JaeLan Shim

Background/Objectives: Patients undergoing hemodialysis experience psychosocial burdens that may hinder self-management. Guided by Bandura’s social cognitive theory, this study examined whether self-esteem statistically mediated the association between perceived social support and self-management behavior. Methods: A descriptive cross-sectional study was conducted with 145 patients receiving regular hemodialysis at three medical institutions in South Korea. The mediation model was tested using Hayes’ PROCESS macro Model 4 with 5000 bootstrap samples and 95% bias-corrected confidence intervals, adjusting for relevant covariates. Results: Self-management behavior was positively correlated with social support (r = 0.41, p < 0.001) and self-esteem (r = 0.52, p < 0.001). Social support was also positively correlated with self-esteem (r = 0.67, p < 0.001). Social support was associated with self-management both directly and indirectly through self-esteem. The bootstrap confidence interval for the indirect association excluded zero, consistent with partial statistical mediation. The indirect association accounted for approximately 45% of the total association. Conclusions: Higher perceived social support and self-esteem were associated with better self-management behavior among patients undergoing hemodialysis. Nursing interventions that strengthen supportive social resources and self-esteem may help promote sustained self-management in this population.

Magnetic resonance imaging is essential to accurately check patients’ health status and apply optimal nursing care and treatment. Understanding patie

Objectives: The purpose of this study was to investigate the relationship between burnout and interpersonal caring behaviors among hemodialysis unit nurses and to verify the mediating effect of job autonomy on this relationship. Methods: This study employed a cross-sectional survey design. Data were collected from 201 nurses working in hemodialysis units at three general hospitals in South Korea. Measurements were obtained using structured self-report questionnaires. Data were analyzed using descriptive statistics, correlation analysis, and regression analysis with the SPSS/WIN 26.0 program. The mediating effect was verified using Hayes' PROCESS macro (Model 4) with a bootstrapping method (5,000 samples). Results: The mean age of the participants was 40.23 (±9.53) years. Burnout showed significant negative correlations with job autonomy (r=-.40, p<.001) and interpersonal caring behaviors (r=-.34, p<.001), while job autonomy showed a significant positive correlation with interpersonal caring behaviors (r=.35, p<.001). Job autonomy was confirmed to partially mediate the relationship between burnout and interpersonal caring behaviors. Conclusions: These findings suggest that to improve the quality of relationship-based care in hemodialysis units, organizational strategies are required not only to reduce nurse burnout but also to enhance job autonomy. Strengthening job autonomy allows nurses to exercise professional judgment and regulate their work, thereby mitigating the negative effects of burnout and promoting better interpersonal caring behaviors in the long-term therapeutic environment of hemodialysis.

Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health information in middle-aged patients with diabetes and to identify factors influencing patient eHL. Methods: This descriptive correlational study included 185 middle-aged patients with diabetes being followed-up with in the outpatient endocrinology department at a South Korean university hospital between 14 January and 29 February 2024. Data were collected using self-report structured questionnaires and were analyzed using IBM SPSS 27.0. Results: eHL was positively correlated with diabetes knowledge (r = 0.31, p < 0.001) and attitudes toward internet health information (r = 0.62, p < 0.001). Diabetes knowledge was also positively correlated with attitudes toward internet health information (r = 0.25, p < 0.001). Attitudes toward internet health information (β = 0.55, p = p = 0.040), and drinking status (β = 0.12, p = 0.044) were significant variables affecting eHL. Conclusions: The most influencing factor in eHL in middle-aged patients with diabetes is the patient’s attitudes toward internet health information; diabetes knowledge was identified as a significant predictor. To improve eHL in middle-aged patients with diabetes, it is important to develop nursing intervention strategies to help promote diabetes knowledge and positive attitudes toward internet health information. Healthcare providers should continuously monitor patients to ensure they acquire and utilize correct information.

Background/Objectives: Implementing evidence-based practice (EBP) among healthcare professionals is a vital strategy for improving the quality of healthcare services, patient outcomes, and professional role satisfaction. In this study, we aimed to identify the effects of work engagement and barriers to EBP implementation among clinical nurses. Methods: In this cross-section study, we collected data from 184 nurses with at least 1 year of clinical experience using a questionnaire. The study was performed in three general hospitals in Korea between 17 July and 4 August 2023. Following data collection, we performed descriptive statistics, independent sample t-test, one-way analysis of variance, Scheffe’s post hoc test, Pearson’s correlation analysis, and multiple regression to analyze the data. Results: EBP implementation was found to be positively correlated with work engagement (r = 0.32, p < 0.001) and negatively correlated with barriers to implementing EBP (r = −0.44, p < 0.001). Factors influencing EBP implementation included work engagement (β = 0.14, p = 0.041) and barriers (β = −0.39, p < 0.001). Notably, barriers had a greater influence on EBP implementation than work engagement. Conclusions: Policy support, including performance incentives and training policies, among others, along with an organizational environment that provides necessary resources, should be established to encourage nurses’ engagement, which influences their organizational performance to improve EBP. In addition, it is crucial to develop and strengthen educational and support programs for nurses regarding EBP to help identify and minimize barriers to implementing this practice.

