Impact of personal protective equipment attached powered air-purifying respirator on nursing-skill performance and psychosocial stress of intensive care unit COVID-19 nurses: A cross-sectional study.

AIM: To investigate how personal protective equipment with an attached powered air-purifying respirator worn by intensive care unit nurses caring for COVID-19 patients in Korea impacts nursing-skill performance and psychosocial stress. DESIGN: A cross-sectional descriptive study was designed using purposive sampling. REVIEW METHODS: Online data collection was conducted from 3 March 2021-20 March 2021on 181 nurses who had worked for more than 1 month in COVID-19 critical care settings wearing personal protective equipment with a powered air-purifying respirator. A structured questionnaire was used to gather data on sociodemographic characteristics, attitude toward personal protective equipment, nursing-skill performance wearing personal protective equipment and psychosocial stress. DATA SOURCES: Data was sourced from structured questionnaire responses. RESULTS: Nursing skill performance decreased to 63.4%, compared with normal performance. Subjects' perceptions and attitudes related to PPE scored 3.56 out of 5; 44.7% of subjects reported severe psychosocial stress, which was significantly affected by attitude toward personal protective equipment usage, nursing performance, experience caring for COVID-19 patients and length of personal protective equipment usage per shift. CONCLUSION: Greater negative attitude toward usage of personal protective equipment with a powered air-purifying respirator, results in lower nursing-skill performance and higher the psychosocial stress of nurses responding to COVID-19 outbreaks. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: High negative attitude toward PPE and low nursing-skill performance due to PPE with an attached PAPR results in significant and debilitating psychosocial stress in ICU nurses responding to COVID-19 outbreaks. To respond effectively to future infectious disease outbreaks and improve nursing performance, minimising the inconvenience and restrictions experienced by nurses wearing personal protective equipment is critical. REPORTING METHOD: We adhered to relevant EQUATOR guidelines to report. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Health-related quality of life among older adults who experienced the Pohang earthquake in South Korea: A cross-sectional survey.

BACKGROUND: Earthquakes are global natural disasters and can cause loss of property, livelihood and affect human health. A 5.4 magnitude earthquake, the Pohang earthquake, occurred in South Korea in 2017. In this study, based on a health-related quality of life (HRQOL) conceptual model, we examined the HRQOL and its associated factors among older adults who had experienced the earthquake. METHODS: A cross-sectional study was conducted with a quota sample of 312 older adults living in eight villages of a district that was the most damaged area during the Pohang earthquake. Data were collected from January 15-March 19, 2019, via face-to-face interviews using structured questionnaires. Structural equation modeling was performed to explore the associations among depression, posttraumatic stress symptoms, community resilience, social support, disaster preparedness, and HRQOL. RESULTS: The mean age of the participants was 77.93 ± 6.11 years. HRQOL scores were 49.85 ± 18.07 (physical health), 50.16 ± 18.75 (psychological health), 61.93 ± 19.20 (social relations), and 49.53 ± 16.37 (environment). The structural equation modeling analysis showed a good fit. Depression had direct (ß = - 2.21; p < 0.001), indirect (ß =- 0.23; p < 0.001), and total effects on HRQOL (ß = - 2.44; p < 0.001). Community resilience (ß = 6.05; p = 0.001) and social support (ß = 0.12, p = 0.001) had direct and total effects on HRQOL. Disaster preparedness had indirect (ß = 0.40; p = 0.001) and total (ß = 0.69, p = 0.031) effects on HRQOL. In contrast, posttraumatic stress symptoms did not have significant effects on HRQOL. CONCLUSIONS: Our findings indicated that lower depression, higher community resilience, social support, and disaster preparedness were associated with increased HRQOL. Thus, it is helpful to decrease depression and strengthen community resilience, social support, and disaster preparedness to promote HRQOL among older adults who have experienced earthquakes. These results can inform the development of HRQOL in socio-psychological improvement programs for older adults in community health centers and disaster-relief psychological support centers.

Influencing Factors of Psychosocial Stress among Korean Adults during the COVID-19 Outbreak.

