Mediating Effect of Digital Information Utilization Ability and Interpersonal Contact on the Relationship between Cognitive Function and Depression in Korean Older Adults.

Background: As Korea rapidly enters a super-aged society, interest in depression, a change in psychological function that occurs with aging, is increasing. Although previous studies have suggested a relationship between depression and cognitive decline in older adults, they have not clarified how cognitive decline leads to depression. We aimed to examine the mediating effects of digital information utilization ability (DIUA) and interpersonal contact (IC) in the relationship between cognitive function and depression in older adults. Methods: This descriptive cross-sectional study used data from the 2020 Korean Elderly Survey. The participants were 9,920 seniors aged 65 years and older. Descriptive statistics, t-test, and one-way ANOVA correlation analysis were performed using SPSS 24.0 and the dual mediation effect was analyzed using PROCESS Macro for SPSS v.3.5 model 6. Results: Depression had a negative correlation with cognitive function (r=-.26, P<.001), DIUA (r=-.20, P<.001), and IC (r=-.13, P<.001). Cognitive function was positively correlated with DIUA (r=.40, P<.001) and IC (r=.08, P<.001). There was a positive correlation between DIUA and IC (r=.10, P<.001). Finally, the mediating effect of cognitive function on depression through the dual parameters of DIUA and IC was also statistically significant (B=.-001, 95% CI [-.002, -.001). Conclusion: The depression caused by cognitive decline can be reduced by improving older adults' ability to use digital information and interact with others. Therefore, social interventions to increase the interpersonal contact of older adults is required, and education programs for improving older adults' ability to utilize digital information may be developed to increase indirect contact using digital devices as well as direct contact.

Physical Leisure Activities in Adolescents with Disabilities: Data from National Survey of Disabled Persons.

The impact of activities of daily living (ADLs) on the life satisfaction of adolescents with disabilities and the potential role of physical leisure activities as a moderator in this context have received attention. However, little is known about the influence of physical leisure activities on the relationship between ADLs and life satisfaction in adolescents with disabilities. This cross-sectional study aimed to investigate the moderating effect of physical leisure activities on the relationship between ADLs and life satisfaction among adolescents with disabilities. Secondary data analysis was conducted by extracting data from 5364 adolescents aged 12-18 years with disabilities from the 2020 National Survey of Disabled Persons of Korea. The potential moderating effect of physical leisure activities on the relationship between ADLs and life satisfaction was investigated using Pearson's correlation analysis and hierarchical multiple regression. Significant positive correlations were found for living, life satisfaction, and physical leisure activities. Physical leisure activities were found to play a moderating role in the relationship between ADLs and life satisfaction. This study concluded that increasing physical leisure activities, even with dependent ADLs, promotes life satisfaction, especially if ADLs are low, highlighting the necessity of increasing leisure activities in adolescents with disabilities.

The Mediating Role of Acceptance Action and Self-Care in Diabetes Self-Stigma's Impact on Type 2 Diabetes Quality of Life: A Cross-Sectional Study.

Recently, the quality of life of individuals with diabetes has been reduced, owing to self-stigma that occurs in the process of managing the disease. This process can be improved by accepting diabetes. This study aimed to verify the dual mediating effect of acceptance action and diabetes self-care on the effect of diabetes self-stigma on the quality of life of individuals with type 2 diabetes mellitus (T2DM) in Korea. In this study, 300 of 400 data collected to develop and evaluate health equilibrium tools for individuals with T2DM were randomly selected and analyzed. Data were collected from 1 September 2020 to 31 September 2020 using a structured online questionnaire. For data analysis, descriptive statistics and Pearson's correlation analysis were performed using the Statistical Package for the Social Sciences (SPSS), version 24.0. Additionally, the dual mediation effect was analyzed using PROCESS Macro for SPSS, version 4.1. Acceptance action (B = -0.088, 95% confidence interval [CI], -0.127 to -0.054) and diabetes self-care (B = 0.046, 95% CI, 0.022-0.072) had a mediating effect on the relationship between diabetes self-stigma and quality of life in patients with T2DM in Korea. In particular, these two variables had dual mediating effects (B = 0.017, 95% CI, 0.015-0.019). This study confirmed that diabetes self-care and quality of life can be increased by improving acceptance behavior to overcome the negative impact of self-stigma on the quality of life of patients with T2DM. Establishing a strategy to increase acceptance action as part of an intervention to reduce the negative impact of self-stigma on the quality of life of patients with T2DM is necessary.

