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Although the importance of health promotion for nurses is increasing, there is a lack of meta-analyses targeting nurses in the world. This study aimed to identify the effect sizes between the health-promoting behaviors and related variables of nurses working in Korea. Methods: Systematic review and meta-analysis were conducted according to the PRISMA and MOOSE guidelines. The literature included in this meta-analysis was published between 1994 and 2022 in core databases such as KMbase, KISS, KoreaMed, ScienceON, DBpia, NAL, RISS, CINAHL, CENTRAL, WoS, PubMed, and hand searched. In this study, the PICO-SD framework was applied with Participants being nurses actively working in various healthcare settings across Korea, and for a more comprehensive search, intervention and comparisons were not set. The outcomes measured were nurses' health-promoting behaviors, assessed using structured tools. The study design included observational studies. The Comprehensive Meta-Analysis and the R software program were used for meta-analysis. Results: In total, 50 articles were selected for the systematic review and meta-analysis. The total effect size of the 50 articles was moderate (correlation effect size [ESr] = 0.30). The individual variables presented in the 50 articles were classified into nine sub-categories according to Pender's Health Promotion Model (HPM). Among them, situational influences demonstrated the largest effect size (ESr = 0.44, number of studies [k] = 2), followed by perceived self-efficacy (ESr = 0.39, k = 10) and activity-related affect (ESr = 0.32, k = 12). Conclusions: To achieve the optimal health status of nurses through health promotion intervention programs, these effective variables – situational influences, perceived self-efficacy, and activity-related affect – should be considered when developing the intervention program for nurses.

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Purpose@#The aim of this study was to predict the subgroups vulnerable to poorer health-related quality of life (HRQoL) according to gender in older adults. @*Methods@#Data from 5,553 Koreans aged 65 or older were extracted from the Korea National Health and Nutrition Examination Survey. HRQoL was assessed using the EQ-5D tool. Complex sample analysis and decision-tree analysis were conducted using SPSS for Windows version 27.0. @*Results@#The mean scores of the EQ-5D index were 0.93 ± 0.00 in men and 0.88 ± 0.00 in women. In men, poorer HRQoL groups were identified with seven different pathways, which were categorized based on participants’ characteristics, such as restriction of activity, perceived health status, muscle exercise, age, relative hand grip strength, suicidal ideation, the number of chronic diseases, body mass index, and income status. Restriction of activity was the most significant predictor of poorer HRQoL in elderly men. In women, the poorer HRQoL groups were identified with nine different pathways, which were categorized based on participants’ characteristics, such as perceived health status, restriction of activity, age, education, unmet medical service needs, anemia, body mass index, relative hand grip, and aerobic exercise. Perceived health status was the most significant predictor of poorer HRQoL in elderly women. @*Conclusion@#This study presents a predictive model of HRQoL in older adults according to gender and can be used to detect individuals at risk of poorer HRQoL.

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Purpose@#The aim of this study was to identify the factors explaining protective behaviors against radiation exposure in perioperative nurses based on the theory of planned behavior. @*Methods@#This was a cross-sectional study. A total of 229 perioperative nurses participated between October 3 and October 20, 2021. Data were analyzed using SPSS/WIN 23.0 and AMOS 23.0 software. The three exogenous variables (attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control) and two endogenous variables (radiation protective intention and radiation protective behaviors) were surveyed. @*Results@#The hypothetical model fit the data (χ2/df = 1.18, SRMR = .02, TLI = .98, CFI = .99, RMSEA = .03). Radiation protective intention (β = .24, p = .001) and attitude toward radiation protective behaviors (β = .32, p = .002) had direct effects on radiation protective behaviors. Subjective norm (β = .43, p = .002) and perceived behavior control (β = .24, p = .003) had direct effects on radiation protective intention, which explained 38.0% of the variance. Subjective norm (β = .10, p = .001) and perceived behavior control (β = .06, p = .002) had indirect effects via radiation protective intention on radiation protective behaviors. Attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control were the significant factors explaining 49.0% of the variance in radiation protective behaviors. @*Conclusion@#This study shows that the theory of planned behavior can be used to effectively predict radiation protective behaviors in perioperative nurses. Radiation safety guidelines or education programs to enhance perioperative nurses’ protective behaviors should focus on radiation protective intention, attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control.

