone; ‘high-stable (35.6%)’, ‘high-declining (32.5%)’, ‘moderate-steep declining (6.2%)’, ‘low-stable (18.9%)’, and ‘low declining (6.8%)’. In older adults living with family, there were four trajectory patterns; ‘high-stable (46.4%)’, ‘high-declining (32.0%)’, ‘low-stable (15.9%)’, and ‘low-declining (5.7%)’. Age, instrumental activities of daily living, and depression were common factors of cognitive changes in both older adults living alone and those living with family members. However, monthly incomes was only associated with the risk of cognitive function in older adults living alone. @*Conclusions@#We found that cognitive function trajectories among older adults may differ depending on the type of living arrangement. Therefore, further studies and health policies are required for avoiding cognitive impairment by living arrangement among older adults based on the results of this study.
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Purpose@#This study aimed to develop and test a reward scale for hospital nurses. @*Methods@#The initial items were identified through a literature review and focus group interviews with ten hospital nurses. The content validity of the items was evaluated by ten experts. Fifty-one items were derived from the pilot survey. Four hundred eighty-eight nurses participated in the study: 248 for exploratory factor analysis (EFA) and 240 confirmatory factor analysis (CFA). Data were analyzed using item analysis, EFA, CFA, convergent validity, known-group validity, and internal consistency using IBM SPSS Statistics 29.0 and IBM SPSS AMOS 29.0. @*Results@#The final scale consisted of 31 items and eight factors (decent wage, opportunity to grow and develop, support for special situations, various benefits, flexibility of work, job-related achievement, reflecting career and performance, and recognition), which explained 67.3% of the total variance. The eight-subscale model was validated by CFA. Convergent validity was evaluated by analyzing correlation with intention to leave (r = - .63, p < .001) and job satisfaction (r = .54, p < .001). The known-group validity was evaluated by comparing the reward scales according to age, clinical career, income level and hospital type. The scale was found to be reliable with a Cronbach’s α of .89. @*Conclusion@#Both the validity and reliability of the reward scale for hospital nurses are verified, which can enhance the understanding of the range of rewards and may assist nurse managers in establishing an effective reward system.
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This study evaluated the nutrient adequacy ratio (NAR) and depression based on the sleep duration of adult women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018. A total of 4,507 subjects were divided into two groups: sleep hours＜7 (lack of sleep, LS) and 7≤ sleep hours (normal sleep, NS). For a more detailed analysis, the subjects were further divided into normal sleep with no depression (NSND) and lack of sleep with depression (LSWD) groups. When compared with NS group, the nutrient intake of the LS group was observed to be higher in carbohydrates (P＜0.05) and thiamine (P＜0.01), but had a significantly lower mean nutrient adequacy ratio (P＜0.05). Also, the LS group showed a higher frequency of early menopause (P＜0.001) and depression (P＜0.05) than the NS group. In the analysis of anthropometry and blood parameters of the subjects based on their sleep duration, the LS group showed a lower body mass index (BMI, P＜0.05), lower blood creatinine (P＜0.01), glycated hemoglobin (P＜0.05), and high-density lipoprotein (HDL) cholesterol (P＜0.01) levels adjusted by age and menopause than the NS group. When compared to the NSND group, the LSWD group had a lower intake of cholesterol (P＜0.05), vitamin A (P＜0.05), vitamin C (P＜0.05), and folic acid (P＜0.05). There was no variation in the menopausal status, NAR, and mean nutrient adequacy ratio between the NSND and LSWD groups. However, there were differences in total blood cholesterol (P＜0.05) and depression based on sleep duration. Apart from nutritional status, differences in BMI and blood parameters were observed based on sleep duration.
