This study was conducted to investigate the impact of delirium knowledge and delirium nursing confidence on delirium nursing practice among nurses working in an integrated nursing and caring services ward. Methods: This descriptive study included 102 registered nurses with a minimum of 6 months of professional experience from the integrated nursing and caring services ward of a university hospital in Uijeongbu City. Data were collected from May 10, 2023 to July 5, 2023 and were subjected to independent samples t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis using the SPSS/WIN 27.0 program. Results: Delirium nursing knowledge was positively correlated with delirium nursing confidence (r=.25, p=.01). Delirium nursing confidence was positively correlated with delirium nursing performance (r=.41, p<.001). Factors influencing delirium nursing performance were delirium nursing confidence (β=.32, p=.001), marital status (β=.21, p=.016), and delirium education experience (β=-.19, p=.032). The model used in this study explained 27% of the variance in delirium nursing performance (adjusted R2=0.27, F=8.46, p<.001). Conclusion: This study identified factors that influence delirium nursing performance of nurses in an integrated nursing and caring services ward in a university hospital. Based on the findings, delirium nursing education programs should include strategies that can improve delirium nursing confidence. Further research is needed to confirm the effectiveness of developing a delirium nursing practice improvement program and guideline that reflects the characteristics of integrated nursing and caring services wards.

Globally, the issue of palliative and end-of-life care (PEOLC) in nursing homes is a common concern, and the need to measure the preparedness of nursing staff for end-of-life care is increasing. This study aimed to verify the validity and reliability of the Korean version of the self-reported scale for the Staff Preparedness for PEOLC in long-term care homes. Methods: A total of 161 staff took part in the study; among them were nine nurses, 19 nursing assistants, 133 care workers at four nursing homes located in Wonju and Suncheon cities, South Korea. The scale was translated according to the guidelines of World Health Organization guidelines and Consensus-Based Standards for the Selection of Health Measurement Instruments, and its reliability and validity were evaluated through assessing its internal consistency, stability, and construct validity (confirmatory factor analysis, CFA). Results: CFA confirmed that the measurement tool had a good fit (comparative fit index=.96, Turker-Lewis index=.95, root mean-squared error of approximation=.07). The items’ internal consistencies of the items were found to be reliable with Cronbach’s alpha=.94; the Pearson’s correlation coefficient between test and retest of the tool was .86 (p<.001); and the intraclass correlation coefficient value was .91 (95% confidence interval: .85~.96). Conclusion: The Korean version of the Staff Preparedness for PEOLC in long-term care homes was confirmed to be a useful and reliable scale for measuring the preparedness of nursing staff in Korean long-term care facilities in Korea for PEOLC.

This study synthesized the literature on constipation among Korean older adults in long-term care (LTC) facilities. Methods: This scoping review utilized the Joanna Briggs Institute protocol. We conducted a literature search using Cumulative Index to Nursing and Allied Health, PubMed, PsycINFO, Korean databases Research Information Sharing Service, Korean Studies Information Service System, and ScienceON. Two reviewers independently selected the studies and extracted their characteristics using pretested forms to determine the final inclusion. In total, 473 articles were identified, and eight were used for the final analysis. Results: Quasi-experimental design was the most common research design. Sex, age, state of mobility, admission periods, LTC classification, sleep satisfaction, depressive symptoms, diet type, daily fluid intake, and history of digestion were identified as factors related to constipation. The most widely used constipation measurement method is measuring the frequency of defecation per week. Massage is the most commonly used nursing intervention to relieve constipation. Conclusion: The diversification of research on constipation is necessary to improve the quality of life of older adults living in LTC facilities. Therefore, the use of reliable tools to determine constipation in older adults in LTC facilities should be expanded. There is a need to develop and implement diverse non-pharmacological interventions for older adults in LTC facilities. The results of this study are intended to serve as a basis for the development of constipation programs for Korean older adults in LTC facilities.

This study identified the attributes and indicators of end-of-life nursing competency in long-term-care-hospital nurses and clarified the definition of the concept. Methods: The Competency Outcomes Performance Assessment model was used as a conceptual framework, and conceptual analysis was performed using the hybrid model presented by Schwartz-Barcott and Kim. In the theoretical phase, the attributes of end-of-life care competencies were explored through a literature review. In the fieldwork phase, focus group interview data were analyzed to derive the attributes of nursing competency at the end of life. In the final analysis phase, the attributes and indicators of end-of-life care competency were compared, analyzed, and integrated. Results: The attributes of end-of-life care competency among nurses in long-term care hospitals included comprehensive symptom management, effective communication, situational response, patient-centered care, information provision and education, resource management, demonstrating leadership, and professional development. Conclusion: End-of-life care competency in long-term-care-hospital nurses can be defined as a comprehensive set of competencies that includes symptom management, situational adaptation, effective communication, resource utilization, leadership, patient-centered care, meeting the needs of patients’ families through adequate information provision and education, and enhancing individual nursing capabilities through professional development. These results can serve as a foundation for developing tools to measure end-of-life care competencies among nurses in long-term care hospitals.