The Mediating Effect of Experiential Avoidance on the Relationship between Diabetes Distress and Self-Stigma in People with Diabetes Mellitus Type 2 in Republic of Korea.

This descriptive study aimed to explore the mediating role of experiential avoidance in the association between diabetes distress and self-stigma in Korean patients with diabetes mellitus type 2. The study included 196 participants with diabetes mellitus type 2, diagnosed by an endocrinologist. Data were collected from 20 September to 31 September 2021, using an online self-report questionnaire focusing on diabetes distress, diabetes self-stigma, and experiential avoidance. For the mediating effect analysis, a three-step hierarchical multiple analysis was performed using SPSS, and the mediating effect was verified using SPSS PROCESS Macro. The findings revealed that the average scores for diabetes distress, self-stigma, and experiential avoidance were 3.01 ± 0.66, 2.57 ± 0.82, and 3.65 ± 0.55, respectively. Positive correlations were observed among diabetes distress, self-stigma, and experiential avoidance. Specifically, experiential avoidance partially mediated the relationship between diabetes distress and self-stigma, accounting for 47.7% of the variance. These findings reveal that it is crucial to focus on countering experiential avoidance to assist patients with diabetes mellitus type 2 in overcoming the self-stigma and distress related to their condition. In addition, it is necessary to develop a gradual and tailored program aimed at reducing experiential avoidance.

Validity and Reliability of the Korean Version of the Weight Self-Stigma Questionnaire (WSSQ-K).

Weight self-stigma refers to negative self-prejudice due to the internalization of negative social messages about one's weight. People with high self-stigma may have low self-esteem and decreased social activity. Weight-related self-stigma can create diet-related disorders since it is highly related to the recognition of body types. However, there are no tools available to measure the weight-related stigma of the general public in Korea. This study evaluated the validity and reliability of the Korean version of the Weight Self-Stigma Questionnaire (WSSQ-K). A methodological study was conducted with 150 Korean university students. Construct validity was evaluated using exploratory factor analysis. The WSSQ-K was correlated with body mass index and measures of self-esteem and weight concern to evaluate concurrent validity. Internal consistency reliability was evaluated with Cronbach's alpha. In the exploratory factor analysis, two factors were proposed: "self-devaluation" (Cronbach's α = 79) and "fear of enacted stigma" (Cronbach's α = 82). Factor loadings for the 12 items on two factors ranged from 0.539 to 0.811, which explained 53.3% of the total variance. The WSSQ-K correlated with body mass index, self-esteem, and weight concern. The findings showed that the WSSQ-K was a reliable and valid measure that could be used for evaluating weight self-stigma in normal-weight adults in Korea.

Health equilibrium in Korean adults with type 2 diabetes mellitus: A hybrid concept analysis.

AIM: The aim of the study was to provide a concept analysis of health equilibrium among patients with diabetes and introduced its operational definition. DESIGN: A concept analysis was conducted using a hybrid model of Schwartz-Barcott and Kim (Nursing research methodology: issues and implementations, Aspen, 1986). METHODS: Using consolidated criteria for reporting qualitative research guidelines, 10 participants with diabetes mellitus were interviewed. Each participant conducted at least two interviews, with each interview session lasting approximately 20-60 min at home or in a quiet place with some privacy. Data were analysed using a grounded theory approach. RESULTS: The health equilibrium concept included four categories with 12 attributes: cognitive (commitment to health, willingness to make life adjustments, balanced awareness, maintaining control), social (social role performance, holding a social support system, participation in social relationships), behavioural (leading a balanced life, making efforts to maintain health, modulating overreaction diabetes) and psychological (hopefulness for a healthy life psychological stability) factors. Thus, health equilibrium was defined as a state in which remain committed to health, while maintaining a stable daily life, social relationships and psychological stability despite prejudices against the disease and self-care experiences. CONCLUSION: Health equilibrium for diabetes patients was defined as maintaining cognitive, social, behavioural and psychological equilibrium as a process of willingly adjusting to life with diabetes. This can help people with diabetes improve self-care and maintain social roles.

Factors Influencing the Health-Related Quality of Life of Workers According to the Type of Work.