The restriction of an individual's daily life due to the strengthening of quarantine and lockdown increases psychosocial stress. This study aimed to determine the factors that influence psychosocial stress during a period of strict quarantine and lockdown to curb the COVID-19 pandemic in Korea. A total of 338 adults participated in a cross-sectional online survey conducted from 19-25 May 2020, which measured knowledge of COVID-19, health belief, resilience, and psychosocial stress. According to the results, there was no difference between the participants' scores from the Daegu area (with concentrated confirmed COVID-19 cases) and the non-Daegu area except for health belief. Eighty-two percent of participants constituted the high-risk group for psychosocial stress. Individual resilience was positively correlated with health belief and negatively correlated with psychosocial stress (p < 0.001). Further, the following factors affected the level of psychosocial stress: resilience, subjective health status, and monthly household income, with an explanatory power of 39.8%. Therefore, those with higher subjective health and higher monthly household income experienced higher psychosocial stress, whereas higher resilience indicated lower psychosocial stress.

Correlations between emergency code awareness and disaster nursing competencies among clinical nurses: A cross-sectional study.

AIMS: This study identified clinical nurses' awareness of emergency codes and disaster nursing competencies and investigated the relationships between these variables. BACKGROUND: Nurses are on the front lines of disaster and emergency response; however, they report not feeling confident about their disaster preparedness. METHODS: Participants included 234 nurses working at a general hospital in Korea. Emergency code awareness was measured by recognition of and self-confidence in eight emergency codes, and disaster nursing competencies were measured using the Disaster Nursing Preparedness Response Competency Scale. Data were collected from 17 to 23 October 2019. RESULTS: The recognition rate of emergency codes was 87.4%, whereas the level of self-confidence was 3.30 out of 5. Nurses scored 2.98 out of 5 on disaster preparedness competencies and 3.37 out of 5 on disaster response competencies. Emergency code recognition was positively correlated with self-confidence and disaster nursing competencies (p < .05). CONCLUSION: Higher recognition of emergency codes among clinical nurses was associated with higher self-confidence and disaster nursing competencies. Further studies need to develop strategies to improve nurses' awareness and confidence concerning emergency codes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should pay attention to provide more opportunities for disaster education to improve nurses' self-confidence and disaster nursing competencies.

Effects of cardiopulmonary resuscitation training for Mozambican nursing students in a low-resource setting: An intervention study.

BACKGROUND: There is an increasing incidence of cardiovascular diseases in Africa. Nurses' ability to undertake cardiopulmonary resuscitation (CPR) can significantly impact the survival of patients who experience cardiac arrest. OBJECTIVES: We aimed to identify the effects of CPR training among Registered Nurse-Bachelor of Science in Nursing (RN-BSN) students in Mozambique. DESIGN: A one-group pretest-posttest repeated-measures quasi-experimental design. SETTING: Auditorium of a general hospital and 2 Anne manikins, but no automatic external defibrillator. PARTICIPANTS: Thirty-two RN-BSN students. METHODS: Students' attitudes and self-efficacy on CPR were measured by self-reported questionnaires three times (before, immediately after, and 20 weeks post intervention). Data were analyzed by the paired t-test and repeated-measures analysis of variance. RESULTS: Attitude and self-efficacy scores of students on CPR significantly increased immediately after CPR training, but decreased 20 weeks after the intervention (p < .001). Sociodemographic characteristics did not significantly differ throughout the measurements of attitude or self-efficacy. CONCLUSIONS: CPR manikin training positively affected attitude and self-efficacy in CPR among RN-BSN nursing students immediately, but not at 20 weeks, after the training. There is a need for research to repeatedly quantify parameters in a controlled study at different intervals and develop an instructor-training course customized to Mozambique.

Development and evaluation of a multimodality simulation disaster education and training program for hospital nurses.

AIM: To develop a multimodality simulation program for hospital nurses to enhance their disaster competency and evaluate the effect of the program. METHODS: The program implementation started in October 2016 and ended in December 2016. It was developed using the ADDIE model (analysis, design, development, implementation, and evaluation). Evaluation consisted of formative assessment and summative assessment. Formative assessment was performed during triage, crisis management, and problem-solving simulation programs through direct feedback and debriefing from the teacher. Summative assessment was performed using the Kirkpatrick curriculum evaluation framework. RESULTS: Needs assessment using the modified Delphi survey resulted in these competencies for hospital disaster nursing: triage, incident command, surge capacity, life-saving procedures, and special situations. Each competency was matched with the appropriate simulation modalities. A total of 40 emergency nurses participated in the study program. The evaluation of the program resulted in improvement in perception, crisis management, problem solving, and technical skills in disaster nursing. CONCLUSION: Multimodality simulation training program was developed to enhance the competency of hospital nurses in disaster response. All participants improved their disaster response competencies significantly. The program that was developed in this study could be used as a fundamental tool in future research in disaster curriculum development.

