The Influence of Long-term Care Hospital Nurses' Nursing Professionalism and Knowledge of COVID-19 on Nursing Intentions for COVID-19 Patients

Purpose: This study attempted to identify the influence of long-term care hospital nurses' nursing professionalism and knowledge of coronavirus disease 2019 (COVID-19) on nursing intentions for COVID-19 patients. Methods: Data were collected from nurses who had worked for at least 6 months at long-term care hospitals with more than 100 beds located in North Gyeongsang Province from July 15 to 31, 2021. In total, 207 questionnaires were analyzed using the t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple linear regression with SPSS for Windows version 25.0. Results: Among the sub-factors constituting nursing professionalism, self-concept of the profession (r=.22, p=.001) and professionalism of nursing (r=.23, p=.001) were correlated with nursing intention for COVID-19 patients, whereas there no correlation was found between knowledge of COVID-19 and nursing intention for COVID-19 patients. In addition, among the sub-factors of nursing professionalism, the only factor influencing nursing intention for COVID-19 patients was professionalism of nursing, which could explain approximately 6.0% of variance in nursing intention for COVID-19 patients (β=.58, p=.049). Conclusion: It is important to strengthen professionalism of nursing among various aspects of nursing professionalism in order to improve long-term care hospital nurses' nursing intention for COVID-19 patients. © 2023 Korean Academy of Fundamentals of Nursing.

CHANGING PERFORMANCE OF COLORECTAL CANCER SCREENING FOLLOWING A COVID-19 PANDEMIC IN KOREA

Background/Aim: It is easy to predict that the actual COVID-19 pandemic would have had a negative impact on cancer screening activities and the outcomes of screenings, but to date, real-time population-based evidence to substantiate this concern is very scarce. In this study, to understand the changes in the behavior and performance of CRC screening following the COVID-19 pandemic, the indicators of CRC screening processes and outcome measures were compared with both monthly data in 2019 and monthly changes focusing on the peaks that appeared in 2020. Method: This population-based nationwide study used fecal immunochemical test (FIT) and colonoscopy claims data from the Korean National Health Insurance System (NHIS) from 2019 to 2020. Data were analyzed from 15,867,759 subjects in 2019 and 16,155,930 subjects in 2020. We compared the data of CRC screening (FIT/ colonoscopy) of the COVID-19 pandemic period (2020) with those of the same period of 2019. Result: In the COVID-19 period, 3,445,660 (21.3%) subjects underwent FIT, whereas in 2019, 6,490,707 (40.9%) subjects performed FIT (almost 2-fold). Participation rate in colonoscopy after FIT positive fell in 2020 by 36.0% compared with the average rate recorded in 2019 (44.5%). In particular, it was confirmed that the participation rate of the CRC screening further decreased immediately after the COVID-19 peak periods (first and second wave: March 2020 and August 2020). Conclusion: The overall adherences to CRC screening tests decreased substantially during COVID-19 pandemic. Therefore, urgent modulation for not only easier access but also planning a restart for CRC screening is needed to address the growing burden of under-detected CRC in Korea.

Group-based multi-trajectory analysis of c-reactive protein and ferritin levels in pediatric sepsis

INTRODUCTION: Interest in using bedside C-reactive protein and ferritin levels to identify patients with hyperinflammatory sepsis who might benefit from anti-inflammatory therapies piqued with the COVID-19 pandemic experience. These widely available low-cost biomarkers might be similarly useful for assessing inflammatory profiles of all critically ill children with sepsis and septic shock and eventually guiding the use of precision anti-inflammatory therapies. We hypothesized groupbased trajectories of CRP and ferritin among critically ill children with sepsis would be associated with mortality and distinct inflammatory cytokine profiles. METHODS: Children with sepsis and organ failure from 9 pediatric intensive care units were enrolled in a prospective, observational cohort. Plasma CRP (mg/dL), ferritin (ng/mL), and 29 cytokine levels were measured at two samplings during sepsis (median Day 2 and Day 5). Group-based multi-trajectory models (GBMTM) identified groups of children with distinct patterns of CRP and ferritin. RESULTS: Two hundred and fifty-five children had at least 2 CRP and ferritin measurements. Five distinct clinical multitrajectory groups were identified with significantly different median maximum organ failures (MOF) and mortality. Group 1 had normal CRP and ferritin levels (n = 8;median MOF 2.0 [interquartile range 1.0, 2.0] and 0 % mortality);Group 2 had high CRP levels that became normal, with normal ferritin levels throughout (n = 80;median MOF 2.0 [1.0, 2.0] and 5% mortality);Group 3 had high ferritin levels alone (n=16;median MOF 2.5 [2.0, 3.0] and 6.3% mortality);Group 4 had very high CRP levels, and increased ferritin levels (n = 121;median MOF 2.0 [2.0, 4.0] and 10.7% mortality);and, Group 5 had very high CRP and very high ferritin levels (n = 30;median MOF 3.0 [2.0, 4.0] and 40% mortality). Cytokine responses differed across the 5 groups, with ferritin levels associated with macrophage inflammatory protein 1 a, and CRP levels reflective of many cytokines. CONCLUSIONS: Bedside CRP and ferritin levels can be used together to compute distinct groups of children with sepsis who have different systemic inflammation cytokine responses and mortality risks potentially targetable in clinical trials evaluating specific anti-inflammatory therapies.