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This study investigated the effects of job embeddedness and resilience on the relationship between job rotation stress and nursing work performance among clinical nurses. Methods: We conducted a nationwide online survey with 205 nurses employed at advanced general or general hospitals. Data were collected from August 17 to October 5, 2021. We analyzed the data using various descriptive statistics, independent t-tests, one-way analysis of variance, Scheffé test, Welch test, Games-Howell test, Pearson's correlation coefficients, multiple regression, and the PROCESS macro with a 95% bias-corrected bootstrap confidence interval. These analyses were conducted using SPSS Windows Software version 23.0 and SPSS PROCESS macro version 3.5.2. Results: Nurses' job embeddedness mediated the relationship between job rotation stress and nursing work performance (B=-0.02, p<.05). Furthermore, their resilience moderated this mediated relationship, also known as moderated mediation, with job embeddedness as the mediating factor (B=-0.02, p<.05). Conclusion: These findings imply that, when devising a strategy to improve the nursing work performance of nurses undergoing job rotation, their resilience levels should be considered. Reducing job rotation stress while concurrently enhancing job embeddedness is essential for enhancing the nursing work performance of nurses with high levels of resilience.

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Purpose@#This study examined the effect of missed nursing care on nursing sensitive indicators. @*Methods@#A nationwide cross-sectional survey was conducted using structured questionnaires. Data of 174 clinical nurses employed in general or tertiary hospitals were collected through proportional quota sampling; the quota used was the location of a working hospital in South Korea. Data were collected through an online survey and snowball sampling from July 16 to July 20, 2022. The collected data were analyzed using IBM SPSS 26.0. @*Results@#Missed nursing care had statistically significant negative correlations with patient safety management activity and job satisfaction, and significant positive correlation with turnover intention. Significant correlation was not found between missed nursing care and adverse event experiences. Hierarchical multiple regression analysis revealed that missed nursing care explained an additional 21%p of patient safety management activity, 14%p of job satisfaction, and 3%p of turnover intention. Thus, missed nursing care was found to be a statistically significant predictor of patient safety management activity, job satisfaction, and turnover intention. @*Conclusion@#Missed nursing care significantly affects nursing sensitive indicators. To improve positive outcomes and decrease negative outcomes, nurses and nursing managers must make efforts to minimize missed nursing care.

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Purpose@#This study aimed to identify the main keyword, network structure, and main topics of the national petition related to “nursing” in South Korea. @*Methods@#Data were gathered from petitions related to the national petition in Korea Blue House related to the topic “nursing” or “nurse” from August 17, 2017, to May 9, 2022. A total of 5,154 petitions were searched, and 995 were selected for the final analysis. Text network analysis and topic modeling were analyzed using the Netminer 4.5.0 program. @*Results@#Regarding network characteristics, a density of 0.03, an average degree of 144.483, and an average distance of 1.943 were found. Compared to results of degree centrality and betweenness centrality, keywords such as “work environment,” “nursing university,” “license,” and “education” appeared typically in the eigenvector centrality analysis. Topic modeling derived four topics: (1) “Improving the working environment and dealing with nursing professionals,” (2) “requesting investigation and punishment related to medical accidents,” (3) “requiring clear role regulation and legislation of medical and nonmedical professions,” and (4) “demanding improvement of healthcare-related systems and services.” @*Conclusion@#This is the first study to analyze Korea's national petitions in the field of nursing. This study's results confirmed both the internal needs and external demands for nurses in South Korea. Policies and laws that reflect these results should be developed.

