Purpose: This study aimed to confirm the mediating effects of transition shock on the relationships among grit, social support, and retention intention of new graduate nurses. Methods: A total of 174 new graduate nurses were recruited from a university hospital and a general hospital. The data were collected between November and December 2022 and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, and the PROCESS Macro Model 4. Results: Nurses’ retention intention was positively correlated with grit (r=.56, p<.001) and social support (r=.48, p<.001) and negatively correlated with transition shock (r=-.56, p<.001). The mediating analysis revealed that transition shock mediated the relationship between grit and retention intention as well as between social support and retention intention. Conclusion Based on the findings, an intervention program should be developed to reduce transition shock in new graduate nurses to increase their intention of retention.

Purpose: This study aimed to confirm the mediating effects of transition shock on the relationships among grit, social support, and retention intention of new graduate nurses. Methods: A total of 174 new graduate nurses were recruited from a university hospital and a general hospital. The data were collected between November and December 2022 and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, and the PROCESS Macro Model 4. Results: Nurses’ retention intention was positively correlated with grit (r=.56, p<.001) and social support (r=.48, p<.001) and negatively correlated with transition shock (r=-.56, p<.001). The mediating analysis revealed that transition shock mediated the relationship between grit and retention intention as well as between social support and retention intention. Conclusion Based on the findings, an intervention program should be developed to reduce transition shock in new graduate nurses to increase their intention of retention.

Purpose: This study aimed to confirm the mediating effects of transition shock on the relationships among grit, social support, and retention intention of new graduate nurses. Methods: A total of 174 new graduate nurses were recruited from a university hospital and a general hospital. The data were collected between November and December 2022 and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, and the PROCESS Macro Model 4. Results: Nurses’ retention intention was positively correlated with grit (r=.56, p<.001) and social support (r=.48, p<.001) and negatively correlated with transition shock (r=-.56, p<.001). The mediating analysis revealed that transition shock mediated the relationship between grit and retention intention as well as between social support and retention intention. Conclusion Based on the findings, an intervention program should be developed to reduce transition shock in new graduate nurses to increase their intention of retention.

Purpose: This study aimed to confirm the mediating effects of transition shock on the relationships among grit, social support, and retention intention of new graduate nurses. Methods: A total of 174 new graduate nurses were recruited from a university hospital and a general hospital. The data were collected between November and December 2022 and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, and the PROCESS Macro Model 4. Results: Nurses’ retention intention was positively correlated with grit (r=.56, p<.001) and social support (r=.48, p<.001) and negatively correlated with transition shock (r=-.56, p<.001). The mediating analysis revealed that transition shock mediated the relationship between grit and retention intention as well as between social support and retention intention. Conclusion Based on the findings, an intervention program should be developed to reduce transition shock in new graduate nurses to increase their intention of retention.

Purpose: This study aimed to evaluate the clinical outcomes and prognostic implications of regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NAC) in patients with residual triple-negative breast cancer (TNBC). Materials and Methods: We analyzed 152 patients with residual TNBC who underwent breast-conserving surgery after NAC between December 2008 and December 2017. Most patients (n = 133; 87.5%) received taxane-based chemotherapy. Adjuvant radiotherapy (RT) was administered at a total dose of 45–65 Gy in 15–30 fractions to the whole breast, with some patients also receiving RT to regional nodes. Survival was calculated using the Kaplan–Meier method, and prognostic factors influencing survival were analyzed using the Cox proportional-hazards model. Results: During a median follow-up of 66 months (range, 9 to 179 months), the 5-year disease-free survival (DFS) rate was 68.0%. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, and overall survival rates were 83.6%, 72.6%, and 78.7%, respectively. In the univariate analysis, the cN stage, ypT stage, ypN stage, axillary operation type, and RT field were associated with DFS. Multivariate analysis revealed that higher ypT stage (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.00–3.82; p = 0.049) and ypN stage (HR = 4.7; 95% CI 1.57–14.24; p = 0.006) were associated with inferior DFS. Among clinically node-positive patients, those who received RT to the breast only had a 5-year DFS of 73.7%, whereas those who received RNI achieved a DFS of 59.6% (p = 0.164). There were no differences between the DFS and RNI. Conclusion In patients with residual TNBC, higher ypT and ypN stages were associated with poorer outcomes after NAC. RNI did not appear to improve DFS. More intensive treatments incorporating systemic therapy and RT should be considered for these patients.

Purpose: This study aimed to evaluate the clinical outcomes and prognostic implications of regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NAC) in patients with residual triple-negative breast cancer (TNBC). Materials and Methods: We analyzed 152 patients with residual TNBC who underwent breast-conserving surgery after NAC between December 2008 and December 2017. Most patients (n = 133; 87.5%) received taxane-based chemotherapy. Adjuvant radiotherapy (RT) was administered at a total dose of 45–65 Gy in 15–30 fractions to the whole breast, with some patients also receiving RT to regional nodes. Survival was calculated using the Kaplan–Meier method, and prognostic factors influencing survival were analyzed using the Cox proportional-hazards model. Results: During a median follow-up of 66 months (range, 9 to 179 months), the 5-year disease-free survival (DFS) rate was 68.0%. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, and overall survival rates were 83.6%, 72.6%, and 78.7%, respectively. In the univariate analysis, the cN stage, ypT stage, ypN stage, axillary operation type, and RT field were associated with DFS. Multivariate analysis revealed that higher ypT stage (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.00–3.82; p = 0.049) and ypN stage (HR = 4.7; 95% CI 1.57–14.24; p = 0.006) were associated with inferior DFS. Among clinically node-positive patients, those who received RT to the breast only had a 5-year DFS of 73.7%, whereas those who received RNI achieved a DFS of 59.6% (p = 0.164). There were no differences between the DFS and RNI. Conclusion In patients with residual TNBC, higher ypT and ypN stages were associated with poorer outcomes after NAC. RNI did not appear to improve DFS. More intensive treatments incorporating systemic therapy and RT should be considered for these patients.

