Mediating effects of patient safety perception and willingness to participate in patient safety on the relationship between health literacy and patient participation behavior among inpatients.

Introduction: In recent years, patient safety activities have shifted from being centered on healthcare providers to involving patients themselves. Health literacy of inpatients has a direct impact on patient participation behavior. Patient safety perception was also associated with willingness to participate in patient safety and patient participation behavior. Therefore, this study aimed to investigate the mediating effects of patient safety perception and willingness to participate in patient safety on the relationship between health literacy and patient participation behavior among inpatients. Methods: This cross-sectional study was conducted to confirm the relationship between study variables. A total of 262 inpatients were recruited from patients admitted to the ward of a tertiary general hospital between October and November 2023. Participants were invited to complete self-reported questionnaires that measured health literacy, patient safety perception, willingness to participate in patient safety, patient participation behavior, and demographic information. Data were analyzed using a dual mediation model applying the PROCESS macro (Model 6) with 95% bias-corrected bootstrap confidence intervals. Results: This study analyzed the direct effects of health literacy on patient safety perceptions and patient participation behavior. Health literacy indirectly affected patient participation behavior through patient safety perceptions and willingness to participate in patient safety. Regarding the relationship between health literacy and patient participation behavior, patient safety perceptions and willingness to participate in patient safety showed a significant dual mediating effect. Conclusions: This study identified the factors that promote patient participation behavior among inpatients. The mediating effect of patient safety perception on the relationship between health literacy and patient participation behavior was found to be strong. Building health literacy among inpatients ensures patient safety by increasing patient safety perceptions.

Development and validation of a quality of healthy work environment instrument for shift nurses.

BACKGROUND: As the importance of a healthy work environment for nurses' good practice and patient safety has been recognized, there is a need to assess nurses' perceptions of the quality of a healthy work environment. METHODS: A conceptual framework and construct components were extracted through a literature review and in-depth interviews with shift nurses. The initial items of the instrument were developed according to the conceptual attributes, and the items were selected through content validity by ten experts. Two hundred and forty-seven shift nurses participated in this study through face-to-face surveys to test the reliability and validity of the instrument. The evaluation was used for item and confirmatory factor analyses to assess the criterion-related validity and internal consistency of the instrument. Test-retest reliability was analyzed using data from thirty-two nurses. RESULTS: The final instrument consisted of 23 items with five components identified through confirmatory factor analysis. Criterion-related validity was established using the K-PES-NWI (r = .54). Cronbach's alpha for the total items was 0.85, and test-retest reliability was 0.73. CONCLUSION: The quality of the healthy work environment instrument developed in this study was considered reliable and valid. The instrument developed in this study can be used to measure the quality of a healthy work environment as perceived by shift nurses and to identify preventive measures needed to improve the quality of the work environment.

Mediating Effect of Quality of Sleep Moderated by Meaning in Life on the Relationship between Hwabyung and Suicidal Ideation in Middle-Aged Korean Women.

The purpose of this study was to determine the role of the quality of sleep and meaning in life in the process by which Hwabyung symptoms affect suicidal ideation in middle-aged Korean women. A total of 265 women aged 40-65 years were enrolled in an online survey. The study variables were measured using the Hwabyung, quality of sleep, meaning in life, and suicidal ideation scales. The data were analyzed using the PROCESS Procedure for SPSS Release 3.5 (Model 14) program with a 95% bias-corrected bootstrap confidence interval. Hwabyung symptoms in middle-aged women had a significant direct effect on suicidal ideation, and an indirect effect through the quality of sleep was also statistically significant. Meaning in life was found to significantly moderate the indirect effect of Hwabyung on suicidal ideation through the quality of sleep. In other words, the greater the meaning in life, the weaker the effect of Hwabyung on suicidal ideation through the quality of sleep. The Hwabyung of middle-aged women caused a psychological crisis and was a great threat to physical health by lowering the quality of sleep. The low quality of sleep and the increase in suicidal ideation due to Hwabyung pose a great threat to the survival of middle-aged women. It was found that it is very important to find meaning in one's life as an effective way to reduce suicidal ideation in middle-aged women.