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This study aimed to develop an emotive role-play program for nursing students focusingon high-risk pregnancy and analyze its effects on communication skills, clinical performance, andemotional intelligence.Methods: A quasi-experimental nonequivalent comparison group design was adopted with 83nursing students (experimental group, 45; comparison group, 38) who participated voluntarily in anextracurricular program. The preliminary survey was conducted on November 3 and November 4,2020, and the follow-up survey was conducted on November 12, 2020, for the comparison groupand on November 27, 2020, for the experimental group. A program that included five role-play scenarios related to induced labor, preeclampsia, premature rupture of membranes, preterm labor, andinfertility was developed by a group of experts and presented to the experimental group over 11 totalhours across 3 days. Each student participated in a role-play scenario as a patient, family member, ornurse and observed three other scenarios. The comparison group received a workbook after the follow-up evaluation. The independent t-test was performed to analyze changes in communicationskills, clinical performance, and emotional intelligence.Results: Communication skills (t=1.84, p=.035) and clinical performance (t=2.75, p=.004) significantly increased in the experimental group compared to the comparison group. A significant difference was not observed between the experimental and comparison groups for emotional intelligence(t=1.36, p=.088).Conclusion: The emotive role-play program concerning high-risk pregnancy was effective in improving nursing students’ communication skills and clinical performance and can be used in nursingeducation related to high-risk pregnancy and childbirth.
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Purpose@#This study aimed to identify the influence of effort-reward imbalance and job satisfaction on turnover intention among hospital nurses. @*Methods@#Data were collected from January 28 to February 10, 2022, from 237 nurses from five hospitals including clinics, general hospitals, and tertiary care hospitals located in B city. The collected data were analyzed using descriptive statistics, t-test, ANOVA, the Scheffé test, Pearson’s correlation coefficients, and multiple linear regression analysis, using SPSS/WIN 26.0. @*Results@#The average of the effort-reward ratio, an indicator of effort-reward imbalance, was 1.67±0.66, and 86.5% of the participants had a value of 1 or more. The mean job satisfaction and turnover intention were 3.32±0.48 and 3.69±0.89 on a 5-point scale, respectively. Multiple regression revealed that factors affecting turnover intention among hospital nurses included effort-reward imbalance (β=.30,p<.001) and job satisfaction (β=-.32, p<.001), and these variables explained 29.0% of turnover intention. @*Conclusion@#These findings indicate that effort-reward imbalance and job satisfaction are associated with turnover intention. Therefore, to decrease the turnover intention of hospital nurses, interventions and policies should be prepared to resolve the nurse's effort-reward imbalance and increase job satisfaction at regional or national level hospitals.
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Background@#Multimorbidity and suicide rates are on the rising among older Korean population. Recent studies have shown that multimorbidity is associated with increased suicidal ideation. Thus, this study was to investigate individual factors of suicidal ideation among older Korean adults with multimorbidity. @*Methods@#A cross-sectional study was conducted using a subsample (n=20,533) with multimorbidity aged 65 over of the 2017 Korean community health survey. Binary logistic regression model assessed the association of physical activity, sitting times, self-reported sleep duration, and depression with suicidal ideation in older adults with multimorbidity. @*Results@#Overall, 2,790 (13.6%) of the sample reported suicidal ideation within the past year. Logistic regression analysis showed that women, low monthly family income, low physical activity, long sitting times, inappropriate sleep duration and depression were significantly associated with increased risk of suicidal ideation in older adults with multimorbidity. @*Conclusions@#To reduce the rate of suicidal ideation in older adults with multimorbidity, healthcare providers should be aware of the importance on routine assessment for physical activities, sleep pattern, and mental status of older adults in clinical settings. Particularly, female and low-income older adults with multimorbidity should be prioritized for early detection and individualized suicide prevention based on our findings.
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Purpose@#The aim of this study was to investigate the educational status and needs of premature birth prevention, and to identify factors associated with preconception health behaviors. @*Methods@#The study design was a crosssectional descriptive study. Data were collected through an online questionnaire survey, and the subjects were 192 women of childbearing age in Korea. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation coefficients, and multiple regression. @*Results@#The proportion of subjects who received education on premature birth prevention was 8.9%, and 75.5% of subjects answered that they needed education on premature birth prevention. They demanded education through online media, small groups, cases, cartoons (webtoon) with stories, pictures, and videos. A related factor of preconception health behavior was self-efficacy for high-risk pregnancy health care (β=.20, p=.012), which accounted for 8.2% of the total variance related to preconception health behavior. @*Conclusion@#There was a need for more development of education programs to prevent premature birth for women of childbearing age. Its education programs should be applied with online, small group activities using various educational media. It is also required to promote preconception health behavior through self-efficacy for high-risk pregnancy health care.
