nursing home–acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER).METHODS: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015–May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression.RESULTS: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics–treated group than in the appropriate antibiotics–treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER.CONCLUSION: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.]]>
Anti-Bacterial Agents ; Bacteria ; Cohort Studies ; Critical Care ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Multivariate Analysis ; Nursing ; Pneumonia ; Retrospective Studies ; Risk Factors

PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.
Models, Structural ; Psychiatric Nursing

PURPOSE: This study was conducted to identify and analyze the trends of theory-based research published in Asian Oncology Nursing (AON) from 2011 to 2017. METHODS: We analyzed 22 theory-based studies taken from among the 232 studies published in AON for 7years. We analyzed the framework developed by researchers, descriptive summaries of theory, keyword classification of nursing meta-paradigms, the generic character of the studies, and the type of research designs. RESULTS: A total of 23 theories were applied in the 22 (9.5%) studies. ‘Nursing’ was the most prevalent field of study (34.8%). In the field of study of theory, nursing theory was the largest with eight (34.8%), and in the method of theory utilization, all 22 studies were theoretical applications 3 middle-range theories were most prevalent. In the keyword classification using meta-paradigm in nursing, we found 83 key words. Among them, ‘Health’ related key words were most frequent (53), followed by ‘Cancer’ keywords (13). CONCLUSION: AON has a high ratio of theoretical study compared to other journals, but the ratio is still less than 10%, which is still weak. Therefore, it is believed that the attention to, utilization of, application, and institutional establishment of nursing theory should be necessary.
Asian Continental Ancestry Group ; Classification ; Humans ; Methods ; Models, Theoretical ; Nursing ; Nursing Theory ; Oncology Nursing ; Research Design

PURPOSE: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. METHODS: The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. RESULTS: The modified model was a good fit for the data. The model fit indices were χ2=423.18 (p<.001), χ2/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=−.51, p=.001), symptom experiences (β=−.27, p=.001), menopausal symptoms (β=−.22, p=.008), and chemotherapy-related cognitive impairment (β=−.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%. CONCLUSION: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.
Anxiety ; Breast Neoplasms ; Breast ; Cognition ; Cognition Disorders ; Depression ; Drug Therapy ; Female ; Humans ; Menopause ; Models, Structural ; Nursing ; Psychology ; Quality of Life

PURPOSE: The aim of this study was to identify factors influencing on the mental health in bereaved adults. METHODS: A descriptive and correlational study was conducted in 160 adults who had experienced bereavement. The collected data was analyzed using descriptive statistics, Pearson's correlation, and hierarchical multiple linear regression analyses with SPSS 26.0. RESULTS: The participants' mental health showed a positive correlation with complicated grief (r=.31, p<.001) and a negative correlation with grief and meaning reconstruction (r=−.30, p<.001). Sex, sleeping time, intimacy with the deceased, grief reaction, and grief and meaning reconstruction were significant factors influencing on the mental health. The total explanatory power of these variables was 31.8%. CONCLUSION: It is necessary to explore the persistent and impairing grief after experiencing bereavement. Our study findings will be fundamental evidence to develop nursing interventions to improve adult mental health dealing with bereavement and grief.
Adult ; Bereavement ; Grief ; Humans ; Linear Models ; Mental Health ; Nursing

PURPOSE: The purpose of this study was to identify the moderating effect of social support on the relationship between violence experiences and violence responses of psychiatric nurses. METHODS: In this descriptive study, 211 psychiatric nurses were recruited from twelve psychiatric hospitals. A structured self-report questionnaire was used to measure the study variables. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and a series of multiple linear regression analyses based on Baron and Kenny's method with the SPSS 24.0 program. RESULTS: Violence responses positively correlated with violence experiences (r=.15, p=.031), but negatively correlated with social support (r=−.25, p<.001). Social support was a significant variable on violence responses (β=−.26, p<.001). Social support did not moderate effect (β=−.06, p=.377). However family support was significant in controlling emotional responses to psychiatric nurses' experience of verbal violence (β=−.15, p=.027). Friends support was significant in controlling social responses to psychiatric nurses experienced verbal violence (β=−.14, p=.041). CONCLUSION: Our study findings indicate a need to provide social support for preventing and alleviating violence responses of psychiatric nurses.
Friends ; Hospitals, Psychiatric ; Humans ; Linear Models ; Methods ; Psychiatric Nursing ; Violence