T cell response to influenza vaccination remains intact in adults with congenital heart disease who underwent early thymectomy

Introduction: Thymectomy is routine during surgery for congenital heart defects to access to the heart. T cells developed in the thymus play a key role in immunity. Individuals with thymectomy in infancy have altered T cell populations suggesting early immunosenescence. Hypothesis: Adults with Congenital Heart Disease (ACHD) who underwent thymectomy in the first year of life have an altered response to influenza vaccination due to T cell immunosenescence. Methods: We recruited ACHD with early thymectomy ≤ 1 year of age (ACHD-ET;n = 12), ACHD and no thymectomy (ACHD-NT;n = 8), and healthy controls (HC;n = 14). Peripheral blood was collected prior to influenza vaccine and 4 weeks following administration. Flow cytometry of T cell subsets and intracellular cytokine staining of CD4 T cells was done following in vitro stimulation with influenza viral antigen. Results: Subject's mean age was 34 ± 10.6 years with no difference between the groups. At baseline, the median (IQR) frequency of naïve CD4 T cells was 24.7% (15.9) in ACHD-ET vs. 43.6% (16.9) in HC (P=0.01). Similarly, naïve CD8 T cells were lower with 37.5% (25.7) in ACHDET vs 62.8% (22.9) in HC (P=0.02). This also resulted in a reciprocal increase in memory CD4 and CD8 T Cells in the ACHD-ET group. The ACHD-NT was not significantly different than the other groups. The frequencies of influenza antigen-specific memory CD4 T cells expressing IFN-γ and TNF-α were significantly increased in post-vaccine blood samples compared to pre-vaccine samples across all 3 groups (P<0.05). Conclusions: ACHD-ET have a smaller population of naïve T cells, suggestive of immunosenescence. Despite this they have an equivalent cytokine response suggesting that early thymectomy does not inhibit the response to vaccination in young adulthood. Our findings support the recommendation that preventative vaccination against pathogens including influenza virus and the newly emerging SARS-CoV-2 should continue to be routinely performed in ACHD.

Experience of Nurses Working at the Drive-Thru COVID-19 Screening Clinic

Purpose: The purpose of this study was to explore the meaning of nurses’ experiences of working at Drive-Thru COVID-19 Screening Clinic. Methods: Participants in this study were 8 nurses who worked for more than two weeks at the Drive-Thru COVID-19 Screening Clinic Screening Clinic in P-city, Gyeongbuk, which was declared a Corona19 disaster area. Data collection was conducted through individual in-depth interviews from June to August 2020. For data analysis, Max van Manen's analytical phenomenology research method was applied. Results: The essential theme of the Drive-Thru COVID-19 screening clinic nurse's experiences was ‘A sense of calling as a nurse’, ‘Physical and psychological stress’, ‘Daily life tailored to the work of the screening clinic’, ‘Time to live together in the fight against the virus’, ‘New perception and rewarding for nursing’. Conclusion: The results of this study provide basic data for preparing a support system and understanding the work of nurses who are put on the front line in the event of a disaster by vividly describing the experiences of nurses working at the Drive-Thru screening clinic. © 2021 Korean Academy of Nursing Administration. All rights reserved.