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This study evaluated the correlation between serum uric acid level and the nutrients adequacy ratio (NAR) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016∼2019. This is a cross-sectional study in which 6,579 Korean male adults were divided into quartiles according to their uric acid levels. All analyses were performed with adjusted age. Uric acid decreased as the age increased from the age group 19∼29 years to 30∼49 years and then to 50∼64 years. Interquartile results of serum uric acid levels showed that increases in the serum uric acid levels were associated with decreases in LDL-cholesterol (P＜0.01), triglycerides (P＜0.001), body weight (P＜0.001), waist circumference (P＜0.001), body mass index (P＜0.001), systolic blood pressure (SBP) (P＜0.001), diastolic blood pressure (DBP) (P＜0.001). However, uric acid levels decreased with an increase in HDL cholesterol (P＜0.001). The analysis of the NARs according to the quartiles of serum uric acid levels in men showed that an increase in serum uric acid levels was associated with a decrease in the NAR levels of dietary fiber (P＜0.001), calcium (P＜0.001), and folic acid (P＜0.001).
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Purpose@#This study aimed to develop and examine the validity and reliability of a self-efficacy scale for preventive health management related to premature labor (PHMSE-PL) for women of childbearing age. @*Methods@#Instrument development and validation were undertaken in three steps: conceptualization through a literature review and in-depth interviews, item generation and evaluation of content validity, and evaluation of construct validity and reliability. The content validity, factorial structure validity, and internal consistency reliability of the PHMSE-PL were evaluated, and cognitive interviewing was undertaken. Data were analyzed using confirmatory factor analyses, Cronbach's α, and 95% confidence intervals (CIs). @*Results@#The content validity was assessed by experts and was strengthened through cognitive interviews with women of childbearing age. The PHMSE-PL comprised 34 items across five factors. The construct validity of the PHMSE-PL was supported. Cronbach's α for the total scale was .97 (95% CI=.96-.97). @*Conclusion@#An evaluation of the psychometric properties of the PHMSE-PL scale found it to be a valid and reliable tool for women of childbearing age. The scale appears to be useful for women of childbearing age to self-assess their preventive health management self-efficacy related to premature labor and for health professionals to evaluate and promote women's preventive health management.
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Due to the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccine development has increased. In particular, a rapid supply of vaccines and prompt deployment of vaccination programs are essential to prevent and overcome the spread of COVID-19. As a part of the vaccine regulations, national lot release is regulated by the responsible authorities, and this process involves the assessment of the lot before a vaccine is marketed. A lot can be released for use when both summary protocol (SP) review and quality control testing are complete. Accelerated lot release is required to distribute COVID-19 vaccines in a timely manner. In order to expedite the process by simultaneously undertaking the verification of quality assessment and application for approval, it is necessary to prepare the test methods before marketing authorization. With the prolonged pandemic and controversies regarding the effectiveness of the COVID-19 vaccine against new variants, public interest for the development of a new vaccine are increasing. Domestic developers have raised the need to establish standard guidance on the requirements for developing COVID-19 vaccine. This paper presents considerations for quality control in the manufacturing process, test items, and SP content of viral vector vaccines.
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Inherited bone marrow failure syndrome (IBMFS) is a group of clinically heterogeneous disorders characterized by significant hematological cytopenias of one or more hematopoietic cell lineages and is associated with an increased risk of cancer. The genetic etiology of IBMFS includes germline mutations impacting several key biological processes, such as DNA repair, telomere biology, and ribosome biogenesis, which may cause four major syndromes: Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, and Shwachman-Diamond syndrome. Although the clinical features of some patients may be typical of a particular IBMFS, overlapping and atypical clinical manifestations and variable penetrance pose diagnostic challenges. Here, we review the clinical and genetic features of the major forms of IBMFS and discuss their molecular genetic diagnosis. Next-generation sequencing-based gene panel testing or whole exome sequencing will help elucidate the genetic causes and underlying mechanisms of this genetically heterogeneous group of diseases.