PURPOSE: The aim of the study was to investigate associations of spiritual well-being, attitude toward death, and quality of life among Alcoholics Anonymous (AA). METHODS: This study was cross-sectional and descriptive in design. The data was collected from August to September 2018 with 133 AA members drawn from two provinces of South Korea. The data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA with Turkey tests, Pearson's correlation coefficients, and hierarchical multiple linear regression analyses using SPSS/WIN 20.0 program. RESULTS: The existential spiritual well-being (β=.52, p<.001), attitude toward death (β=.24, p<.001), dual diagnosis (β=−.17, p=.003), occupation (β=.12, p=.035) of the participants were significant factors, which explained 63.7% of the variance of quality of life. CONCLUSION: The study findings highlight the need to develop psychological nursing strategies to enhance the spiritual well-being and improve a positive attitude toward death based on the job and dual diagnosis among AA members to improve their better quality of life.
Alcohol-Related Disorders ; Alcoholics Anonymous ; Alcoholics ; Attitude to Death ; Diagnosis, Dual (Psychiatry) ; Humans ; Korea ; Linear Models ; Nursing ; Occupations ; Quality of Life ; Spirituality ; Turkey

PURPOSE: This aim of this study was to investigate the mediating effect of interpersonal relations on the association between emotional intelligence and happiness of nursing students. METHODS: Both junior and senior nursing students were selected for this study (N=187). The survey was conducted using self-reported questionnaire between March and May, 2018. The data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis with Sobel test. RESULTS: The happiness of nursing students had positive correlation with emotional intelligence (r=.70, p<.01) and interpersonal relations (r=.60, p<.01). Emotional intelligence had positive correlation with interpersonal relations (r=.63, p<.01). Interpersonal relations had a partially mediating effect on the relationship between emotional intelligence and happiness of nursing students. CONCLUSION: According to this study, interpersonal relations played an important role to buffer the impact of emotional intelligence on happiness among nursing students. Therefore, it is necessary to develop a psychological program to improve interpersonal relations to enhance the happiness of nursing students.
Emotional Intelligence ; Happiness ; Humans ; Interpersonal Relations ; Linear Models ; Negotiating ; Nursing ; Students, Nursing

PURPOSE: The purpose of this study was to explore uncertainty, depression, and anxiety in isolated inpatients and to identify associations between them, with specific focus on state anxiety. METHODS: Data were collected using structured questionnaires and semi-structured interviews, administered to isolated inpatients at an acute care hospital (N=92). The structured questionnaires consisted of the State-Trait Anxiety Inventory, Mishel Uncertainty in Illness Scale, and the Center for Epidemiologic Studies Depression Scale. Multiple linear regression and content analysis were conducted. RESULTS: Isolated inpatients showed significant differences in uncertainty, depression, trait anxiety, and state anxiety according to gender, perception of sufficient information about isolation, and the type of isolation. State anxiety scores increased when sufficient information about isolation was not provided (β=.23, p=.005), with higher levels of depression (β=.24, p=.020) and trait anxiety (β=.49, p<.001). Through the content analysis, three themes were identified regarding patient's information needs about isolation specifically for disease, explanation, and environment. CONCLUSION: Based on the findings, it is crucial to improve the awareness of emotional responses of isolated patients experiencing uncertainty, depression, and anxiety. Our study findings are expected to support the development of nursing interventions to provide proper information and mental health support when caring for isolated inpatients.
Anxiety ; Depression ; Epidemiologic Studies ; Humans ; Information Seeking Behavior ; Inpatients ; Linear Models ; Mental Health ; Nursing ; Patient Isolation ; Uncertainty

PURPOSE: The purpose of this study was to identify influencing factors of metabolic index and cardiovascular risk factors, on depressive and non-depressive groups, in vulnerable diabetic elderly women. METHODS: Participants were 137 vulnerable diabetic elderly women, using health centers in D city. Data were collected through interviews September though December 2017. The metabolic index was measured using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), and cardiovascular risk factors were measured using Framingham Risk Score (FRS). Depressive and non-depressive groups were divided by the score of Geriartric Depress Scale Short Korea Version (GDSSF). Collected data were analyzed using a x2 test, independent t-test, and binary logistic regression, with the SPSS/WIN 25.0 program. RESULTS: Vulnerable diabetic elderly women, did not exercise in the depressive groups, and had higher triglyceride (TG), total cholesterol (TC) and larger waists, than in the non-depressive group. Results show that lack of exercise (OR=6.30), is the highest risk factor, influencing the depressive symptom in vulnerable diabetic elderly women. CONCLUSION: These results suggest that to reduce depressive symptom levels among vulnerable diabetic elderly women, nursing interventions are needed to increase exercise and decrease TG, TC, and waist size, particularly in improving exercise of vulnerable diabetic elderly women.
Aged ; Cardiovascular System ; Cholesterol ; Depression ; Education ; Female ; Humans ; Korea ; Logistic Models ; Nursing ; Risk Factors ; Triglycerides ; Vulnerable Populations