• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

• Clinical and Experimental Pediatrics
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• v.64 no.1
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• pp.3-11
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• 2021

There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children's health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.

• Women's Health Nursing
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• v.6 no.4
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• pp.506-515
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• 2000

The purpose of this study was to validate abuse outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1 (indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follows: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Abuse Recovery : Emotional' attained an OCV score of 0.780 and was the highest OCV score among abuse outcomes. The highest indicator was 'demonstration of positive interpersonal relationship'. 3. 'Abuse cessation' attained an OCV score of 0.739 and was the lowest OCV score among abuse outcomes. The highest indicator was 'physical abuse has ceased'. 4. 'Abuse Protection' attained an OCV score of 0.743 and the highest indicator was 'plans for avoiding abuse'. 5. 'Abuse Recovery: Financial' attained an OCV score of 0.762 and the highest indicator was 'court-ordered benefits received'. 6. 'Abuse Recovery: Physical' attained an OCV score of 0.767 and the highest indicator was 'resolution of physical health problem'. 7. 'Abuse Recovery: Sexual' attained an OCV score of 0.768 and the highest indicator was 'expression of confidence with gender identity'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

• Women's Health Nursing
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• v.17 no.4
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• pp.407-414
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• 2011

Purpose: The purpose of this study was to compare birth outcomes between Korean women and immigrant women. Methods: Medical records were reviewed retrospectively from 201 immigrant women and 201 Korean women who delivered babies at K women's hospital in U city from January 2006 to December 2009. Maternal outcomes related factors included nationality, age, obstetric history, delivery type, indications of cesarean section, and complications of pregnancy and delivery. Principal neonatal outcomes were birth weight, Apgar scores, and complications of newborns. Results: Immigrant women were younger and had fewer pregnancies, abortions, and surviving children than Korean women. The rate of primary cesarean section and its indication in immigrant women were not significantly different from Korean women. However, immigrant women's newborn were more likely to have low birth weight and meconium staining. Conclusion: The results of this study indicate less equity of immigrant women in women's health care, although immigrant women's babies had lower Apgar score and more meconium staining. Nurses should help immigrant women cope with labor process effectively to prevent adverse health outcomes for their newborns.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.11-24
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• 2014

Objectives: The purpose of this article was to investigate the current practice of diabetes education along with the specific interventions, process, and outcomes in community health centers in Korea. Methods: Data were collected by a mail questionnaire from September 20, 2012 to December 20, 2012. Among 253, a total of 161 responded, constituting a 63.3% return rate. Results: Primary staff of diabetes education was the nurse and respondents recognized their role largely as a director. More than half of respondents provided education to people with type 2 diabetes by group. Most common service offered was nutrition therapy and the majority of respondents used printed materials. Among 4 criteria of outcomes, eating (nutrition), knowledge scores, blood pressure, and patients' survey on satisfaction were collected most frequently. Nearly three quarters of respondents were not participated in activities for quality improvement and outcomes were not reported properly. Conclusions: The results are able to draw ideas for organizing diabetes education programs and evaluating outcomes in community heath centers. This article has significance that it is the first comprehensive survey of diabetes education practice in community health centers and provides a baseline for establishing national standards of diabetes self-management education.

• Dementia and Neurocognitive Disorders
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• v.21 no.1
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• pp.1-16
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• 2022

Background and purpose: We investigated existing nonpharmacological programs for people with dementia (PWD) to explore critical factors related to the effectiveness of these types of programs. Methods: We conducted a qualitative systematic literature review to identify nonpharmacological intervention programs developed for PWD and reviewed 36 randomized controlled trials. Among several outcomes reported in each study, we focused on the most common outcomes including quality of life (QoL), neuropsychiatric symptoms, depression, agitation, and cognition for further review. Results: Several factors were identified that might affect the outcomes of nonpharmacological interventions for PWD including study design, characteristics of the intervention, maintaining research participants, heterogeneity issues, and implementation fidelity. About half of studies in this review reported positive program effects on their targeted outcomes such as Well-being and Health for PWD on improving quality of life, neuropsychiatric symptoms and agitation; cognitive stimulation therapy on QoL, neuropsychiatric symptoms and cognition; and a stepwise multicomponent intervention on neuropsychiatric symptoms, depression and agitation. Conclusions: We found some programs even with a rigorous study design did not produce expected outcomes while other programs with poor designs reported positive outcomes, which necessitates further investigation on the validity of the assessments. Factors such as individual tailored and customized interventions, promoting social interactions, ease of administration and compatibility of interventions, and developing program theory need to be considered when developing nonpharmacological intervention programs.

• Safety and Health at Work
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• v.13 no.4
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• pp.379-386
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• 2022

Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.321-332
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• 2000

The purpose of this study was to test the hypothetical model designed to explain nursing students' perceived stress, coping levels, and stress outcomes. This hypothetical model was based on the Kim. Jung Hee(l987)' s stress model and stress-related literature. Exogenous variables were self-efficacy. hardiness. social support. and exercise. Endogenous variables were stress perception. coping levels. and stress outcomes. Empirical data for testing the hypothetical model consisted of 205 nursing students. SAS PC Program and LISREL 8.12a program were used for descriptive statistics and linear structural relationship(LISREL) modeling. The results were as follows. 1) The overall fit of the hypothetical model to the data was good( $x^2$=78.41(p=0.010), $x^2$/ df=1.50. RMSEA=0.05, standardized RMR= 0.05, GFI=0.95, AGFI=0.91, NNFI=0.90, NFI=0.94). 2) The results of statistical testing of the hypotheses were as follows. (1) As expected. self-efficacy had a significant effect on stress perception. But. hardiness. social support, and exercise did not have a significant effect on stress perception. Self-efficacy, hardiness. social support, and exercise explained 12% of the total variance of stress perception. (2) As expected, self-efficacy, hardiness, social support, exercise, and stress perception had a significant effect on coping behavior, Self-efficacy, hardiness, social support, exercise, and stress perception explained 53% of the total variance of coping behavior. (3) As expected, stress perception and coping behavior had a significant effect on stress outcomes. Stress perception and coping behavior explained 84% of the total variance of stress outcomes. In conclusion, the hypothetical model of this study was confirmed in explaining and predicting stress perception, coping levels, and stress outcomes in nursing students. And these findings suggest the need to develop nursing intervention to enhance self-efficacy, hardiness, social support, and exercise to decrease the harmful outcomes of stress.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.7-26
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• 2020

Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

• Journal of Home Health Care Nursing
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• v.26 no.1
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• pp.5-18
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• 2019

Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.