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Background/Aims@#Waldenström macroglobulinemia (WM) is a rare lymphoproliferative disorder that usually follows an indolent clinical course. However, some patients show an aggressive clinical course leading to death. We explored the risk factors predicting poor prognosis in WM patients. @*Methods@#We retrospectively analyzed 47 patients diagnosed with WM between 2000 and 2018 to explore risk factors predicting poor prognosis using various clinical and laboratory parameters and risk models including the International Prognostic Staging System for WM (IPSS-WM). @*Results@#Over a median follow-up duration of 80.4 months, 29 patients died. The main causes of death were disease progression, organ failure related to amyloidosis, and infection. The median overall survival (OS) was 55.1 months, and 14 patients, including three with amyloidosis, died within 2 years. Serum β2-microglobulin level higher than 4 mg/dL was significantly associated with poor OS. Accordingly, the IPSS-WM showed a significant association with poor prognosis compared with other risk models, and the low-risk group had better OS than intermediate- and high-risk groups. In the retrospective analysis using the results of targeted sequencing in two cases representing good and bad prognosis, different patterns of mutation profiles were observed, including mutations of MYD88, TP53, ARID1A, and JAK2 in a refractory case. @*Conclusions@#Serum β2-microglobulin could be a single biomarker strongly predictive of poor survival of WM patients, and the low-risk group of the IPSS-WM risk model including serum β2-microglobulin has better prognostic value than other risk models. Mutation analysis also might provide additional information to predict high-risk patients.
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Purpose@#This study compared maternal age at childbirth, the number of live births, and the weight of live births between Korean women and immigrant women using statistical data from the Republic of Korea for 2018. @*Methods@#The analysis was conducted using data from the Microdata Integrated Service of Statistics Korea (https://mdis.kostat.go.kr/index.do). @*Results@#Korean women and immigrant women showed a higher age at childbirth in 2018 than in 2008. The percentage of newborns of Korean women with a birth weight of less than 2.5 kg increased slightly for 3 consecutive years from 2016 to 2018, whereas for immigrant women, this percentage increased in 2017 compared to 2016 and then decreased again in 2018. Very low birth weight (less than 1.5 kg) became more common among immigrant women from 2016 to 2018. Birth at a gestational age of fewer than 37 weeks increased both among Korean and immigrant women from 2016 to 2018. In both groups, the percentage of women who had their first child within their first 2 years of marriage decreased from 2008 to 2018. @*Conclusion@#Immigrant women had higher birth rates than Korean women, while both groups showed an increasing trend in premature birth. Greater attention should be paid to the pregnancy and birth needs of immigrant women, and steps are needed to ensure health equity and access in order to prevent premature births. It is also necessary to identify factors that affect preterm birth and birth of very low birth weight infants among immigrant women in the future.
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Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.
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Background/Aims@#Waldenström macroglobulinemia (WM) is a rare lymphoproliferative disorder that usually follows an indolent clinical course. However, some patients show an aggressive clinical course leading to death. We explored the risk factors predicting poor prognosis in WM patients. @*Methods@#We retrospectively analyzed 47 patients diagnosed with WM between 2000 and 2018 to explore risk factors predicting poor prognosis using various clinical and laboratory parameters and risk models including the International Prognostic Staging System for WM (IPSS-WM). @*Results@#Over a median follow-up duration of 80.4 months, 29 patients died. The main causes of death were disease progression, organ failure related to amyloidosis, and infection. The median overall survival (OS) was 55.1 months, and 14 patients, including three with amyloidosis, died within 2 years. Serum β2-microglobulin level higher than 4 mg/dL was significantly associated with poor OS. Accordingly, the IPSS-WM showed a significant association with poor prognosis compared with other risk models, and the low-risk group had better OS than intermediate- and high-risk groups. In the retrospective analysis using the results of targeted sequencing in two cases representing good and bad prognosis, different patterns of mutation profiles were observed, including mutations of MYD88, TP53, ARID1A, and JAK2 in a refractory case. @*Conclusions@#Serum β2-microglobulin could be a single biomarker strongly predictive of poor survival of WM patients, and the low-risk group of the IPSS-WM risk model including serum β2-microglobulin has better prognostic value than other risk models. Mutation analysis also might provide additional information to predict high-risk patients.