This paper describes a descriptive cross-sectional study that was conducted to identify and compare the factors affecting health-related quality of life (HRQoL) according to the type of work. The method involved a secondary analysis of 4131 workers who participated in the first year of the 8th Korea National Health and Nutrition Examination Survey (2019). In this study, a complex sample plan file was created and then weighted and analyzed. For the analyses, frequency, χ2-test, t-test, and linear regression analyses were used for complex sample analysis. Factors that significantly affected the HRQoL of daytime workers were educational background, living with a spouse, regular work, depression for two consecutive weeks, and suicidal thoughts. The explanatory power was 18.9% (p < 0.001). The factor that significantly affected the HRQoL of shift workers was whether they took dietary supplements for 2 weeks or more during the past year, and the explanatory power was 17.6% (p = 0.007). This study confirmed that the factors affecting HRQoL differ according to the type of work. Based on the results of this study, when developing a program to improve the HRQoL of workers, it is necessary to establish a differentiated strategy according to the type of work.

Mediating Effect of Communication Competence in the Relationship between Compassion and Patient-Centered Care in Clinical Nurses in South Korea.

This study investigates the mediating effect of communication competence in the relationship between compassion and patient-centered care (PCC) in clinical nurses. We used a descriptive research approach, and our sample comprised nurses (n = 204) with more than one year of experience in patient nursing in a general hospital in South Korea. The data were collected between December 2020 and June 2021 and analyzed using descriptive statistics, t-tests, one-way analysis of variance, Pearson's correlation coefficient analysis, and hierarchical multiple regression using SPSS 24.0. The Sobel test and PROCESS macro in SPSS were applied to verify the mediating effect. The mean scores for communication competence, compassion, and PCC were 3.67 ± 0.42, 64.04 ± 7.71, and 3.75 ± 0.46, respectively. Communication competence was found to partially mediate the relationship between compassion and PCC (z = 6.977, p < 0.001), and its explanatory power was 63.9%. To improve nurses' PCC, developing a step-by-step and differentiated PCC improvement program that includes communication competence and compassion is necessary.

Reliability and Validity of the Korean Version of the High-Performance Work System Scale (HPWS-K).

The application of the concept of high-performance work system (HPWS) to nurses can improve the quality of nursing care by enhancing nurse supply and patient safety culture. This study aimed to test the validity and reliability of the Korean version of the HPWS Scale (HPWS-K) and verify its adequacy for measuring HPWS within the context of nurses working in Korean hospitals. Data analyses were performed by using data from 214 nurses engaged in patient care in Korean general hospitals with over 300 beds, with SPSS version 22.0 and AMOS version 26.0 software. The data collected were translated into Korean and the adapted Korean version was back-translated into English by bilingual nursing professionals. The content validity of the HPWS-K was tested by administering it to 10 participants, and the collected data underwent reliability and validity testing. In the exploratory factor analysis, the total variance explained was 49.97%, and the instrument's reliability (Cronbach's α) was 0.87. A one-factor confirmatory factor analysis showed an acceptable model fit. The results confirmed the feasibility of using the HPWS-K with Korean nurses, and its application in this context is expected to contribute to creating a safe and effective healthcare environment in Korea.

Dual Mediating Effect of Electronic Device Utilization and Life Satisfaction on the Relationship between Instrumental Activities of Daily Living and Depression in Older Adults.

This study aimed to investigate the correlation between instrumental activities of daily living (IADL), depression, electronic device utilization (EDU) and life satisfaction in older adults and to evaluate the dual mediating effect of EDU and life satisfaction on the relationship between IADL and depression. A secondary data analysis of the 2020 Korean Elderly Survey was carried out with 9906 older adults. The dual mediating effect was analyzed using model 6 of PROCESS Macro for SPSS v. 4.1 (New York, NY, USA). EDU (B = -0.010, 95% CI [0.007, 0.013]) and life satisfaction (B = 0.071, 95% CI [0.064, 0.079]) each had a mediating effect on the relationship between IADL and depression in older adults, and in particular, these two variables were shown to dual mediate (B = 0.017, 95% CI [0.015, 0.019]). This study confirmed that life satisfaction can be increased and depression decreased by improving the ability to use electronic devices to combat the limitations in daily functioning due to aging. It is necessary to establish a strategy to increase EDU as a part of the intervention methods for managing depression in older adults.

