Purpose: This study was conducted to synthesis the results of research on relationships of cognitive impairment with multi-dimensional correlates of rheumatic disease through a systematic literature review and meta-analysis. Methods: For the study purpose, 23 studies were selected through a systematic process of searching the literature. Results: The study results showed that among general characteristics, age and education were the variables having a significant relationship with cognitive impairment. Among health risk factors, obesity appeared to have a significant positive relationship with cognitive impairment. For past history, diabetes and hypertension were shown to have a significant positive relationship with cognitive impairment. It was noted also that aPL, one of the physiological factor, had significant association with cognitive impairment. None of the medication related factors had a significant relationship with cognitive impairment. Results showed that among disease related factors, disease activity had the highest relationship with cognitive impairment. Depression, among psychological factors, was the only variable having a significant relationship with cognitive impairment. Conclusion: The findings indicate that the variables strongly impacting on cognitive impairment in rheumatic disease are depression and disease activity.

Purpose: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. Methods: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. ($R^2=29%$). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL ($R^2=43%$). Psychological distress had a partial mediating effect (${\beta}=-.56$, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

Purpose: This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Methods: Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Results: Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Discussion: Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

Purpose: The purpose of this study was to identify the knowledge structure of cancer survivors. Methods: For data, 1099 articles were collected, with 365 keywords as a Noun phrase extracted from the articles and standardized for analyzing. Co-occurrence matrix were generated via a cosine similarity measure, and then the network analysis and visualization using PFNet and NodeXL were applied to visualize intellectual interchanges among keywords. Results: According to the result of the content analysis and the cluster analysis of author keywords from cancer survivors articles, keywords such as 'quality of life', 'breast neoplasms', 'cancer survivors', 'neoplasms', 'exercise' had a high degree centrality. The 9 most important research topics concerning cancer survivors were 'cancer-related symptoms and nursing', 'cancer treatment-related issues', 'late effects', 'psychosocial issues', 'healthy living managements', 'social supports', 'palliative cares', 'research methodology', and 'research participants'. Conclusion: Through this study, the knowledge structure of cancer survivors was identified. The 9 topics identified in this study can provide useful research direction for the development of nursing in cancer survivor research areas. The Network analysis used in this study will be useful for identifying the knowledge structure and identifying general views and current cancer survivor research trends.

Purpose: Increase in suicide rate for senior citizens which has become widespread in our society today. It is not a normal social phenomenon and is beyond the danger level. The contents of this study include Korean senior citizens' suicide related risk factors and warning signs, and the development of a simple Geriatric Suicide Risk Scale. Methods: This study is Methodological Research to verify reliability and validity of the Geriatric Suicide Risk Scale according to the tool development process suggested by Devellis (2012). Results: For predictive validity assessment, high suicide screening accuracy was showed with an Area under the ROC curve (AUC) of .93. For the optimal cutoff point of 11, sensitivity was 93.9%, and specificity, 75.7% which are excellence levels. Cross validity for assessment of generalization possibility showed the Area under the ROC curve (AUC) as .82 and in case of a cutoff point of 11, sensitivity was 73.7%, and specificity, 65.9%. Conclusion: When it comes to practical nursing, it is significant that the Korean Geriatric Suicide Risk Scale has high reliability and validity through adequate tool development and the tool assessment step to select degree of suicide risk of senior citizens. Also, it can be easily applied and does not take a long time to administer. Further, it can be used by health care personnel or the general public.

Purpose: The purpose of this study was to develop a wellness index for workers (WIW) and examine the validity and reliability of the WIW for assessing workers' wellness. Methods: The developmental process for the instrument included construction of a conceptual framework based on a wellness model, generation of initial items, verification of content validity, preliminary study, extraction of final items, and psychometric testing. Content validity was verified by 4 experts from occupational health nursing and wellness disciplines. The construct validity, convergent validity and discriminant validity were examined with confirmatory factor analysis. The reliability was examined with Cronbach's alpha. The participants were 494 workers from two workplaces. Results: Eighteen items were selected for the final scale, and the results of the confirmatory factor analysis supported a five-factor model of wellness with acceptable model fit, and factors named as physical emotional social intellectual occupational wellness. The convergent and discriminant validity were also supported. The Cronbach's alpha coefficient was .91. Conclusion: The results indicate that the WIW is a valid and reliable instrument to comprehensively assess workers' wellness, and to provide basic directions for developing workplace wellness program.

Purpose: This paper reports the results of a hospital centered follow-up program on parenting stress, parenting efficacy and coping for mothers with very low birth weight (VLBW) infants. Methods: The follow-up program consisted of home visiting by an expert group and self-help program for 1 year. A non-equivalent control group pre-post quasi-experimental design was used. Participants were 70 mothers with low birth weight infants and were assigned to one of two groups, an experimental groups (n=28), which received the family support program; and a control group (n=27), which received the usual discharge education. Data were analyzed using ${\chi}^2$-test, t-test, and ANCOVA with IBM SPSS statistics 20.0. Results: Mothers' parenting stress (F=5.66, p=.004) was significantly decreased in the experimental group. There were also significant increases in parenting efficacy (F=13.05, p<.001) and coping (F=8.91, p=.002) in the experimental group. Conclusion: The study findings suggest that a follow-up program for mothers with VLBW infants is an effective intervention to decrease mothers' parenting stress and to enhance parenting efficacy and coping.