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Purpose@#This study compared maternal age at childbirth, the number of live births, and the weight of live births between Korean women and immigrant women using statistical data from the Republic of Korea for 2018. @*Methods@#The analysis was conducted using data from the Microdata Integrated Service of Statistics Korea (https://mdis.kostat.go.kr/index.do). @*Results@#Korean women and immigrant women showed a higher age at childbirth in 2018 than in 2008. The percentage of newborns of Korean women with a birth weight of less than 2.5 kg increased slightly for 3 consecutive years from 2016 to 2018, whereas for immigrant women, this percentage increased in 2017 compared to 2016 and then decreased again in 2018. Very low birth weight (less than 1.5 kg) became more common among immigrant women from 2016 to 2018. Birth at a gestational age of fewer than 37 weeks increased both among Korean and immigrant women from 2016 to 2018. In both groups, the percentage of women who had their first child within their first 2 years of marriage decreased from 2008 to 2018. @*Conclusion@#Immigrant women had higher birth rates than Korean women, while both groups showed an increasing trend in premature birth. Greater attention should be paid to the pregnancy and birth needs of immigrant women, and steps are needed to ensure health equity and access in order to prevent premature births. It is also necessary to identify factors that affect preterm birth and birth of very low birth weight infants among immigrant women in the future.
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Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.
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Purpose@#The purpose of this study was to investigate the impact of nurse practice environment, coworker support, and work-life balance on job satisfaction for newly graduated nurses. @*Methods@#This study used a cross-sectional design, and the participants were 118 registered nurses who acquired license within the last 1 year and were working in hospitals. They completed questionnaires through online survey systems. Data were collected from June to July 2019 and were analyzed using descriptive statistics, t-test, Pearson’s correlation coefficients, and multiple stepwise regression using IBM/SPSS 26.0 for Windows program. @*Results@#The mean job satisfaction was 2.66±0.70 points on a 5-point scale. Multiple stepwise regression revealed that factors affecting job satisfaction of nurses included age ( β=.18, p=.014), nurse practice environment (β=.28, p<.001), coworker support ( β=.26, p=.002), and work-life balance ( β=.29 p<.001), and these variables explained 39.1% of job satisfaction. @*Conclusion@#These findings indicate that it is necessary to enhance nurse practice environment, coworker support, and work-life balance to improve job satisfaction among newly graduated nurses. These results can be used to help nurse managers develop related policies and retention programs for newly graduated nurses.
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Purpose@#The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. @*Methods@#This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. @*Results@#The participants’ awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. @*Conclusion@#In order to improve long term care hospital nurses’ end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.
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Procalcitonin (PCT) is a useful bacterial infection biomarker with the potential for guiding antibiotic therapy. We evaluated the concordance of three automated PCT immunoassays: Kryptor (BRAHMS GmbH, Hennigsdorf, Germany), Atellica IM 1600 (Siemens Healthcare Diagnostics, Munich, Germany), and Cobas e801 (Roche Diagnostics, Mannheim, Germany). In 119 serum samples with a PCT concentration < 5.00 μg/L, Kryptor (reference assay) was compared with the other two immunoassays by Spearman’s rank correlation, regression analysis, and concordance at two antibiotic stewardship medical decision points: 0.25 and 0.50 μg/L. The Atellica IM 1600 and Cobas e801 results showed high correlations with those of Kryptor, with correlation coefficient (ρ) values of 0.97 and 0.99, respectively. However, negative biases were observed in both immunoassays (slope/y-intercept: 0.75/–0.00 for Atellica IM 1600; 0.88/–0.01 for Cobas e801). Atellica IM 1600 and Cobas e801 demonstrated excellent concordance with Kryptor at both medical decision points, with linearly weighted κ values of 0.90 and 0.92, respectively, despite discrepancies, which were more prominent at the 0.25 μg/L medical decision point. Based on these biases and discrepancies, the alternate use of different PCT immunoassays in repeat examinations is inadvisable. Standardization is required before comparing the results of different PCT immunoassays.