Effects of Nursing Work Environment, Need Satisfaction, and Depression on Turnover Intention in Korea.

This study examined the effects of the nursing work environment, need satisfaction, and depression on turnover intention in South Korean nurses through a mediating model. This study was a descriptive cross-sectional research study and was conducted through an online questionnaire. A total of 248 nurses were recruited for this study. Data were collected in August 2022. Participants were invited to complete self-reported questionnaires that measure nursing work environment, need satisfaction, depression, turnover intention, and demographic information. The data obtained were analyzed using the dual mediation model applying the PROCESS macro (Model 6). This study analyzed the direct effects of the nursing work environment on need satisfaction, depression, and turnover intention. The nursing work environment also had indirect effects on their turnover intention via need satisfaction and depression. The mediating effect of need satisfaction, which affects the turnover intention by increasing the satisfaction of the nursing work environment, was found to be the greatest. It has been shown that the more positive a nurse's experience of the nursing work environment, the higher the nurse's need satisfaction. According to the study results, the increase in nurses' need satisfaction greatly contributes to the decrease in depression and turnover intention. Therefore, active efforts should be made to improve the nursing work environment to fulfill basic needs.

Experiences of Patient Safety Education and Factors Affecting the Willingness to Participate in Patient Safety in Undergraduate Nursing Students in South Korea.

Patient safety (PS) education must be provided to medical personnel who deal with life and death situations. This study aimed to examine the current state of PS education and to investigate the factors affecting the willingness of undergraduate nursing students to participate in PS. This study was a cross-sectional descriptive correlational survey. In this study, an online survey targeting members of an online café in South Korea that prepares nursing students was conducted from 19-21 April 2023. In total, 296 undergraduate nursing students in their fourth grade at 132 nursing colleges across the country participated. The results showed that 94.6% (280 students) had experience in PS education and 45.6% (135 students) had witnessed a PS incident in clinical practice. Most students (90.9%) responded that PS education was necessary and that 'clinical practice at the hospital' was the most effective method of PS education. PS perception increased as PS knowledge increased, and it was confirmed that an increase in PS perception increased the willingness to participate in PS. Factors that increased nursing students' willingness to participate in PS were high satisfaction with clinical practice, high PS education needs, and high PS perception scores. To increase nursing students' willingness to participate in PS, it is important to improve their PS perception and ensure that they have a variety of PS education experiences, which requires the development of a standardized PS education program.

Physiochemical Properties of Chicken Breast Sausage with Red Ginseng Marc Powder.

This study explored the physiochemical and rheological properties of chicken breast sausages containing red ginseng marc (RGM) which contains useful components but is discarded. When compared to the control group, the use of RGM significantly increased the water holding capacity (WHC) as the particle size increased. As for the change in color value, addition of RGM resulted in an increase in a and b values; as the quantity was increased and particle size decreased, the a and b values increased significantly. The smaller the particle size of RGM, the greater was the radical scavenging activity. According to the results of the measurement of the viscoelasticity of chicken breast sausage containing RGM, the G' and G'' values increased with increasing amounts of RGM and particle size. Neither the addition of RGM nor its amount or particle size had any significant effect on gel formation temperature. The texture profile analysis (TPA) experiment examined the average TPA measurements of each sample under different measurement conditions, and no significant difference between the RGM and control groups were observed. In conclusion, when RGM is used in chicken breast sausages, the WHC, antioxidant capacity, and viscoelastic properties are affected. RGM can possibly be utilized in high value-added processed meat products if its quantity and particle size are altered based on product characteristics.

Associations between Fear of COVID-19, Depression, and Internet Addiction in South Korean Adults.