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Purpose@#The purpose of this study was to evaluate the applicability of ChatGPT in biological nursing science education. @*Methods@#This study was conducted by entering questions about the field of biological nursing science into ChatGPT versions GPT-3.5 and GPT-4 and evaluating the answers. Three questions each related to microbiology and pharmacology were entered, and the generated content was analyzed to determine its applicability to the field of biological nursing science. The questions were of a level that could be presented to nursing students as written test questions. @*Results@#The answers generated in English had 100.0% accuracy in both GPT-3.5 and GPT-4. For the sentences generated in Korean, the accuracy rate of GPT-3.5 was 62.7%, and that of GPT-4 was 100.0%. The total number of Korean sentences in GPT-3.5 was 51, while the total number of Korean sentences in GPT-4 was 68. Likewise, the total number of English sentences in GPT-3.5 was 70, while the total number of English sentences in GPT-4 was 75. This showed that even for the same Korean or English question, GPT-4 tended to be more detailed than GPT-3.5. @*Conclusion@#This study confirmed the advantages of ChatGPT as a tool to improve understanding of various complex concepts in the field of biological nursing science. However, as the answers were based on data collected up to 2021, a guideline reflecting the most up-to-date information is needed. Further research is needed to develop a reliable and valid scale to evaluate ChatGPT’s responses.

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Purpose@#The aim of this study was to assess lipid levels and to identify groups with poor lipid control group among patients with dyslipidemia. @*Methods@#Data from 1,399 Korean patients with dyslipidemia older than 20 years were extracted from the Korea National Health and Nutrition Examination Survey. Complex sample analysis and decision-tree analysis were conducted with using SPSS for Windows version 27.0. @*Results@#The mean levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein cholesterol were 211.38±1.15 mg/dL, 306.61±1.15 mg/dL, 118.48±1.08 mg/dL, and 42.39±1.15 mg/dL, respectively. About 61% of participants showed abnormal lipid control. Poor glycemic control groups (TC ≥ 200 mg/dL or TG ≥ 150 mg/dL or LDL-C ≥ 130 mg/dL) were identified through seven different pathways via decision-tree analysis. Poor lipid control groups were categorized based on patients’ characteristics such as gender, age, education, dyslipidemia medication adherence, perception of dyslipidemia, diagnosis of myocardial infarction or angina, diabetes mellitus, perceived health status, relative hand grip strength, hemoglobin A1c, aerobic exercise per week, and walking days per week. Dyslipidemia medication adherence was the most significant predictor of poor lipid control. @*Conclusion@#The findings demonstrated characteristics that are predictive of poor lipid control and can be used to detect poor lipid control in patients with dyslipidemia.

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Purpose@#The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports. @*Methods@#Data were media articles related to the topic “nurse” reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. @*Results@#The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are “a nurse who committed suicide because she could not withstand the Taewoom at work” andf “a nurse as a perpetrator of a newborn abuse case,” while post-COVID-19 examples are “a nurse as a victim of COVID-19,” “a nurse working with the support of the people,” and “a nurse as a top contributor and a warrior to protect from COVID-19.” @*Conclusion@#Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses’ image.

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Purpose@#The aim of this study was to explore the causes and effects of burnout experienced by insurance review nurses working in hospitals. @*Methods@#Data were collected from April to May, 2021, using focus group interviews. The study enrolled 19 insurance review nurses with at least one year of experience. Data were analyzed using the content analysis method. @*Results@#Causes of burnout were divided into three categories: eight subcategories (feeling of insufficient competence in an insurance review, closed mind in a limited working space, incompetency from other departments, harsh words and deeds that exclude me, insurance cuts controlling my work performance, cloudy mind chased by the billing date, ineffective hospital information systems, and question with no answer) and 23 causes. The impact of burnout was divided into three categories: six subcategories (experiencing mental and physical symptoms, projecting one’s feelings into family or neglecting them, withdrawing myself, wearing a mask, decreased work performance, and desiring to leave one’s work), and 14 concepts. @*Conclusion@#This study provides basic data for strategy development to prevent and solve burnout problems among insurance review nurses. It is important to develop programs and policies to solve the burnout problem of insurance review nurses in the future.