Despite advances in prevention and treatment, postoperative atrial fibrillation (POAF) is the most common type of complication undergoing cardiac surgery. This study aimed to identify the relationship between POAF and clinical outcomes after coronary artery bypass graft. In this cross-sectional study, we retrospectively reviewed the medical records of 324 patients who had undergone coronary artery bypass grafting in an intensive care unit between 2010 and 2019 at a tertiary hospital in Korea. Propensity score matching was used to estimate a 1:1 match (without: with POAF) using seven covariates to overcome selection bias. Kaplan–Meier survival analysis and Cox proportional hazards modeling were performed to determine the effect on intensive care unit readmission and length of hospital stay. After controlling for covariates, 1:1 matching was performed for 91 patients in each group. The occurrence of postoperative atrial fibrillation was found to increase the probability of readmission to the intensive care unit, with a 23% reduced probability of readmission for every 10% increase in left ventricular ejection fraction. Multivariate analysis indicated that postoperative atrial fibrillation, chronic obstructive pulmonary disease as a comorbidity, and preoperative hemoglobin were factors affecting the length of hospitalization after surgery. The Kaplan–Meier survival analysis results indicated that the without POAF group had a higher survival rate than the with POAF group. Healthcare professionals should recognize negative factors such as postoperative atrial fibrillation and abnormal hematologic parameters that impact major clinical outcomes in patients and may require closer monitoring before and after coronary artery bypass grafting.

Aims: To evaluate the validity and reliability of the self‐care behaviour scale for patients with left ventricular assist devices.Design: Methodological study.Methods: The English version of the scale was translated into Korean, and it was then back‐translated into English. Survey data were collected from 32 patients with left ventricular assist device in South Korea, and construct validity, content validity and reliability were analysed.Results: The original self‐care behaviour scale comprises three domains and 33 items, whereas the Korean self‐care behaviour scale comprises 27 items and five domains: device management, wound management, symptom monitoring, activated healthcare system and self‐care management. Cronbach's alpha for the overall scale was 0.94, and that for the five domains ranged from 0.36 to 0.90. The intraclass correlation coefficient for the overall scale was 0.89, and the five domains ranged from 0.71 to 0.88.Conclusion: The newly evaluated scale would be valid and reliable in measure self‐care behaviour for patients with a left ventricular assist device.Implications for the profession and/or patient care: Patients can manage the left ventricular assist device on their own based on evidence and use it as a tool for effective communication with medical professionals.

Genital cancers are particularly important compared to other cancers because of the psychological impact they have on the individual. This study investigated the complexity in illness and quality of life among female genital cancer patients and determined the effects of these factors on supportive care needs to provide evidential data for the development of nursing intervention strategies to reduce supportive care needs in female genital cancer patients. This cross-sectional study collected data from July 22 to August 17, 2021. The study subjects were 103 female outpatients and inpatients aged 19 years or older who were treated for cervical cancer, endometrial cancer, ovarian cancer, or other female genital cancers such as vulvar cancer and vaginal cancer in a university hospital in Korea. The data were analyzed with t-tests and Scheffé’s test using SPSS 26.0. The factors affecting supportive care needs were examined using hierarchical regression. The average age of the subjects was 56.41 (±9.91) years. Cervical cancer was the most common diagnosis at 42.7%, followed by ovarian cancer at 34.0%, and endometrial cancer at 21.4%. The factors affecting supportive care needs included a middle school education or below (β = 0.21, P = .028), unemployment (β = 0.23, P = .018), complexity in illness (β = 0.32, P < .001), and quality of life (β = −0.68, P < .001). Developing a strategy for managing the complexity in illness and quality of life caused by various variables including disease stage and type of treatment is necessary to reduce the supportive care needs of female genital cancer patients. Improving their quality of life through effective communication with healthcare providers is essential.

Sedentary behavior has been associated with poor adherence to treatment in patients with coronary artery disease. Low left ventricular ejection fraction and obesity have been separately linked to increased sedentary behavior in patients with coronary artery disease. However, the combined effect of low left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease has not been thoroughly investigated. Therefore, this study aimed to examine the combined influence of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. This descriptive cross-sectional study enrolled 200 inpatients aged ≥ 20 years who were diagnosed with coronary artery disease at a tertiary hospital in Korea between March and August 2022. Data were collected using structured questionnaires, and multivariate logistic regression analysis was performed to determine the combined effect of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. Among the 111 patients with sedentary behavior, 38 (34.2%) had both low left ventricular ejection fraction and obesity, whereas only 11 (12.4%) of the 89 patients without sedentary behavior had both low left ventricular ejection fraction and obesity. In multivariate logistic regression analysis, patients with coronary artery disease who had both low left ventricular ejection fraction and obesity had the highest risk of sedentary behavior compared to those without either low left ventricular ejection fraction or obesity (odds ratio = 13.98, 95% confidence interval = 5.19–37.69, P < .001). The co-existence of low left ventricular ejection fraction and obesity in patients with coronary artery disease may be associated with sedentary behavior. Therefore, evaluating both left ventricular ejection fraction and obesity when assessing sedentary behavior in patients with coronary artery disease may be valuable in implementing patient-centered approaches for the secondary prevention and management of sedentary behavior in patients with coronary artery disease. However, further prospective cohort studies with larger sample sizes are required to establish causal relationships and explore interventions to mitigate sedentary behavior in this population.