Factors associated with health-related quality of life on mental and oral health in patients with cancer and cancer survivors using the Korea National Health and Nutrition Examination Survey (2005-2018).

Objective: To investigate the association of mental and oral health with the health-related quality of life (HRQOL) in patients with cancer and cancer survivors. Methods: This cross-sectional study involved 1643 patients with cancer and 1628 individuals who survived cancer (aged ≥ 19 years) using data from the 2005-2018 Korean National Health and Nutrition Examination Survey. The data were analyzed using SAS survey procedures (version 9.4), t-tests, χ2 test, and multiple regression. Results: Regarding differences in mental and oral health factors by group, the results revealed significant differences between depression, suicidal ideation, subjective oral health, chewing problems, and speaking problems due to oral issues. The HRQOL of patients with cancer was lower than that of cancer survivors. The factors influencing HRQOL in both patients with cancer and cancer survivors were education status, economic activity, subjective health, suicidal ideation, and speaking problems due to oral issues. HRQOL was also associated with depression in patients with cancer. Conclusions: Patients with cancer had a lower HRQOL than cancer survivors. The two groups of patients showed significant differences in the factors associated with HRQOL. Therefore, customized health programs and policies should be developed and implemented for each group to improve their QOL.

Nursing students' clinical practice education experience during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Nursing education, including some elements of clinical practice, has largely been conducted online during the coronavirus disease 2019 (COVID-19) pandemic. Numerous studies have examined the experiences of nursing students in academia during the pandemic. However, research on nursing students' clinical practice experiences is limited. This study aimed to analyze nursing students' clinical practice experiences during the COVID-19 pandemic. METHODS: This study used a qualitative research design and performed thematic analysis. Participants comprised 13 nursing university students with clinical practice experience at a hospital during the COVID-19 pandemic. Interviews were conducted either online or face-to-face. Data were collected during June‒July 2021. RESULTS: Four themes and eight subthemes were generated through thematic analysis. Theme 1 was "Nursing students' anxiety and strict adherence to quarantine practices," with the subthemes of "Fear of infection" and "Protecting themselves." Theme 2 was "Nursing students' belief that their organization is protecting them," with the subthemes of "Strict quarantine rules at hospitals and universities" and "The nursing students regretted the limited scope of practice but felt safe." Theme 3 was "Learning through valuable practice," with the subthemes of "Recognizing the importance of practice" and "Realizing the benefits of practice." Theme 4 was "A sense of duty as a prospective nurse," with the subthemes of "Accepting a sense of duty as a nurse" and "Establishing the expanded role of a nurse." CONCLUSIONS: The nursing students recognized the importance of nursing practice during the pandemic and worked harder. A better understanding of the experiences of nursing university students who completed their clinical practice during the COVID-19 pandemic can help nursing professors and managers more effectively train students during times of high stress.

Exploring factors influencing health-related quality of life in adult females with injuries: a cross-sectional nationwide study.

Objectives: This study aimed to identify the types of injury experiences affecting adult females and the associations between injury experiences and health-related quality of life. Methods: This study used a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey, which employed a stratified multistage probability sampling design to obtain nationally representative data. Health-related quality of life was measured with the EuroQol Five-Dimension and consisted of mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Results: Among women aged 19-64, the prevalence of injury experience was 5.9%. Women's injury experience varied by age, subjective health perception, menstruation details, osteoporosis status, and osteoarthritis status. The following injury experience-related factors were significantly associated with health-related quality of life: self-care (odds ratio [OR] = 0.32, 95% confidence interval [CI]: 0.17-0.60), usual activity (OR = 0.43, 95% CI: 0.27-0.70), and pain/discomfort (OR = 0.56, 95% CI: 0.44-0.72). Conclusion: Health-related quality of life among adult women was significantly associated with injury experience. The results of this study highlight risk factors for injury that are associated with aging, such as menopause, osteoporosis, and osteoarthritis. Accurate assessments of pain and discomfort, as well as daily activities, are essential for designing effective interventions for injured women. Tailored training and education can promote self-management and improve outcomes for recovery.

Health-related quality of life in older women with injuries: a nationwide study.