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Purpose@#This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). @*Methods@#Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. @*Results@#The mean level of hemoglobin A1c (HbA1c) was 7.22± 0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥ 6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients’ characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. @*Conclusion@#The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

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Purpose@#This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes. @*Methods@#A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. @*Results@#The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice. @*Conclusion@#Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses’ constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

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Purpose@#This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes. @*Methods@#A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. @*Results@#The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice. @*Conclusion@#Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses’ constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

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PURPOSE: This study was done to identify trends in leadership-related research by reviewing studies on hospital nurses in South Korea.METHODS: The research was conducted from April 2 to 14, 2018 and search databases were RISS, KISS, DBpia, KM base, NAL, and NDSL. Search terms were ‘leadership’ and ‘nursing’ in the Korean language, and total 141 papers were selected.RESULTS: Analysis of the research on leadership showed that 96.4% of research methods were quantitative research, and 60.3% were predictive researches. For study settings, 46.2% were general hospitals, 96.5% were staff nurses. In the study of leadership variables, 60.3% were independent variables and recent leadership was used as a mediating variable (4.3%) and a moderating variable (2.8%). Among the leadership types, self-leadership (31.2%) was the most common, and the main variable related to leadership was job satisfaction (25.8%).CONCLUSION: These results provide useful data for deriving new research ideas about nursing leadership. Furthermore, this study has significance for providing the evidence for developing new leadership programs and policies in nursing organizations.

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PURPOSE: This study was done to identify the effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit (ICU) nurses. METHODS: A cross-sectional survey was used and data were collected from 203 ICU nurses working in two advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and Hierarchical multiple regression with SPSSWIN 23.0 program. RESULTS: The sub-domains of nursephysician collaboration were as follows: 3.77±0.51 for sharing of patient information, 3.36±0.65 for decision-making process on the cure or care, and 3.20±0.72 for relationship between nurse and physician. Nurse-physician collaboration was significantly positively correlated with nursing performance and organizational commitment. Regression analysis showed that nurse-physician collaboration explained an additional 24.9%p of nursing performance and an additional 13.4%p of organizational commitment. 'Sharing of patient information' and 'Relationship between nurse and physician' were significant predictors of nursing performance. 'Relationship between nurse and physician' was a significant predictor of organizational commitment. CONCLUSION: These results provide evidence that the collaboration between nurses and physicians should be enhanced in terms of sharing patient information and mutual respect, to improve nursing performance and organizational commitment of ICU nurses.

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PURPOSE: This study was performed to analyze the levels of blood pressure and to identify good or poor blood pressure control (BPC) groups among hypertension patients. The study was based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) conducted from 2013 to 2016. METHODS: The sociodemographic and clinical data of 4,151 Korean hypertension patients aged 20-79 years and who were taking antihypertensive medications was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples and a decision-tree analysis were performed using the SPSS WIN 24.0 program. RESULTS: The mean age was 62.46±0.21 years. The mean systolic blood pressure (SBP) was 128.07±0.28mmHg, and the diastolic blood pressure (DBP) was 76.99±0.21mmHg. 71.9% of participants showed normal blood pressure (SBP <140mmHg and DBP <90mmHg). From the decision-trees analysis, the characteristics of participants related to good BPC group were presented with 9 different pathways same as those from the poor BPC group. Good or poor BPC groups were classified according to the patients' characteristics such as age, living status, occupation, education, hypertension diagnosis period, numbers of comorbidity, perceived health status, total cholesterol, high density lipoprotein-cholesterol, alcohol drinking per month, and depressive mood. Total cholesterol level (<201mg/dL or ≥201mg/dL cutoff point) was the most significant predictor of the participants' BPC group. CONCLUSION: This decision-tree model with the 18 different pathways can form a basis for the screening of hypertension patients with good or poor BPC in either clinical or community settings.

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PURPOSE: This study was aimed at identifying the types of perceptions of ethical issues among perioperative nurses. METHODS: Q-methodology focusing on individual subjectivity was used with data collected in November 2016. Thirty-four Q-statements were selected and scored by the 35 participants on a 9-point scale with normal distribution. Participants were perioperative nurses working in advanced general hospitals and general hospitals. The data were analyzed using the PC-QUANL program. RESULTS: total of 35 perioperative nurses were classified into 4 factors based on the following viewpoints: self-centered (type 1), onlooking and avoiding (type 2), patient-centered (type 3), and problem-centered (type 4). The 4 factors accounted for 57.84% of the total variance. Individual contributions of factors 1, 2, 3, and 4 were 41.80%, 7.18%, 5.20%, and 3.66%, respectively. CONCLUSION: The major contribution of this study is the clarification of perioperative nurses' subjective perceptions of ethical issues. These findings can be used in formulating effective strategies for nursing educators, professional nurses, and nursing administrators to improve ethical decision-making abilities and to perform ethical nursing care by the appropriate management of ethical issues in everyday nursing practice.