This study investigates the associations between Internet addiction and psychological distress, including fear of coronavirus disease 2019 (COVID-19), and depression in South Korean adults during the COVID-19 pandemic. A population-based cross-sectional online survey was conducted from 14 to 18 May 2021. Potential adult survey respondents aged 20 years or older were randomly extracted from one of the largest online survey panels in South Korea, matching the South Korean national demographic proportions (i.e., region, gender, and age). Subsequently, 1155 participants were included in the study. Descriptive and logistic regression analyses were performed to investigate the participants' characteristics and analyze the adjusted odds ratios (aORs). Of the South Korean adults, 11.17%, 15.15%, and 37.23% were at risk of Internet addiction, COVID-19 fear, and depression, respectively. Internet addiction was positively associated with COVID-19 fear (aOR = 3.25, 95% CI [2.10, 5.04]) and depressive symptoms (aOR = 6.40, 95% CI [4.15, 9.86]). Addictive Internet use was significantly associated with psychological distress during the COVID-19 pandemic. The development of public health strategies that mitigate addictive Internet use and increase eHealth literacy will be useful for securing the public's psychological well-being.

Smoking Awareness and Intention to Quit Smoking in Smoking Female Workers: Secondary Data Analysis.

Although the smoking rate among women has been continuously increasing recently, it is very difficult to explore the actual situation because of negative social views. This study aimed to analyze the effects of smoking awareness and living environment on the intention to quit smoking among female smokers. After receiving approval from the Research Ethics Committee in September 2021, secondary data analysis was performed for this study. A total of 378 working women who smoked were included in this study. The mean age was 34.4 years. The results showed that women living alone had significantly lower intentions to quit smoking, and women with experience in smoking cessation education had significantly higher intentions to quit smoking. In addition, it was found that the group having awareness of smoking cessation policy and smoking cessation treatment had high intention to quit smoking. As a result of the analysis of decision trees using data mining techniques, the strongest predictor of the intention of female workers who smoke to quit smoking was their perception of smoking cessation policies. In addition, it was found that the state's policy support was important in that the group with the highest intention to quit smoking was the one with high awareness of both the smoking cessation policy and smoking cessation treatment. Finally, the risk group with the lowest intention to quit smoking was the group with low awareness of the anti-smoking policy, living alone, and having low awareness of the harmfulness of cigarettes. The importance of establishing policies for this vulnerable group, smoking cessation policies and treatment of female smokers, and improving awareness of the harmful effects of tobacco are discussed.

Effects of Health Belief, Knowledge, and Attitude toward COVID-19 on Prevention Behavior in Health College Students.

This study aimed to identify the factors affecting the practice of COVID-19 prevention behaviors among college students as future medical workers. A cross-sectional online survey was conducted in September 2021. A total of 526 health college students were included in this study. A hierarchical regression analysis was performed to examine the effect on the practice of COVID-19 prevention behavior. As a result of the analysis, experiences of education on infectious diseases had significant positive effects on the practice of prevention behavior (ß = 0.22, p < 0.001). Additionally, a higher COVID-19 health belief had a significant positive effect on the practice of prevention behavior (ß = 0.15, p = 0.004). Increased smoking and drinking among lifestyle changes after COVID-19 had significant negative effects on the practice of prevention behavior compared with decreased physical activity (ß = -0.12, p = 0.007). Based on these findings, the study discussed the importance of education on the prevention of infectious diseases among health college students, promotion of health beliefs related to infectious diseases, and formation of healthy lifestyle habits in daily life.

Variation in Significant Difference of Sausage Textural Parameters Measured by Texture Profile Analysis (TPA) under Changing Measurement Conditions.

This study examined the measurement conditions of the texture profile analysis (TPA) experiments that are typically used to measure the physical properties of sausage. As the measurement conditions (compression ratio and cross-head speed) were changed, the significant differences between the values of textural parameters (hardness, adhesiveness, springiness, cohesiveness, chewiness) of samples changed. Furthermore, among the measurement conditions, there was more variation in the significant difference between the value of samples due to a change in the compression ratio than due to a change in the cross-head speed. The highest variation in significant difference was observed between the values of cohesiveness of samples due to changes in measurement conditions, whereas the lowest variation in significant difference was observed between the values of springiness of samples due to change in measurement conditions. Therefore, it is desirable to provide a clear basis for setting specific measurement conditions for TPA test, since significant differences in the values of textural parameters of samples were caused by differences in cross-head speed or compression ratio, not by a difference in samples, when analyzing the cohesiveness of sausage, especially.