Purpose: This study was conducted to examine effects of a learning portfolio by identifying the learning of nursing students taking a learning portfolio-utilized nursing management class. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 83 senior students taking the nursing management course in one of the Departments of Nursing at 2 Universities. Experimental group (n=42) received a learning portfolio-utilized nursing management class 15 times over 15 weeks (3 hours weekly). Self-directed learning abilities, approaches to learning and learning flow of the participants were examined with self-report structured questionnaires. Data were collected between September 2 and December 16, 2014, and were analyzed using chi-square test, Fisher's exact test, independent t-test and ANCOVA with SPSS/PC version 21.0. Results: After the intervention the experimental group showed significant increases in self-directed learning abilities, deep approaches to learning and learning flow compared to the control group. However, no significant difference was found between groups for surface approaches to learning. Conclusion: Learning activities using the learning portfolios could be effective in cultivating the learning competency for growth of knowledge, technology and professionalism by increasing personal concentration and organization ability of the nursing students so that they can react to the rapidly changing environment.

Purpose: The aim of this study was to examine the mediating effect of empowerment in the relationship of nurse managers' authentic leadership, with nurses' organizational commitment and job satisfaction. Methods: The participants in this study were 273 registered nurses working in five University hospitals located in Seoul and Gyeonggi Province. The measurements included the Authentic Leadership Questionnaire, Condition of Work Effectiveness Questionnaire-II, Organizational Commitment Questionnaire and Korea-Minnesota Satisfaction Questionnaire. Data were analyzed using t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficients, simple and multiple regression techniques with the SPSS 18.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. Results: There were significant correlations among authentic leadership, empowerment, organizational commitment and job satisfaction. Empowerment showed perfect mediating effects in the relationship between authentic leadership and organizational commitment. It had partial mediating effects in the relationship between authentic leadership and job satisfaction. Conclusion: In this study, nurse managers' authentic leadership had significant influences on nurses organizational commitment and job satisfaction via empowerment. Therefore, to enhance nurses' organizational commitment and job satisfaction, it is necessary to build effective strategies to enhance nurse manager's authentic leadership and to develop empowering education programs for nurses.

Purpose: The aim of this study was to develop a Korean version of Night Eating Questionnaire (KNEQ) and test its psychometric properties and evaluate items according to item response theory. Methods: The 14-item NEQ as a measure of severity of the night eating syndrome was translated into Korean, and then this KNEQ was evaluated. A total of 1171 participants aged 20 to 50 completed the KNEQ on the Internet. To test reliability and validity, Cronbach's alpha, correlation, simple regression, and factor analysis were used. Each item was analyzed according to Rasch-Andrich rating scale model and item difficulty, discrimination, infit/outfit, and point measure correlation were evaluated. Results: Construct validity was evident. Cronbach's alpha was .78. The items of evening hyperphagia and nocturnal ingestion showed high ability in discriminating people with night eating syndrome, while items of morning anorexia and mood/sleep provided relatively little information. The results of item analysis showed that item2 and item7 needed to be revised to improve the reliability of KNEQ. Conclusion: KNEQ is an appropriate instrument to measure severity of night eating syndrome with good validity and reliability. However, further studies are needed to find cut-off scores to screen persons with night eating syndrome.

Purpose: The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital. Methods: A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. Results: Model fit indices for the hypothetical model were suitable for the recommended level: ${\chi}^2=796.40$ (df=79, p<.001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors. Conclusion: Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

Purpose: This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. Methods: A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. Results: Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. Conclusion: The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.

Purpose: This study was performed to determine the physical and psychological effects of an urban forest-walking program for office workers. For many workers, sedentary lifestyles can lead to low levels of physical activity causing various health problems despite an increased interest in health promotion. Methods: Fifty four office workers participated in this study. They were assigned to two groups (experimental group and control group) in random order and the experimental group performed 5 weeks of walking exercise based on Information-Motivation-Behavioral skills Model. The data were collected from October to November 2014. SPSS 21.0 was used for the statistical analysis. Results: The results showed that the urban forest walking program had positive effects on the physical activity level (U=65.00, p <.001), health promotion behavior (t= - 2.20, p =.033), and quality of life (t= - 2.42, p =.020). However, there were no statistical differences in depression, waist size, body mass index, blood pressure, or bone density between the groups. Conclusion: The current findings of the study suggest the forest-walking program may have positive effects on improving physical activity, health promotion behavior, and quality of life. The program can be used as an effective and efficient strategy for physical and psychological health promotion for office workers.

Purpose: This study was done to develop of the Korean intensive care delirium screening tool (KICDST). Methods: The KICDST was developed in 5 steps: Configuration of conceptual frame, development of preliminary tool, pilot study, reliability and validity test, development of final KICDST. Reliability tests were done using degree of agreement between evaluators and internal consistency. For validity tests, CVI (Content Validity Index), ROC (Receiver Operating Characteristics) analysis, known group technique and factor analysis were used. Results: In the reliability test, the degree of agreement between evaluators showed .80~1.00 and the internal consistency was KR-20=.84. The CVI was .83~1.00. In ROC analysis, the AUC (Area Under the ROC Curve) was .98. Assessment score was 4 points. The values for sensitivity, specificity, correct classification rate, positive predictive value, and negative predictive value were found to be 95.0%, 93.7%, 94.4%, 95.0% and 93.7%, respectively. In the known group technique, the average delirium screening tool score of the non-delirium group was $1.25{\pm}0.99$ while that of delirium group was $5.07{\pm}1.89$ (t= - 16.33, p <.001). The factors were classified into 3 factors (cognitive change, symptom fluctuation, psychomotor retardation), which explained 67.4% of total variance. Conclusion: Findings show that the KICDST has high sensitivity and specificity. Therefore, this screening tool is recommended for early identification of delirium in intensive care patients.