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PURPOSE: This study was performed to assess problems associated with sleep (short and long sleep duration) and to identify risky subgroups with sleep problems among adult cancer survivors. The study is based on the Korea National Health and Nutrition Examination Survey (KNHANES VI and VII) from 2013 to 2016. METHODS: The sociodemographic and clinical data of 504 Korean cancer survivors aged 20-64 years was extracted from the KNHANES VI and VII database. Descriptive statistics for complex samples was used, and decision-tree analyses were performed using the SPSS WIN 24.0 program. RESULTS: The mean age for survivors was approximately 51 years. The mean sleep duration was 6.97 hours; 36.2% of participants had short ( 8 hours) sleep duration. From the decision-trees analyses, the characteristics of the adult cancer survivors related to sleep problems were presented with six different pathways. Sleep problems were analyzed according to the survivors' sociodemographic information (age, education, living status, and occupation), clinical characteristics (body mass index, hypercholesterolemia, and anemia) and health-related quality of life (HRQoL). The HRQoL (≤0.5 or >0.5 cutoff point) was a significant predictor of the participants' sleep problems because all six pathways were started from this predictor in the model. CONCLUSION: Health care professionals could use the decision-tree model for screening adult cancer survivors with sleep problems in clinical or community settings. Nursing interventions considering these specific individual characteristics and HRQoL level should be developed to have adequate sleep duration for Korean adult cancer survivors.

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PURPOSE: The aim of this study was to identify effects of perceived nurse-nurse collaboration and nurse-physician collaboration on nursing performance in perioperative nurses. METHODS: A cross-sectional survey was used and data were collected in September 2016. Participants were 186 perioperative nurses from three advanced general hospitals and nine general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and hierarchical multiple regression with the SPSS/WIN 23.0 program. RESULTS: The mean scores were for nurse-nurse collaboration, 2.92±0.28 out of 4, for nurse-physician collaboration, 3.29±0.65 out of 5, and for nursing performance, 3.85±0.47 out of 5. There were statistically significant positive correlations among nurse-nurse collaboration, nurse-physician collaboration, and nursing performance. Hierarchical multiple regression analysis revealed that nurse-nurse collaboration explained an additional 29%p of nursing performance. Shared processes, conflict management, and professionalism of nurse-nurse collaboration were statistically significant predictors of nursing performance. The nurse-physician collaboration explained an additional 3%p of nursing performance. Sharing of patient information was a statistically significant predictor of nursing performance. CONCLUSION: Findings indicate that intervention programs that integrate and strengthen shared processes, conflict management, professionalism, and sharing of patient information are useful to enhance nursing performance.

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BACKGROUND: The purpose of the study was to analyze the contents and importance of clinical practicum education in adult health nursing.METHODS: This is a descriptive study using content analysis for identifying the items of clinical nursing checklists gathered from 13 university nursing programs accredited by Korean Accreditation Board of Nursing Education. Items in the checklist were standardized in accordance with the Nursing Intervention Classification (NIC) and categorized into simple-technical skill, complex-technical skill, and disease-specific care. The perceived significance of each item was examined by surveying nurses who in charge of nurse education from various clinical setting.RESULTS: A total of 182 items in the clinical practicum contents were analyzed, and the terminologies of each item were variously described among nursing schools. Fifty percent of the total items were categorized into simple-technical skill. In terms of clinical importance, expert validity results showed that nurses considered infection control, infection protection, and fall prevention as the most significant items, which was not the same as the most common items in the clinical nursing checklist.CONCLUSION: These findings suggest that standardized nursing terminologies are needed to describe a nursing practicum checklist. Clinical importance of each item in the checklist should be taken into consideration in developing a clinical nursing checklist to assist the students in achieving the competencies as a clinical nurse.

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