Development and Effectiveness of a Patient Safety Education Program for Inpatients.

BACKGROUND: Patient safety is considered an important issue in the field of healthcare, and most advanced countries. PURPOSE: This study was designed to evaluate a patient safety education program among hospitalized patients. Of the 69 participants, 33 completed the patient safety education program while the 36 remaining participants were given educational booklets. The program was used to measure knowledge about patient safety, patient safety perception, and willingness to participate in patient safety. METHODS: Patient safety education was developed by the analysis-design-development-implementation-evaluation model considering expert advice, patient needs, and an extensive literature review. Data were collected from 20 July to 13 November 2020. Data were analyzed using SPSS statistical program. The effectiveness of the experimental and control groups before and after education was analyzed using paired t-tests, and the difference in the amount of increase in the measured variables for each group was analyzed using independent t-tests. RESULTS: The experimental group had significantly higher patient safety scores (t = 2.52, p = 0.014) and patient safety perception (t = 2.09, p = 0.040) than those of the control group. However, there was no significant difference between the two groups regarding the willingness to participate in patient safety. CONCLUSION: The patient safety education program developed using mobile tablet PCs could be an effective tool to enhance patient involvement in preventing events that may threaten the safety of patients. Further studies are recommended to develop a variety of educational interventions to increase patient safety knowledge and perceptions of patients and caregivers.

[Analysis of Subgroups with Lower Level of Patient Safety Perceptions Using Decision-Tree Analysis].

PURPOSE: This study was aimed to investigate experiences, perceptions, and educational needs related to patient safety and the factors affecting these perceptions. METHODS: Study design was a descriptive survey conducted in November 2019. A sample of 1,187 Koreans aged 20-80 years participated in the online survey. Based on previous research, the questionnaire used patient safety-related and educational requirement items, and the Patient Safety Perception Scale. Descriptive statistics and a decision tree analysis were performed using SPSS 25.0. RESULTS: The average patient safety perception was 71.71 (± 9.21). Approximately 95.9% of the participants reported a need for patient safety education, and 88.0% answered that they would participate in such education. The most influential factors in the group with low patient safety perceptions were the recognition of patient safety activities, age, preference of certified hospitals, experience of patient safety problems, and willingness to participate in patient safety education. CONCLUSION: It was confirmed that the vulnerable group for patient safety perception is not aware of patient safety activities and did not prefer an accredited hospital. To prevent patient safety accidents and establish a culture of patient safety, appropriate educational strategies must be provided to the general public.

Content Analysis of the Meaning of Spiritual Care as Perceived by Nursing Students.

Purpose: This study aimed to describe the meaning of spiritual care as perceived by nursing students. Methods: This study used a descriptive research design, and the participants were 126 fourth-year nursing students from three nursing colleges. Data were collected from August to September 2019, and were analyzed using the content analysis method. Results: Four themes of spiritual care with 15 sub-themes were extracted from the content analysis 1) "promoting spiritual well-being" (sub-themes "providing religious help", "caring for the patient as a spiritual being", and "presupposing human dignity regardless of religion"); 2) "taking place in actual nursing practice" (representative sub-themes "considering the perspective of the patient", "reducing suffering"); 3) "caring for the multifaceted needs of human beings" (representative sub-themes "providing physical, mental, and spiritual care", "caring for both the mental and physical health of the patient"), and 4) "growing together" (sub-themes "positively affecting patient well-being", "beginning with the nurse's self-transcendence"). Conclusion: These results suggest that nursing students consider spiritual care to be a highly positive and practical form of nursing care. However, because few students have been exposed to religion and spirituality, more systematic training should be provided.