Objectives: This study aims to describe the health-related quality of life (HRQoL) and influencing factors of older women who experienced injuries. Methods: This study is a secondary analysis of data from 4,217 women aged 65 years or older sampled from the Korea National Health and Nutrition Examination Survey (KNHANES) (2016-2020) database. Two-way analysis of variance was used to analyze the data. Results: The mean HRQoL scores of older women with and without injuries were 0.81 ± 0.19 (n = 328) and 0.85 ± 0.17 (n = 3,889), respectively, which were significantly different (p < 0.001). The results of multiple regression analysis revealed that working, physical activity, BMI, osteoarthritis, stress, and subjective health status significantly affected the HRQoL of older women with injuries, and the explanatory power of the model was 29%. Conclusion: The results of this study on factors affecting HRQoL can contribute to the understanding of the experience of older women with injuries and can be used as a reference to develop health promotion programs.

Nurses' duty to care during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: Despite the increased demand for nurses worldwide, discussion of nurses' duty to care is lacking. This study aimed to examine nurses' duty to care during the coronavirus disease 2019 (COVID-19) pandemic and to identify the influencing factors. METHODS: This was a cross-sectional descriptive research study that used a structured online questionnaire. Registered Korean nurses answered a demographic questionnaire and the Nash Duty to Care Scale. RESULTS: Age and employment at tertiary hospitals increased nurses' duty to care. Male sex, a highly educated status, and employment at tertiary hospitals increased the perceived risk. Male sex and employment at tertiary or general hospitals increased confidence in the employer, while a high level of education and a longer total clinical career decreased the same. Age and a higher monthly wage increased perceived obligation. Age, lack of religious beliefs, and clinical experience of 3-7 years increased professional preparedness. CONCLUSION: Without enough nursing manpower, the disaster response system could prove to be inefficient. Considering that adequate nurse staffing is essential in disaster management, it is crucial to ensure that nurses have a will to provide care in the case of disaster. In the future, a more active discussion on nurses' duty to care and additional research on factors that may hinder and facilitate the same are needed.

Health Risk Behaviors Affecting Internet Usage in Adolescents: Evidence from the 2018 Korea Youth Risk Behavior Web-Based Survey.

Background: The purpose of this cross-sectional study was to assess the effects of health risk behaviors on the daily Internet usage of Korean high school students. Methods: The data of 19,830 high school students who responded to the Korea Youth Risk Behavior Web-based Survey were analyzed from June to July 2018. Results: The mean daily Internet usage of high school students was 193.3±125.7 minutes. There were differences in daily Internet usage according to body mass index, grade level, school type, academic achievement, economic status, physical activity, number of physical education classes attended, safety accidents, and safety education (p<.05). Daily Internet usage also differed according to health risk behaviors, including smoking (t=8.32), alcohol consumption (t=9.36), drug use (t=4.51), and risky sexual behaviors (t=5.94). The daily Internet usage of students significantly increased in the absence of physical activity and with health risk behaviors such as smoking, alcohol consumption, drug use, and risky sexual behaviors. Conclusion: It is necessary to develop an intervention program and provide education on increasing physical activity and reducing health risk behaviors for the proper management of health and Internet usage in adolescents.

Influence of AI ethics awareness, attitude, anxiety, and self-efficacy on nursing students' behavioral intentions.

BACKGROUND: Artificial intelligence (AI) technology has recently seen rapid advancement, with an expanding role and scope in nursing education and healthcare. This study identifies the influence of AI ethics awareness, attitude toward AI, anxiety, and self-efficacy on nursing students' behavioral intentions to use AI-based healthcare technology. METHODS: The participants included 189 nursing students in Gyeonggi-do, with data collected from November to December 2021 using self-reported questionnaires. We analyzed the data using the SPSS/WIN 26.0 program, including a t-test, Pearson's correlation coefficient, and hierarchical multiple linear regression. RESULTS: The results revealed that AI ethical awareness (t = - 4.32, p < .001), positive attitude toward AI (t = - 2.60, p = .010), and self-efficacy (t = - 2.65, p = .009) scores of the third and fourth-year nursing students were higher, while their anxiety scores were lower (t = 2.30, p = .022) compared to the scores of the first and second-year nursing students. The factors influencing behavioral intention included a positive attitude toward AI (ß = 0.58) and self-efficacy (ß = 0.22). The adjusted R2 was 0.42. CONCLUSION: It is necessary to inculcate a positive attitude toward AI and self-efficacy by providing educational programs on AI-based technology in healthcare settings.

Nursing students' intent to use AI-based healthcare technology: Path analysis using the unified theory of acceptance and use of technology.