Purpose: This study aimed to evaluate the clinical outcomes and prognostic implications of regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NAC) in patients with residual triple-negative breast cancer (TNBC). Materials and Methods: We analyzed 152 patients with residual TNBC who underwent breast-conserving surgery after NAC between December 2008 and December 2017. Most patients (n = 133; 87.5%) received taxane-based chemotherapy. Adjuvant radiotherapy (RT) was administered at a total dose of 45–65 Gy in 15–30 fractions to the whole breast, with some patients also receiving RT to regional nodes. Survival was calculated using the Kaplan–Meier method, and prognostic factors influencing survival were analyzed using the Cox proportional-hazards model. Results: During a median follow-up of 66 months (range, 9 to 179 months), the 5-year disease-free survival (DFS) rate was 68.0%. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, and overall survival rates were 83.6%, 72.6%, and 78.7%, respectively. In the univariate analysis, the cN stage, ypT stage, ypN stage, axillary operation type, and RT field were associated with DFS. Multivariate analysis revealed that higher ypT stage (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.00–3.82; p = 0.049) and ypN stage (HR = 4.7; 95% CI 1.57–14.24; p = 0.006) were associated with inferior DFS. Among clinically node-positive patients, those who received RT to the breast only had a 5-year DFS of 73.7%, whereas those who received RNI achieved a DFS of 59.6% (p = 0.164). There were no differences between the DFS and RNI. Conclusion In patients with residual TNBC, higher ypT and ypN stages were associated with poorer outcomes after NAC. RNI did not appear to improve DFS. More intensive treatments incorporating systemic therapy and RT should be considered for these patients.

Purpose: The Avoid Axillary Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy (ASLAN) trial aims to demonstrate the oncologic safety of omitting axillary surgery in patients with excellent response after neoadjuvant chemotherapy (NACT) for early human epidermal growth factor 2 (HER2)-positive (+)/triple-negative breast cancer (TNBC) who have undergone breast-conserving surgery (BCS) and adjuvant radiotherapy. The ASLAN trial will provide crucial information that could change the procedure in highly selected patients undergoing axillary surgery after NACT. Methods ASLAN is a prospective, multicenter, and single-arm surgical trial. The recruitment will be conducted among five tertiary care hospitals in the Republic of Korea. The total number of patients to be recruited will be 178, and we plan to complete patient enrollment by December 2023. The enrollment is considered among patients with HER2+ breast cancer (BC) or TNBC at clinical stage T1–3N0–1M0 who are expected to achieve breast pathological complete response (BpCR) based on a combination of radiologic imaging and physical examination after NACT. BCS was performed on eligible patients. After BCS, patients who showed BpCR were enrolled with the omission of sentinel lymph node biopsy (SLNB). The primary study endpoint upon completion of this trial is 5-year recurrence-free survival, and the secondary endpoints include the 5-year ipsilateral breast tumor recurrence interval, 5-year ipsilateral axillary recurrence interval, 5-year distant metastasis-free survival, 5-year BC-specific survival, 5-year overall survival, 5-year contralateral BC-free survival, re-operation rate according to breast biopsy after NACT, adverse events within 5 years, and quality of life.Discussion: Several clinical trials are currently underway to determine whether SLNB can be omitted after NACT in patients with HER2+ BC or TNBC that are expected to achieve pathologic complete response. The ASLAN trial is expected to provide valuable clues regarding the feasibility of omitting axillary surgery in highly selected patients.

Purpose: This study examined the relationships between organizational silence, organizational commitment, organizational justice, and organizational citizenship behavior among clinical nurses. Additionally, it determined the mediating effect of organizational commitment moderated by organizational justice on the relationship between organizational silence and organizational citizenship behavior among clinical nurses. Methods: A total of 160 clinical nurses were recruited from a university hospital. Data were collected from June to July, 2023. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, Hayes’ PROCESS macro model, and bootstrapping using SPSS/WIN 27.0 program. Results: Organizational commitment had a full mediating effect on the relationship between organizational silence and organizational citizenship behavior (B=-0.04, CI [-0.098~-0.001]). Among the subscales of organizational justice, distributive justice had a moderating effect on the relationship between organizational silence and organizational commitment (B=-0.17, p=.009). There was no significant mediating effect of organizational commitment moderated by organizational justice on the relationship between organizational silence and organizational citizenship behavior. Conclusion Appropriate strategies are needed to effectively manage nursing personnel and improve nursing performance.

Purpose: This study examined the relationships between organizational silence, organizational commitment, organizational justice, and organizational citizenship behavior among clinical nurses. Additionally, it determined the mediating effect of organizational commitment moderated by organizational justice on the relationship between organizational silence and organizational citizenship behavior among clinical nurses. Methods: A total of 160 clinical nurses were recruited from a university hospital. Data were collected from June to July, 2023. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, Baron and Kenny’s three-step regression analysis, Hayes’ PROCESS macro model, and bootstrapping using SPSS/WIN 27.0 program. Results: Organizational commitment had a full mediating effect on the relationship between organizational silence and organizational citizenship behavior (B=-0.04, CI [-0.098~-0.001]). Among the subscales of organizational justice, distributive justice had a moderating effect on the relationship between organizational silence and organizational commitment (B=-0.17, p=.009). There was no significant mediating effect of organizational commitment moderated by organizational justice on the relationship between organizational silence and organizational citizenship behavior. Conclusion Appropriate strategies are needed to effectively manage nursing personnel and improve nursing performance.