[Development and Validation of the Nurse Needs Satisfaction Scale Based on Maslow's Hierarchy of Needs Theory].

PURPOSE: The purpose of this study was to develop an instrument to evaluate the needs satisfaction of nurses and examine its validity and reliability. METHODS: The initial items for the instrument were developed through a literature review and interviews, using the conceptual framework of Maslow's hierarchy of needs theory. The initial items were evaluated for content validity by 14 experts. Four hundred and eighty-six clinical nurses participated in this study through offline and online surveys to test the reliability and validity of the instrument. The first evaluation (n = 256) was used for item analysis and exploratory factor analysis, and the second evaluation (n = 230) was used to conduct a confirmatory factor analysis and to assess the criterion-related validity and internal consistency of the instrument. Test-retest reliability was analyzed using data from 30 nurses. RESULTS: The final instrument consisted of 30 items with two sub-factors for five needs that were identified through the confirmatory factor analysis. The criterion-related validity was established using the five need satisfaction measures (r = .56). Cronbach's α for total items was .90, and test-retest reliability was .89. CONCLUSION: The findings from this study indicate that this instrument has sufficient validity and reliability. This instrument can be used for the development of nursing interventions to improve the needs satisfaction of clinical nurses.

Anti-cancer effects of disulfiram in head and neck squamous cell carcinoma via autophagic cell death.

BACKGROUND: Disulfiram (DSF), which is used to treat alcohol dependence, has been reported to have anti-cancer effects in various malignant tumors. In this study, we investigated the anti-cancer effects and mechanism of DSF in HNSCC. METHODS: Head and neck squamous carcinoma cell lines (FaDu and Hep2) were used to analyze the anti-cancer effects of DSF. The anti-cancer effects of DSF were confirmed in vivo using a xenograft tumor model. RESULTS: The anti-cancer effects of DSF in HNSCC were found to be copper (Cu) dependent. Specifically, DSF/Cu markedly inhibited HNSCC at a concentration of 1 µM. After DSF/Cu administration, production of reactive oxygen species (ROS) was remarkable starting at 0.5 µM, suggesting that the inhibitory effects of DSF/Cu on HNSCC are mediated through the formation of ROS. The levels of phospho-JNK, phospho-cJun and phospho-p38 were increased after DSF/Cu treatment while levels of phospho-Akt were decreased. These results suggested that the inhibitory effects of DSF/Cu on HNSCC cells involve ROS formation and down-regulation of Akt-signaling. Through these molecular mechanisms, DSF ultimately induce the inhibitory effects on HNSCC cell lines mainly through autophagic cell death, not apoptotic cell death. Lastly, we investigated the clinical relevance of DSF/Cu using a HNSCC xenograft animal model, which showed that tumor growth was remarkably decreased by DSF (50 mg/kg injection). CONCLUSION: In treating patients with HNSCC, DSF may contribute to improved HNSCC patient's survival. The characteristic anti-cancer effects of DSF on HNSCC may suggest new therapeutic potential for this medication in HNSCC patients.

Corrigendum to "Effect of Lead on Human Middle Ear Epithelial Cells".

[This corrects the article DOI: 10.1155/2018/5058729.].

Effect of Lead on Human Middle Ear Epithelial Cells.

Lead is a ubiquitous metal in the environment, but no studies have examined lead toxicity on the middle ear. Here, we investigated lead toxicity and its mechanism in human middle ear epithelial cells (HMEECs). Moreover, we investigated the protective effects of amniotic membrane extract (AME) and chorionic membrane extract (CME) against lead toxicity in HMEECs. Cell viability was analyzed using the cell counting kit, and reactive oxygen species (ROS) activity was measured using a cellular ROS detection kit. After lead(II) acetate trihydrate treatment, mRNA levels of various genes were assessed by semiquantitative real-time polymerase chain reaction. Following treatment with AME or CME after lead exposure, the changes in cell viability, ROS activity, and gene expression were analyzed. Exposure to >100 µg/mL of lead(II) acetate trihydrate caused a significant decrease in cell viability and increased ROS production in HMEECs. Lead exposure significantly increased the mRNA expression of genes encoding inflammatory cytokines and mucins. Administration of AME or CME restored cell viability, reduced ROS activity, and ameliorated mRNA levels. Our findings suggest that environmental lead exposure is related to the development of otitis media, and AME and CME may have antioxidative and anti-inflammatory effects against lead toxicity.

