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: Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required. METHODS: The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables. RESULTS: The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care. CONCLUSION: These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.
Delivery of Health Care ; Empathy ; Humans ; Korea ; Leadership ; Models, Theoretical ; Nursing ; Organizational Culture ; Patient-Centered Care

BACKGROUND: Quality ratings could provide vital information to help people in choosing a nursing home. PURPOSE: This study investigated factors aligned with quality ratings of nursing homes. METHODS: We employed a cross-sectional descriptive design to assess publicly available data on 1,354 nursing homes with 30 or more beds in the Republic of Korea. After excluding 289 nursing homes with no reported quality-evaluation ratings, we analyzed the 2015 data of 1,065 nursing homes. To prevent multicollinearity among independent variables, we carefully selected the final set of variables based on clinical and theoretical meaningfulness to direct nursing care. Quality, the ordinal outcome, was scored from 1 to 5 with a higher score indicating higher quality of the organization. We constructed a multivariate ordered logistic regression model. RESULTS: Higher quality ratings of nursing homes was significantly related to the number of unoccupied beds (OR=0.99, p=.024), registered nurses (RNs) (OR=1.30, p=.003), qualified care workers (OR=1.03, p=.011), cognitive-improvement programs (OR=1.05, p=.024), and other programs for residents' activities (OR=1.09, p<.001). CONCLUSION: The number of RNs had the strongest influence on the publicly reported quality rating, while the rating of qualified care workers demonstrated little effect and that of nursing assistants had no effect. The number of RNs could be used as a crucial indicator for high-quality homes; more resident-engaging programs also demonstrated better quality of nursing home care.
Humans ; Korea ; Logistic Models ; Nurses ; Nursing Care ; Nursing Homes ; Nursing ; Quality of Health Care ; Republic of Korea

PURPOSE: The objective of this study was to investigate the prevalence of antenatal depression in pregnant women and its influencing factors. METHODS: With a cross-sectional survey design, a total of 396 pregnant women were recruited from a local obstetrics and gynecology clinic. Measurements included antenatal depression, perceived stress, predictors of depression during pregnancy, and demographic and obstetric characteristics. RESULTS: Mean antenatal depression score was 8.20 (standard deviation=4.95) out of 30, falling into its normal range. However, the prevalence of antenatal depression was 35.9% when cut-point of 9/10 was used. The prevalence of antenatal depression among women in the first trimester was 31.4%. It was slightly increased to 34.9% in the second trimester but significantly increased to 40.5% in the third trimester. In multiple logistic regression analysis, experiencing prenatal anxiety (odds ratio [OR], 4.16), having no job (OR, 2.90), lower self-esteem (OR, 1.62), and higher perceived stress (OR, 1.32) were significant factors influencing antenatal depression. CONCLUSION: Negative feeling such as feeling anxious, lower self-esteem, and higher perceived stress during pregnancy are key factors affecting antenatal depression. Thus, antenatal nursing intervention focusing on pregnant women's feeling upon their job status is necessary to improve their antenatal psychological well-being.
Accidental Falls ; Anxiety ; Cross-Sectional Studies ; Depression ; Female ; Gynecology ; Humans ; Logistic Models ; Maternal Health ; Nursing ; Obstetrics ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Prevalence ; Reference Values

PURPOSE: This study aimed to investigate the status of caffeine-containing energy drink consumption among Korean nursing students and to identify associated psychological factors. METHODS: In total, 187 Korean nursing students participated in this cross-sectional study. A self-administered questionnaire was used to identify participants' general characteristics and psychosocial factors (self-esteem, academic stress, depression, and college adjustment) associated with energy drink consumption. Data were analyzed with SPSS using descriptive statistics, the χ² test, the t-test, and logistic regression. RESULTS: More than two-thirds (73.3%) of the participants had consumed energy drinks. Among the investigated psychological factors, depression appeared to most strongly influence energy drink consumption behaviors in this population. CONCLUSION: The consumption of caffeine-containing energy drinks was found to be common among nursing students preparing to become health care professionals; depressed nursing students were more likely to have consumed energy drinks than non-depressed students. Nursing educators should emphasize the early detection of unhealthy beverage consumption habits and provide appropriate education to enhance healthy behaviors in future health care professionals.
Beverages ; Cross-Sectional Studies ; Delivery of Health Care ; Depression ; Education ; Energy Drinks* ; Humans ; Logistic Models ; Nursing* ; Psychology* ; Students, Nursing*