This study aimed to understand the lives of recovered COVID-19 patients from the viewpoints of people over the age of 60. Methods: The participants were 15 recovered patients aged over 60 who had been infected with COVID-19. Data were collected individually through in-depth interviews from September 12, 2022 to February 27, 2023. Contents of the transcribed interviews were analyzed using Corbin and Strauss’s grounded theory approach. Results: Analysis of the psychological recovery experience for older adults with COVID-19-resulted in six themes, 14 sub-themes, and 41 codes. The core category revealed was turning crisis into opportunities throughout making meaning of living in the time of COVID-19. The causal conditions included feeling disrupted due to unknowns during a crisis. The contextual conditions were a lack of support system for COVID-19 groups. The central phenomenon was a life shattered amidst COVID-19-related helplessness. The intervening conditions were rebound for changes for transformation. As a result, the action/interactional strategies were employed to find a breakthrough. In consequence, enhancement of resilience was achieved after overcoming obstacles. Conclusion: The findings provide important recommendations for healthcare professionals regarding older patients who have had COVID-19. We encourage healthcare providers to improve patient care by gaining a deeper understanding of their recovery experiences.

The purpose of this study is to identify the prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit (ICU). Methods: A retrospective descriptive correlational study design was used. Among 675 older adults who admitted to ICU after cardiac surgery in a tertiary hospital from May 2021 to April 2022, 528 were selected for data analysis. Data were collected through electronic medical records. Delirium and pain intensity were evaluated using the Confusion Assessment Method-Intensive Care Unit and Critical Care Non-verbal Pain Scale, respectively. Results: The incidence rate of delirium was 41.3% (n=218). Multivariate logistic regression analysis of the variables identified that ICU length of stay (odds ratio [OR]=1.77, p<.001), anesthesia time (OR=1.21, p=.016), pain intensity (OR=1.14, p=.044), and age (OR=1.07, p=.002) were identified as risk factors of delirium after cardiac surgery. Conclusion: ICU length of stay, anesthesia time, pain score, and advanced age should be considered as the prevention and management of delirium at the intensive care unit of older adults after cardiac surgery.

The purpose of this study was to investigate the effects of death anxiety and social support on the preferences for care near the end of life in older adults staying at long-term care hospitals. By understanding these relationships among the factors, we provide crucial insights for enhancing end-of-life care with respect to patients’ end-of-life care preferences. Methods: This was a cross-sectional study. A total of 155 older adults staying at long-term care hospitals participated in the study. Data collection was performed from January 9, 2023 to March 9, 2023. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression analysis. Results: The results of this study show that death anxiety (β=.23, p=.002), social support (β=.22, p=.003), intensive care transfer (β=.18, p=.022), and severity of illness (β=.16, p=.033) were significantly affecting factors to the care preferences near the end of life in older adults staying at long-term care hospitals. Conclusion: Understanding the end-of-life care preferences of older adults with death anxiety in long-term care hospitals is important. Expressing these preferences in a timely manner requires extensive support from patients, family, and health professionals. Developing an effective program for end-of-life care preferences is continuously needed for future studies.

Patients with cancer experience psychological and social problems; in particular, older patients with cancer face many difficulties during the cancer treatment process owing to aging and underlying diseases. Furthermore, the lives of individuals may be impacted by the COVID-19 pandemic. Therefore, the purpose of this study is to describe the experiences of older patients with cancer during the cancer diagnosis and treatment process amid the COVID-19 pandemic. Methods: This study employed a qualitative, descriptive phenomenological approach to explore and analyze the experiences of the participants. The participants in this study consisted of patients aged over 65 who were diagnosed with cancer, and data were collected from May 4 to June 30, 2022 through in-depth individual interviews. The collected data were analyzed using Giorgi’s phenomenological analysis. Results: Participants were six older patients with cancer with an average age of 69.66 years. Five theme clusters and 15 themes were generated. The theme clusters were “psychological adaptation to cancer diagnosis,” “receiving social and medical support,” “difficulty in the treatment process,” “fear of the COVID-19 pandemic,” and “living through difficulties.” Conclusion: This study revealed that older patients with cancer demonstrated a unique psychology about how to accept the shock of the diagnosis and the resulting coping patterns and feelings of depression. Additionally, it was verified that older patients with cancer, susceptible to infections due to their advanced age and weakened immunity, also face an increased vulnerability to COVID-19. Therefore, a support system tailored to the characteristics of older patients with cancer should be established.

This study aimed to explore the participation experiences of patients with type 2 diabetes in an Automated Personalized Self-Care program, assess the changes in self-care behavior and glycemic control, and evaluate the stages of change and readiness to change using the transtheoretical model (TTM). Methods: We examined 16 patients with type 2 diabetes who participated in a diabetes self-care program using a mobile application. Purposive sampling continued until data saturation. Using a mixed method study, we analyzed the participants’ characteristics, self-care behavior, stage of change, and readiness to change quantitatively and analyzed the qualitative data using Elo and Kyngas’s content analysis method. Results: The compliance group (CG) showed improved self-care behavior and glycemic control. In the CG, the proportion of participants in the action stage was higher in the exercise and diet domains and lower in the blood glucose testing and medication domains than in the non-compliance group (NCG). Readiness to change, motivation for health behaviors, and social motivation were higher in the CG, whereas personal motivation was higher in the NCG. In this qualitative study, three categories and 11 subcategories were identified. The findings suggest the CG regarded their experience in the program more frequently as positive, whereas the NCG perceived greater barriers to using the mobile application in the program. Conclusion: Based on the differences identified between the CG and NCG, TTM-based strategies are needed to facilitate the progression of NCG to the action stage.