BACKGROUND: Marked advances in artificial intelligence (AI)-based technologies throughout industries, including healthcare, necessitate a broader understanding their use. Particularly, intent to use AI-based healthcare technologies and its predictors among nursing students, who are prospective healthcare professionals, is required to promote the utilization of AI. OBJECTIVE: This study conducted a path analysis to predict nursing students' intent to use AI-based healthcare technologies based on the unified theory of acceptance and use of technology. DESIGN: A cross-sectional survey was performed. PARTICIPANTS: The participants were 210 nursing students from two nursing schools in Korea. METHODS: This study established hypothetical paths for the influence of performance expectancy, effort expectancy, social influence, facilitating conditions, self-efficacy, and anxiety on intent to use AI-based technologies. Mediation of positive and negative attitudes and facilitating conditions' direct effects on intent to use were examined. RESULTS: Positive attitude toward AI (ß = 0.485, p = .009) and facilitating conditions (ß = 0.117, p = .045) predicted intent to use, whereas the path from negative attitude to intent to use was not significant. Performance expectancy, self-efficacy, and effort expectancy predicted positive attitude. Performance expectancy and self-efficacy had a negative effect on the path to negative attitude, whereas anxiety had a positive effect. Facilitating conditions did not significantly predict positive or negative attitude and only directly predicted intent to use. Social influence did not have a significant effect on intent to use. CONCLUSIONS: Intervention programs and other measures should be developed to provide education and information to boost performance expectancy, effort expectancy, facilitating conditions, and self-efficacy regarding the use of AI to lower anxiety and foster positive attitude toward AI-based health technologies.

Impact of Internet usage time on mental health in adolescents: Using the 14th Korea Youth Risk Behavior Web-Based Survey 2018.

Dependency on the Internet in daily life is increasing, and the negative consequences this dependence may have on mental health are not sufficiently understood. The aim of this study was to investigate the relationship between Korean adolescents' Internet usage time and their mental health. This cross-sectional study included 29,811 high school students ages 16-18 from the 2018 Korea Youth Risk Behavior Web-Based Survey. Participants' mean Internet usage time was 193.4±1.6 min/day. Internet usage time was associated with sex, grade level, type of school, living arrangement, economic status, academic achievement, and experience of school violence. With regard to mental health, subjective health status, stress, feelings of sadness, and suicidal ideation were also related to Internet usage time. The group with more than average Internet usage had poorer subjective health, higher level of stress, and had feelings of sadness and suicidal ideation compared to the group with less than average Internet usage. To effectively manage Internet usage time, interventions to lower Internet usage and leisure programs that could replace Internet usage need to be developed.

Mental Health and Handgrip Strength Among Older Adults: A Nationwide Study.

Handgrip strength is used as an important indicator of health in older adults. We aimed to explore the association between stress, depression, and suicidal ideation and handgrip strength among older adults. We conducted this cross-sectional study involving 1254 individuals (aged ≥65 years), using data from the 2015 Korean National Health and Nutrition Examination Survey VI. We used logistic regression analysis to examine associations between handgrip strength and mental health. Among mental health factors, a significant difference was noted between stress and handgrip strength among the older adults. After adjusting for confounding factors, the odd ratio (OR) of stress among older adults with low handgrip strength was statistically significant in Models 1 (1.61 (95% CI: 1.01-2.57)) and 2 (1.59 (95% CI: 1.01-2.52)) but not in Model 3 (1.52 (95% CI: .96-2.43)). No significant association was found between depression or suicidal ideation and handgrip strength. The risk of stress was 1.59-1.61 times higher in older adults with low handgrip strength, compared to that in older adults with normal handgrip strength. It is necessary to develop strategies aimed at managing stress among older adults with low handgrip strength and educating them about the importance of handgrip strength and exercises that increase handgrip strength.

Influence of smartphone addiction and poor sleep quality on attention-deficit hyperactivity disorder symptoms in university students: a cross-sectional study.

Objective: This study examined the relationship between attention-deficit hyperactivity disorder ((ADHD)) symptoms, smartphone addiction, and poor sleep quality in university students, and identified factors affecting ADHD symptoms. Participants: Data were collected from 197 students from March to June 2017. Methods: We adopted a descriptive cross-sectional study design. Results: ADHD symptoms were positively correlated with smartphone addiction (r = .424, p < .01) and poor sleep quality (r = .313, p < .01). The regression analysis showed that academic achievement (ß =.128, p = .038), smartphone addiction (ß =.327, p < .001), sleep disturbance (ß = .197, p = .003), and daytime dysfunction (ß = .269, p < .001) were identified as factors significantly influencing ADHD symptoms, accounting for 31.1% of their variance. Conclusions: Interventions for university students with ADHD symptoms should involve the evaluation of these four factors as a multifaceted approach to reducing ADHD symptoms.