PURPOSE: The purpose of this study was to identify predictors of eating disorders in adolescents with type 1 diabetes, with the goal of providing data in support of nursing interventions to improve their health.METHODS: A total of 136 adolescents aged 13–18 years with type 1 diabetes completed the Diabetes Eating Problem Survey-Revised, Rosenberg Self-Esteem Scale, and the Beck Depression Inventory-II, using structured self-reported questionnaires. The collected data were analyzed using the t-test, χ² test, and binominal logistic regression with SPSS version 23.0 for Windows.RESULTS: The prevalence of eating disorders in adolescents with type 1 diabetes was 39%. Four significant predictors of eating disorders were identified; absence of body satisfaction (odds ratio [OR]=3.87, 95% confidence interval [CI]=1.55~9.65), depression (OR=2.87, 95% CI=1.13~7.28), female gender (OR=2.67, 95% CI=1.09~6.54), and glycosylated hemoglobin type A1c levels (OR=1.47, 95% CI=1.10~1.97).CONCLUSION: In order to prevent eating disorders among adolescents with type 1 diabetes, programs for managing adolescents' depression and improving their body satisfaction should be developed. Futhermore, more attention should be directed towards programs aiming to prevent eating disorders in female adolescents.
Adolescent ; Body Image ; Depression ; Diabetes Mellitus, Type 1 ; Eating ; Female ; Hemoglobin A, Glycosylated ; Humans ; Logistic Models ; Nursing ; Prevalence

PURPOSE: The aim of this study was to identify the effect of metacognition, communication skills, and confidence in the performance of core basic nursing skills on clinical competency in nursing students.METHODS: A total of 158 students were recruited from two nursing colleges in B metropolitan city. Data were collected by means of self-reported questionnaires from December 3–31, 2018 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple linear regression with SPSS 21.0.RESULTS: Metacognition, communication skills, and confidence in the performance of core basic nursing skills were higher than normal and the relationship between the variables metacognition (r=.69, p=<.001), communication skills (r=.69, p=<.001), and confidence in the performance of core basic nursing skills (r=.59, p=<.001) were highly positively correlated with clinical performance. Factors influencing these three variables accounted for 64.4% of clinical competency.CONCLUSION: Further research on the development of the curriculum and intervention program, and the verification of the effect are needed.
Clinical Competence ; Curriculum ; Humans ; Linear Models ; Metacognition ; Nursing ; Students, Nursing

PURPOSE: The study was done to investigate the influence of voice behavior, self-esteem and sexual knowledge on sexual assertiveness of nursing college students.METHODS: A structured self-report questionnaire was used to measure voice behavior, self-esteem, sexual knowledge and sexual assertiveness. During March, 2019, data were collected from 133 nursing students in D city and G city. Data were analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple linear regression with the SPSS/WIN 25.0 program.RESULTS: Voice behavior and self-esteem were positively correlated with the sexual assertiveness of participants, while voice behavior was positively correlated with the self-esteem of participants. Also, self-esteem was a significant predictor of sexual assertiveness in nursing college students. The predictor explained 12% of their sexual assertiveness.CONCLUSION: The finding indicates that self-esteem is an important factor for sexual assertiveness of nursing students. It is also expected that self-esteem can further promote their sexual assertiveness.
Assertiveness ; Humans ; Linear Models ; Nursing ; Reproductive Health ; Students, Nursing ; Voice