Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. Methods: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness. Results: The median age was 40 years (range, 20–73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5–7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT). Conclusion The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.

PURPOSE: This study was performed to identify factors associated with human papillomavirus vaccination intention among unvaccinated nursing students. METHODS: Two hundred-and-five female nursing students from three universities completed self-administered questionnaires including participants' characteristics, human papillomavirus-related knowledge, attitude toward human papillomavirus vaccination, and human papillomavirus-related health beliefs. Multivariate logistic regression analysis was used to determine significant independent predictors of human papillomavirus vaccination intention. RESULTS: Of 205 participants, 134 (65.4%) reported an intention to obtain a vaccination against human papillomavirus. As a result of the analysis of the bivariate relationships, family history of cervix cancer, perceived needs, importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier were significantly related to vaccination intention. A multivariate logistic regression model identified factors of human papillomavirus vaccination intention: higher importance of prevention (Adjusted Odds Ratio [AOR]: 4.20, 95% Confidence Interval [CI]: 1.73~10.19), higher perceived benefit (AOR: 6.94, 95% CI: 2.01~23.98), lower perceived barrier (AOR: 0.39, 95% CI: 0.20~0.73). CONCLUSION: The results of this study indicated significant factors influencing the intention to obtain human papillomavirus vaccination in unvaccinated nursing students. Also, the importance of prevention, perceived susceptibility, perceived benefit, and perceived barrier in obtaining human papillomavirus vaccination should be taken into account when developing educational programs.
Family Relations ; Female ; Human Characteristics ; Humans* ; Intention* ; Korea* ; Logistic Models ; Nursing* ; Odds Ratio ; Students, Nursing* ; Uterine Cervical Neoplasms ; Vaccination*

PURPOSE: This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients.METHOD: Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses.RESULTS: The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life.CONCLUSION: This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.
Critical Care ; Education ; Humans ; Intensive Care Units ; Methods ; Sublimation ; Tertiary Care Centers

PURPOSE: This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality.METHOD: This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups.RESULTS: The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units.CONCLUSION: Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.
Confidentiality ; Critical Care ; Delivery of Health Care ; Education ; Ethics ; Intensive Care Units ; Mental Competency ; Methods ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life.METHODS: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital.RESULTS: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members.CONCLUSIONS: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.
Critical Care ; Decision Making ; Delivery of Health Care ; Hospitals, General ; Humans ; Methods

PURPOSE: The purpose of this study was to identify university students' willingness to write advance directives and factors related to this willingness. METHOD: A cross-sectional survey design was used and 400 nursing students and 287 non-nursing students participated in the study. Data were collected by convenience sampling using self-report questionnaires. Data were analyzed with descriptive statistics, t-test, ANOVA, correlation, and multiple regression. RESULTS: The mean score for willingness to write advance directives was 4.09. From the multiple regression analysis, predictors of willingness to write advance directives were found to be majoring in nursing, awareness of advance directives, preference for autonomous decision making related to the end of life care, family preference related to the end of life care, and self esteem. CONCLUSION: The study results indicate that various factors are related to willingness to write advance directives and nurses need to consider client characteristics, knowledge, and own values when taking care of issues on advance directives.
Advance Directives ; Cross-Sectional Studies ; Decision Making ; Female ; Humans ; Surveys and Questionnaires ; Students, Nursing ; Terminal Care

PURPOSE: This study aimed to describe Korean nurses' willingness to report suspected elder abuse and examine its related factors. METHODS: A descriptive correlational design was used. A convenience sample of 365 nurses from a hospital completed our questionnaires. Stepwise logistic regression analysis was performed to examine predictors of willingness to report. RESULTS: Sixty-eight nurses (18.6%) were not willing to report suspected elder abuse. In the stepwise logistic regression analysis, fewer years in clinical work, a higher level of knowledge on elder abuse law, and the perception of more severe abuse were found to be significant predictors of willingness to report elder abuse. CONCLUSION: As the Welfare of the Aged Act included a clause on mandated reporters, nurses' role in intervening in elder abuse cases has become more critical. In order to increase nurses' reporting, education on elder abuse should be provided to all nurses, and support programs should be designed for nurses to effectively involve them in reporting elder abuse.
Aged ; Elder Abuse ; Humans ; Jurisprudence ; Logistic Models ; Mandatory Reporting ; Surveys and Questionnaires

BACKGROUND: Type 2 diabetes mellitus (T2DM) has a strong genetic component, and its prevalence is notably increased in the family members of T2DM patients. However, there are few studies about the family history of T2DM. We carried out this study to assess the influences of family history on clinical characteristics in T2DM patients. METHODS: This is a cross-sectional study involving 651 T2DM patients. Patient history and physical examination were performed and fasting blood was taken. If any first degree relative was diabetic, a family history of diabetes was considered to exist. RESULTS: Among the total 621 patients, 38.4% had a family history of diabetes. Patients with a family history had a younger age, higher weight, younger age at diagnosis and higher triglyceride level than did those without a family history. Dyslipidemia medication and metabolic syndrome were more prevalent in familial diabetes. Sex, blood pressure, previous treatment for diabetes, HbA1C, C-peptide, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were not different between familial and non-familial diabetes. Upon multiple linear regression analysis, the family history of diabetes remained significantly associated with serum triglyceride level. CONCLUSION: In T2DM patients with a family history of diabetes, the disease tended to develop earlier. Metabolic syndrome and cardiovascular risk factors are more prevalent in familial T2DM than they were in non-familial T2DM. These results support the necessity of earlier screening for diabetes in family members of T2DM patients and more active prevention against cardiovascular disease in T2DM patients with a family history.
Blood Pressure ; C-Peptide ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Fasting ; Humans ; Linear Models ; Lipoproteins ; Mass Screening ; Physical Examination ; Prevalence ; Risk Factors

PURPOSE: The purpose of this study was to explore the factors related to physical and affective well-being of taxi drivers. The main factors of interests were workplace hazards and work environment. METHOD: This was a cross-sectional descriptive study. A convenience sampling method was utilized. 181 taxi drivers in Seoul metropolitan area completed survey questionnaires. RESULT: In bivariate analysis, payment system, workplace hazards, and work environment were associated with physical health of taxi drivers. Multiple regression analysis revealed payment system and workplace hazards were significant predictors of physical health. On the other hand, age and workplace hazards, and work environment were significantly associated with affective health in the bivariate analysis. Moreover, workplace hazards and environment were significant predictors of affective health in the multiple regression analysis. CONCLUSION: To improve taxi drivers' health status, it is critical to reform payment system to monthly payment, establish prevention policies of workplace hazards, and encourage employers and taxi drivers to make efforts for better work environment.
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PURPOSE: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. METHODS: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. RESULTS: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. CONCLUSION: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.
Adult ; Aged ; Aged, 80 and over ; Anxiety/*epidemiology/etiology ; Coronary Care Units ; Cross-Sectional Studies ; Female ; Humans ; Inpatients/*psychology ; *Intensive Care Units ; Male ; Middle Aged ; Questionnaires ; Time Factors