Differences in Health-Related Quality of Life of Adults with Cardiovascular or Metabolic Diseases Compared to the General Population.

BACKGROUND: We aimed to compare demographic, health-related characteristics, and quality of life between adults with cardiovascular or metabolic diseases and the general population. METHODS: Data from 25,712 adults assessed on the Korea National Health and Nutrition Examination Survey V & VI (2010-2013) were analyzed for differences in health-related quality of life. RESULTS: The corrected EuroQol-5 Dimension score mean among participants with cardiovascular or metabolic diseases was significantly lower than for the general population across all five dimensions (P<0.001). Individuals with cardiovascular disease had lower quality of life than those with metabolic diseases. CONCLUSION: Adults with cardiovascular or metabolic diseases reported lower health-related quality of life in all domains when compared to adults in the general population. Therefore, interventions and management to improve quality of life among patients with cardiovascular or metabolic diseases are necessary.

Self-efficacy, post-traumatic growth, and quality of life of pediatric cancer survivors: A cross-sectional study.

PURPOSE: This study explored the relationships among self-efficacy, post-traumatic growth, and quality of life in a sample of pediatric cancer survivors and analyzed the factors associated with quality of life in pediatric cancer survivors. METHOD: A questionnaire assessed self-efficacy, post-traumatic growth, and health-related quality of life. Data were collected from December 2017 to December 2018 at a hospital in Seoul, South Korea from 115 pediatric cancer survivors. RESULTS: Health-related quality of life showed significant positive correlations with general self-efficacy and social self-efficacy, but did not significantly correlate with post-traumatic growth. Factors that significantly influenced health-related quality of life were current age (ß = 0.24, p = .007), currently not attending school (ß = -0.19, p = .029), having many uncomfortable symptoms (ß = -0.26, p = .006), some daily life difficulties (ß = -0.23, p = .015), general self-efficacy (ß = 0.17, p = .043), and social self-efficacy (ß = 0.32, p = .001). This model explained 50% of the variance in self-reported health-related quality of life. CONCLUSION: Health-related quality of life in pediatric cancer survivors was not associated with post-traumatic growth. However, high health-related quality of life was related to being older, attending school, lacking uncomfortable symptoms and difficulties in daily life, and having high self-efficacy. Interventions may improve health-related quality of life in pediatric cancer survivors if they increase self-efficacy, reduce uncomfortable symptoms and difficulties in daily life and for children who are survivors of cancer, and encourage maintaining school life.

Factors associated with post-traumatic growth in male patients with rectal cancer: A cross-sectional study.

PURPOSE: This study investigated the major functional issues experienced by male patients with rectal cancer, including fecal function, sexual function, and social support and how they relate to post-traumatic growth. Factors that can be associated with post-traumatic growth were also identified. METHODS: A questionnaire was administered to 143 male patients with rectal cancer receiving either treatment at a national cancer center or post-therapeutic follow-up in outpatient clinics, from February 18 to May 22, 2020. In addition to questions relating to patients' characteristics, the questionnaire included measures of fecal function, sexual function, social support, and post-traumatic growth. RESULTS: Post-traumatic growth showed a weak to moderate positive correlation with both sexual function and social support. Moreover, an analysis of the factors associated with post-traumatic growth showed that religion, marital status, and social support were statistically significant; these factors explained 22% of the variance in post-traumatic growth. CONCLUSIONS: Post-traumatic growth in male patients with rectal cancer can be associated with psychosocial factors, such as religion and social support, rather than physical functions, such as fecal function and sexual function. Interventions to enhance social support for men who are single or non-religious could promote post-traumatic growth in male patients with rectal cancer.

Mental Health Status of Adults with Cardiovascular or Metabolic Diseases by Gender.