Effects of a simulation-based education program for nursing students responding to mass casualty incidents: A pre-post intervention study.

BACKGROUND: The necessity of disaster preparedness among nursing students has been continuously emphasized. OBJECTIVES: This study aimed to verify the effectiveness of a simulation-based education program for nursing students responding to mass casualty incidents (MCI) from the perspectives of triage accuracy, response attitude, teamwork, and program satisfaction. DESIGN: This study employed a pre-post intervention design. SETTINGS: Disaster Simulation Lab and a debriefing room in the University Nursing Simulation Center in South Korea. PARTICIPANTS: The participants were 34 graduating nursing students attending a university in Seoul. METHODS: The program consisted of lectures on disaster nursing, group discussions, practice, debriefings, and a pre- and post-test, conducted over 180 min. Simulation-based training was conducted using the Emergo Train System®. The simulation environment comprised pre-hospital and hospital sections, with videos displayed on a large screen and sound effects played on loudspeakers. RESULTS: Participants were likely to undertriage. There was a significant increase in positive attitudes after the intervention (p < .001). Self-reported teamwork was high, and among its subfactors, "leadership and team coordination" scored the highest. Participants' satisfaction with the program was high (4.5/5.0). CONCLUSIONS: The simulation-based MCI program was effective in boosting positive attitudes among nursing students. In future, comparative studies including control groups and different instructional methods should be conducted. A patient bank should also be developed considering participants' knowledge levels and the circumstances of each country.

Mediating role of post-traumatic stress disorder in post-traumatic growth in adults who experienced the 2017 Pohang earthquake.

BACKGROUND: The largest earthquake recorded in Korea occurred in Pohang in 2017. This study aimed to investigate the mediating role of post-traumatic stress disorder (PTSD) on the relationship between earthquake exposure level and post-traumatic growth (PTG) in adults who experienced the earthquake. METHODS: We used a cross-sectional survey via convenience sampling to collect data from 200 respondents 18 months after the earthquake. RESULTS: PTSD was severe in individuals who were married, had no religious affiliation, lower income, and higher earthquake exposure. PTG was higher in older, married, and more religious respondents. PTSD and PTG had a positive relationship, with PTSD fully mediating the relationship between earthquake exposure level and PTG. LIMITATIONS: The Pohang earthquake, with limited damage to life and property, may have had different effects on exposed individuals than more destructive earthquakes. Additionally, this study used the Korean version of the Posttraumatic Growth Inventory; most of the participants reporting a religious affiliation were Christians, which may have affected the results. CONCLUSIONS: Exposure to the Pohang earthquake was strongly associated with PTSD, which indirectly affected PTG. Future research should focus on developing an adequate PTG tool for natural disaster victims, more extensively investigating PTSD and PTG, and analyzing PTSD and PTG in terms of the disaster type.

Effects of Audio-Visual Stimulation on Hand Hygiene Compliance among Family and Non-Family Visitors of Pediatric Wards: A Quasi-Experimental Pre-post Intervention Study.

PURPOSE: This study aimed to identify the differences in interventional effects on hand hygiene compliance (HHC) among families and visitors in pediatric wards. DESIGN & METHODS: A total of 2787 family and non-family visitors entering through the glass sliding door of 6 pediatric wards at a university children's hospital were observed for 4 h, respectively, before and after interventions between April 27 and May 20, 2018. In the first intervention, a visual stimulus emphasized the location of the hand sanitizer. In the second intervention, an additional auditory stimulus transmitted a cue through a motion sensor speaker. RESULTS: During the preliminary observation, the HHC rates of family and non-family visitors were 0.0% and 1.5%, respectively; after the visual stimulus, they were 0.6% and 5.4%, and after the audio-visual stimulus, 1.8% and 8.2%. There was a significant increase in the overall HHC with the visual (OR, 5.22; 95% CI, 1.76-20.90) and audio-visual (OR, 8.67; 95% CI, 3.08-33.70) stimuli (Fisher's exact test, p < .05). CONCLUSIONS: The HHC of family and non-family visitors entering pediatric wards was very low and the audio-visual stimulus was found to be more effective than was the visual stimulus alone. PRACTICE IMPLICATIONS: To reduce healthcare-associated infection, pediatric wards must actively implement effective interventions. Using audio-visual stimulation to increase HHC among visitors will provide advantages. Follow-up research should examine the current state of HHC among visitors in various locations and conditions.