Genome Sequence of a Novel Reassortant and Very Virulent Strain of Infectious Bursal Disease Virus.

Here, we report the complete coding genome sequence of a novel reassortant and very virulent infectious bursal disease virus (IBDV), designated JBN2011. Characterization of the JBN2011 genome suggests that it is a rare recombinant virus having a very virulent IBDV segment A and a Bursine-2-like attenuated IBDV segment B.

Assessment of EGFR mutation status using cell-free DNA from bronchoalveolar lavage fluid.

BACKGROUND: Much attention has been focused on epidermal growth factor receptor (EGFR) mutation testing since the introduction of EGFR-tyrosine kinase inhibitors have improved survival in EGFR-positive lung cancer patients. Liquid biopsy using circulating tumor cells or cell-free DNA (cfDNA) has enabled less invasive testing, but requires a highly sensitive method. To date, liquid biopsy using bronchoalveolar lavage (BAL) fluid has rarely been used. METHODS: From 20 patients with lung adenocarcinoma, we isolated cfDNA from 20 samples of cell-free BAL fluid and 19 cell-free bronchial washing samples. cfDNA was examined for EGFR mutations using peptide nucleic acid (PNA)-mediated PCR clamping method. In cases where the results from the tumor biopsy and BAL-derived cfDNA test were not consistent, PANAMutyper™ R EGFR kit was used along with PNA clamping-assisted fluorescence melting curve analysis. RESULTS: We included 17 patients with advanced stage disease and three with non-advanced stage disease. Tumor biopsy detected EGFR mutations in 12 of the patients. One patient had a p.L858R mutation and a de novo p.T790M mutation. The results from PNA-mediated PCR clamping were 75.0% (9/12) concordant with the tumor biopsy results for EGFR mutation status. PANAMutyper with fluorescence melting curve analysis was performed in three cases, which detected EGFR mutations in two more patients (11/12, 91.7%). EGFR mutations were detected in the cfDNA extracted from two bronchial washing samples. CONCLUSIONS: cfDNA from BAL fluid could be used for molecular testing of EGFR mutations and identification of p.T790M mutations, with an easily applicable method.

[Development and Validation of the Empowerment Scale for Woman with Breast Cancer].

PURPOSE: The purpose of this study was to develop a scale to evaluate empowerment in woman with breast cancer and to examine the validity and reliability of the scale. METHODS: The development process for the initial items included a literature review, interviews, and construction of a conceptual framework. The identified items were evaluated for content validity by experts, resulting in 3 factors and 48 preliminary items. Participants were 319 women with breast cancer recruited to test reliability and validity of the preliminary scale. Data were analyzed using item analysis, confirmatory factor analysis, criterion related validity, internal consistency and test-retest reliability. RESULTS: The final scale consisted of 30 items and 3 factors. Factors, including 'intrapersonal factor' (14 items), 'interactional factor' (8 items), and 'behavioral factor' (8 items), were drawn up after confirmatory factor analysis. Goodness of fit of the final research model was very appropriate as shown by χ²/df=1.86, TLI=.90, CFI=.92, SRMR=.06, and RMSEA=.05. Criterion validity was evaluated by total correlation with the Cancer Empowerment Questionnaire .78. Cronbach's alpha for total items was .93 and test-retest reliability was .69. CONCLUSION: Findings from this study indicate that the scale can be used in the development of nursing interventions to promote the empowerment of women having breast cancer.