This study aimed to compare mental health in people with cardiovascular or metabolic diseases and the general adult population in each gender. Cardiovascular and metabolic diseases affect mental health, and the prognosis and incidence rates of these diseases differ by age. To date, studies comparing mental health in adults with cardiovascular or metabolic diseases by gender and with the general population have been insufficient. This work is a cross-sectional study. Data from 9828 men and 13,389 women aged 19 years or older from the Korea National Health and Nutrition Examination Survey V and VI (2010-2013) were used. Men and women with cardiovascular diseases showed high risks of stress, depression, and suicidal ideation. Men with metabolic diseases had worse mental health in relation to depression and suicidal ideation, and women with metabolic diseases in relation to stress and depression, indicating a need for intervention and management of mental health by gender for these individuals. There is a need to develop a clear perception and understanding, both among practitioners and the general population, of mental health issues associated with having cardiovascular or metabolic diseases. Active, specific health improvement and training programmes considering gender differences are necessary.

Factors influencing posttraumatic growth in ovarian cancer survivors.

PURPOSE: The purpose of this study was to examine posttraumatic growth (PTG), cancer coping, posttraumatic stress, and genetics knowledge among ovarian cancer survivors and to identify factors affecting PTG. METHODS: This cross-sectional study included 148 outpatient ovarian cancer survivors at a cancer center. Data were collected between February 25 and April 11, 2019, and were analyzed using t tests, ANOVA, Pearson-correlations, and multiple regression. RESULTS: On average, the ovarian cancer survivors scored 68.09 ± 20.17 in PTG, 59.75 ± 13.37 in cancer coping, 29.30 ± 17.25 in posttraumatic stress, and 9.42 ± 3.33 in genetics knowledge. There were significant differences in PTG according to religion (t = - 2.92, p = .004), marital status (F = 3.06, p = .050), and family history of cancer (t = 2.00, p = .047). In the final analysis, the statistically significant factors influencing PTG were religion (ß = .170, p = .004) and cancer coping (ß = .691, p < .001), and posttraumatic stress had borderline statistical significance (ß = - .107, p < .068). These factors explained 52.2% of the variance in PTG. CONCLUSIONS: Ovarian cancer survivors showed a moderate level of genetics knowledge while having a high risk for posttraumatic stress. Overall, this study showed that cancer coping was a powerful factor that influenced PTG in ovarian cancer survivors. Religion was found to positively affect PTG, and posttraumatic stress had a small negative effect. Spiritual nursing interventions and improving cancer coping while reducing posttraumatic stress are necessary to increase the PTG of ovarian cancer survivors.

Sex-Associated Differences in the Handgrip Strength of Elderly Individuals.

This study aimed to identify sex-specific factors associated with handgrip strength in elderly individuals. The analysis cohort comprised 1,197 men and 1,384 women aged ≥65 years. In men, factors associated with low handgrip strength included advanced age; low body mass index; low frequency of performing flexibility exercises; limited self-care ability (which is a measure of the health-related quality of life); and the presence of diabetes, stroke, or osteoporosis (R² = 0.285, F = 7.52, p < .001). In women, the factors included advanced age, low body mass index, low frequency of performing muscle strengthening exercises, stress, and osteoarthritis (R² = 0.225, F = 4.17, p < .001). Effective health-promoting interventions for elderly individuals require the development of individualized programs that enhance handgrip strength while considering sex-related factors.

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students.

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March-May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.

Impact of emotional labour and workplace violence on professional quality of life among clinical nurses.

AIM: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. BACKGROUND: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. METHODS: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. RESULTS: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. CONCLUSIONS: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational-level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed.

Prevalence of irregular menstruation according to socioeconomic status: A population-based nationwide cross-sectional study.

Irregular menstruation is an important indicator of current and potential health problems. A woman's health is greatly influenced by her socioeconomic status. The purpose of this study was to examine the prevalence of irregular menstruation by socioeconomic status among South Korean women. Secondary data analyses were conducted among 4,709 women, aged 19-54 years, using raw data from the Korea National Health and Nutrition Examination Survey V (2010-2012), a nationally representative survey. Compared to women who graduated from university, the adjusted odds ratios (95% confidence intervals) for those who graduated from elementary school or lower, middle school, and high school were 3.256 (1.969-5.385), 2.857 (1.866-4.376), and 1.607 (1.261-2.048), respectively. Compared to women with a medium-high income level, the adjusted odds ratio (95% confidence interval) for women with the highest household income level was 1.409 (1.091-1.819). Irregular menstruation was prevalent among adult women and appeared to be associated with socioeconomic status, especially in terms of education and household income. This study's findings suggest that attention must be paid to women with low educational levels or high household incomes, to ensure early diagnosis and the provision of medical attention for irregular menstruation.