Difficulties faced by Korean disaster relief workers while providing humanitarian aid: A descriptive study.

The aim of the present study was to identify difficulties experienced by Korean disaster relief workers during humanitarian aid deployment. A convenience sample of disaster relief workers aged >18 years, who had been dispatched to an overseas disaster site, were recruited; 107 relief workers completed the Humanitarian Aid Difficulty Scale that consists of 23 items comprising five factors. The average difficulty rating was 2.64 on a five point scale. By item, participants gave the highest scores for bathroom use and the lowest scores for cooperation among team members. By factor, infrastructure was rated as the greatest difficulty, followed by health conditions, goods and equipment, culture and customs, and cooperation. Considering sociodemographic characteristics, there were significant age differences in the culture and customs factor, as well as significant occupation differences in the cooperation, culture and customs, and goods and equipment factors. These findings highlight the need to improve the welfare of workers. It is recommended that further research be conducted according to occupation and with repeated measurement prior to, in the middle of, and after deployment of relief workers.

International Nursing: Needs Assessment for Training in Disaster Preparedness for Hospital Nurses: A Modified Delphi Study.

Despite high awareness of the need, opportunities for nurses to gain disaster experience or training are limited. In Korea, most disaster training is done in an undergraduate curriculum where there is very limited practice, and the educational topics are mostly focused on the field aspect of disaster events. The purpose of this study was to determine the need for such training for hospital nurses and to determine appropriate and relevant components of the training contents. A qualitative survey approach using the modified Delphi method was used to collect and analyze the data. The surveys were conducted in 3 rounds. After the results were analyzed from the third-round survey, the authors finalized the contents for a training program to prepare nurses for their roles during disasters. Through a structured needs analysis using a modified Delphi survey, the framework for the content development of disaster training curriculum for hospital nurses was developed.

Perceptions of hospital emergency color codes among hospital employees in Korea.

INTRODUCTION: Hospital emergency codes frequently comprise of colors to prevent confusion and enhance prompt response to emergency situations. The purpose of this study was to identify perceptions of emergency color codes among hospital employees in Korea. METHODS: A 12-color spectrum and emergency situations were selected from the standardized emergency color codes used in the US and Canada. Participants were selected via convenience sampling from four general hospitals in Seoul and Gyeonggi-Do. Between October 25 and November 30, 2016, 295 questionnaires were distributed and 266 of them were analyzed. RESULTS: The participants showed the highest consistency in the association between emergency images related to colors and emergency code color images associated with emergency situations in the following cases: "red for fire," "blue for adult cardiopulmonary resuscitation (CPR)," "yellow for pediatric CPR," "orange for external disaster," "pink for infant/child abduction," "white for deactivation," and "black for violent/combative person." Meanwhile, the most confusing colors were purple, gray, and silver. Hospital employees tended to select colors that matched the emergency codes used in their respective hospitals. CONCLUSIONS: The four colors of "red," "blue," "pink," and "white," were strongly associated with "fire," "cardiac arrest," "infant/child abduction," and "emergency deactivation," respectively. The use of four colors for hospital emergency code standardization domestically in Korea is recommended.

[Health literacy and health status of Korean-Chinese elderly people living in Yanbian, China].

PURPOSE: This descriptive study was done to identify the relationship between health literacy and health status and to provide basic data for developing nursing interventions for Korean-Chinese elders living in Yanbian, China. METHODS: For data collection, intentional sampling of 300 elders was used. The questionnaire was composed of 5 items based on "Ministry of Health, the People's Republic of China (2008)" to measure health literacy, 33 health status items from the "Korean Health Status Measure for Elderly People" developed by Shin (2002), revised for use in China, and 9 general characteristics. Data were analyzed using SPSS Win 13.0 program. RESULTS: Total level of health literacy was relatively high (68.7%). Elders had high scores for taking medicines according to doctor's instruction, but lower ones for full comprehension through communication with doctors. Health status was high for emotional, physical, and social function in that order. There were significant differences between general characteristics and health status for gender, age, marital status, education, family, smoking, and alcohol consumption in that order. Results of multiple regression analysis for factors influencing health status showed that self-report health level was the most influential, followed by health literacy, age, gender. CONCLUSION: Health literacy is the main factor affecting health promotion among minority elders indicating a need to develop health promotion programs for elders who have low health literacy.