Validity and Reliability of the Korean Version of the Holistic Nursing Competence Scale.

This methodological study aimed to verify the validity and reliability of the Korean version of the Holistic Nursing Competence Scale (HNCS), which comprises five dimensions and 36 items. The English version of the HNCS was forward and backward translated and administered to 251 participants with more than a year of work experience in a general hospital. Data were analyzed using SPSS WIN 24.0(Chicago, IL, USA), and AMOS program was used for confirmatory factor analysis. Additionally, the "Task Performance Evaluation Instrument for Clinical Nurses" was used for concurrent validity. Reliability assessed using Cronbach's α was 0.969. Convergent, discriminant, and concurrent validity were good. Average variance extracted and construct reliability ranged from 0.845 to 0.932 and 0.980 to 0.987, respectively. The model was suitable with the chi-square value being 1216.563 (df = 584, p < 0.001), and Q value being less than three. Goodness-of-fit index, root mean square residual, and root mean square error of approximation were 0.784, 0.066, and 0.066, respectively. Moreover, comparative fit index, Tucker−Lewis index, and incremental fit index were 0.913, 0.906, and 0.913, respectively. Thus, this study verified the validity and reliability of the Korean version of the HNCS. Our findings suggest that the scale is helpful in measuring and developing the holistic nursing competence of clinical nurses.

Mediating Effect of Compassion Competence on the Relationship between Caring Behaviors and Quality of Nursing Services in South Korea.

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson's correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses' caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary.

Validity and reliability of the Korean version of the Humanism Scale Short Form: A cross-sectional study.

AIM: To examine the reliability and validity of a Korean version of the Humanism Scale Short Form. DESIGN: A cross-sectional descriptive design. METHODS: This study involved 191 nurses in Korea. Data were collected from 1 May to 30 June 2019. Bilingual nursing professionals translated the scale into Korean, and reverse translation was performed. Validity and reliability were assessed, and the correlation coefficients of the developed scale were compared with those of the Korean version of the Empathy Quotient Scale and Compassion Competence Scale to evaluate concurrent validity. RESULTS: Exploratory factor analysis with 15 items showed that two factors (human equality and respect for human beings) explained 50.86% of the variance. Cronbach's alpha for the overall scale was 0.88. Thus, the scale has acceptable reliability and validity. Humanism measures can predict a nurse's approach to holistic care and provide fundamental data for developing programs to improve integrated caring capacities.

Factors Influencing Suicide Attempts of Adolescents with Suicidal Thoughts in South Korea: Using the 15th Korean Youth Risk Behavior Web-Based Survey (KYRBS).

Background: Adolescence is a period of physical and psychological change that causes adolescents to experience anxiety, stress, and loss of control. These experiences can lead to thoughts about suicide. However, not all adolescents with suicidal thoughts attempt suicide. This study aimed to identify the factors that influence suicide attempts among adolescents with suicidal thoughts, and to prepare a theoretical basis for a method to prevent suicide among adolescents. Methods: In this descriptive cross-sectional study, the 15th Korean Youth Risk Behavior Web-Based Survey (2019) was used. The participants were 7,498 adolescents aged 12-18 yr with thoughts of suicide. Factors influencing suicide attempts among adolescents with suicidal thoughts were analyzed using a complex sample logistic analysis. Results: Gender, age, academic performance, and economic level were the general factors associated with suicide attempts of adolescents with suicidal thoughts. Physical and psychological factors included smoking, alcohol use, drug use, sex-related experience, experiencing violence, efforts to reduce weight, level of physical activity, and depression. Conclusion: Age and gender should be taken into consideration when designing suicide prevention activities. In addition, in order to lower the suicide rate of adolescents in Korea, an effective system of prevention and intervention strategies should be implemented, which attend to the issues of adolescents from low-income families, adolescent weight and body image concerns, and adolescent depression.

Validity and Reliability of the Korean Version of the Acceptance and Action Questionnaire-Stigma (AAQ-S-K).

This study investigated the validity and reliability of the Korean version of the Acceptance and Action Questionnaire-Stigma (AAQ-S-K) in people with diabetes. A total of 208 patients with diabetes participated in the study. After performing forward and backward translation of the original version of the AAQ-S into Korean, its validity (construct and concurrent validity) and reliability were assessed. Construct validity measured using confirmatory factor analysis showed a good fit. Concurrent validity was confirmed through the significant correlation between the AAQ-S-K, acceptance and action, diabetes self-stigma and diabetes distress. The AAQ-S-K was positively correlated with acceptance and action and had a negative correlation with diabetes self-stigma and diabetes distress. The reliability of the AAQ-S-K ranged from 0.82 to 0.88. The AAQ-S-K can be applied to assess stigma acceptance and action in Korean patients with diabetes and to compare the level of psychological flexibility of patients with diabetes internationally.

Moderating Effect of Nurse's Character on the Relationship between Attitudes toward Nursing Care of the Dying and Performance of Terminal Care in South Korea.

This study aimed to investigate the moderating effect of nurses' characteristics on the relationship between attitudes toward nursing care and terminal care performance of hospice nurses. The participants included nurses working in hospice care units in general hospitals in South Korea. Data collected from August 1 to 31, 2020 were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and hierarchical multiple regression. The performance of terminal care was positively correlated with attitudes toward nursing care of the dying (r = 0.45, p < 0.001) and nurses' characteristics (r = 0.60, p < 0.001). There was also a positive correlation (r = 0.58, p < 0.001) between attitudes toward nursing care for dying patients and nurses' characteristics. Nurses' characteristics had a significant moderating effect on the relationship between attitudes toward nursing care of the dying and performance of terminal care. This means that the nurses' character had a buffering effect on the relationship between attitudes toward nursing care of the dying and performance of terminal care in hospice care units. These findings suggest that continuous and repetitive educational programs on terminal care need to be enhanced, and strategies to strengthen attitudes toward nursing care of the dying and nurses' character need to be included in these programs.

Development and validation of the self-stigma scale in people with diabetes.

AIM: To develop and initially validate the Diabetes Self-Stigma Scale for assessing self-stigma in people with diabetes. DESIGN: Scale development and evaluation. METHODS: Participants were 399 patients with diabetes. In phase 1, initial items were generated based on the concept analysis of diabetes self-stigma. Moreover, content validity was established by diabetes experts. Phase 2 evaluated structural validity through item analysis, exploratory factor analysis and confirmatory factor analysis. Reliability was evaluated by examining stability and internal consistency. RESULTS: The findings revealed that the self-stigma scale for patients with diabetes is a valid and reliable instrument. The Diabetes Self-Stigma Scale was confirmed with 16 items. It consists of four domains: comparative inability, social withdrawal, self-devaluation and apprehensive feeling. The scale developed in this study can measure self-stigma in diabetes patients and can be used as an intervention to reduce self-stigma.

Impact of Job Engagement on the Quality of Nursing Services: The Effect of Person-Centered Nursing in South Korean Nurses.

Nurses' job engagement could help improve the quality of nursing services, and person-centered nursing is expected to play an important role in this relationship. However, little is known about the role of person-centered nursing in the association between job engagement and quality of nursing services. This study examines the moderating and mediating effects of person-centered nursing on the relationship between the job engagement and the quality of nursing services in Korean nurses. In October 2020, 200 hospital nurses were surveyed at three university hospitals. The moderating and mediating effects of person-centered nursing were determined using hierarchical regression analysis. There was a significant positive correlation between job engagement, person-centered nursing, and quality of nursing services. Person-centered nursing was found to have a mediating and moderating role in the relationship between job engagement and quality of nursing service. In conclusion, in the impact of job engagement on the quality of nursing service, it plays a buffering role, and the job engagement of nurses improves the quality of nursing services through improvement of person-centered nursing. Therefore, this study recommends the development and implementation of an educational program to foster person-centered nursing in order to improve the quality of nursing services.

Self-stigma among Korean patients with diabetes: A concept analysis.

AIMS AND OBJECTIVES: To conduct a concept analysis of self-stigma among patients with diabetes and introduce an operational definition of self-stigma. BACKGROUND: Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients' self-care and socialisation. DESIGN: A concept analysis was conducted using a three-phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz-Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). METHODS: During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in-depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. RESULTS: In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self-stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self-esteem and self-efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. CONCLUSIONS: Self-stigma among patients with diabetes is defined as a state in which patients develop negative self-feelings as they deal with the disease. This can cause diminished self-esteem and self-efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. RELEVANCE TO CLINICAL PRACTICE: Based on this self-stigma concept analysis, we clarified the attributes of diabetes self-stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment.