We investigated factors associated with malnutrition in nursing home residents and estimated pooled effect sizes of those associations. Methods: We report this study according to the PRISMA checklist 2020. After registering the protocol, we conducted a systematic search using the keywords “malnutrition,” “nursing home,” and “factor” on PubMed, EMBASE, CINAHL, and Scopus and conducted a hand search of relevant sources in November 2023. We conducted the meta-analysis using R4.3.1 software. Results: We included 46 studies and entered 35 studies into the meta-analysis. Meta-analysis results showed that (1) demographic factors included being female: pooled odds ratio (pOR) 1.38 (95% confidence interval [95% CI], 1.29~1.47) and higher body mass index: pOR 0.74 (95% CI, 0.66~0.83); (2) health functional factors including dependence with activities of daily living: pOR 3.70 (95% CI, 2.97~4.60) and being immobile: pOR 2.50 (95% CI, 1.39~4.47); (3) eating and oral intake factors including: eating <50% of offered food portions: pOR 3.56 (95% CI, 2.05~6.19) and loss of appetite: pOR 3.60 (95% CI, 1.36~9.57); (4) disease-related factors including dementia: pOR 1.98 (95% CI, 1.59~2.46), depression: pOR 1.84 (95% CI, 1.18~2.85), diabetes: pOR 0.76 (95% CI, 0.58~0.99), and pressure ulcers: pOR 2.14 (95% CI, 1.54~2.97); and (5) medication-related factors such as taking polypharmacy pOR 1.75 (95% CI, 1.24~2.47) were found to have a significant association with malnutrition in nursing homes. Conclusion: These results contribute to updating knowledge about factors associated with malnutrition in nursing homes. Results supported that demographic status, health function, eating and oral intake, and disease, and medication factors significantly aligned with malnutrition. Study results contribute to improving nutritional care in nursing homes and long-term-care settings.

The purpose of this study was to investigate the effects of organizational communication and grit on nurses’ turnover intention in rehabilitation hospitals. Methods: The subjects of this study included 159 nurses with more than 6 months of experience working in a rehabilitation hospital. The collected data was analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficient, and stepwise multiple regression analysis using SPSS 29.0. Results: The subjects’ organizational communication was 3.34±0.38, grit 2.99±0.31, and turnover intention 2.84±0.57. Turnover intention showed a negative correlation with organizational communication (r=-.38, p<.001) and grit (r=-.41, p<.001). The factors significantly affecting turnover intention included grit (β=-.30, p<.001), the scheduled period of employment (age of retirement; β=-.30, p<.001), organizational communication (β=-.26, p<.001), and salary satisfaction (satisfied to very satisfied; β=-.17, p=.014) in order. These actors explained 38.2% of turnover intention. Conclusion: Based on this study’s findings, reducing nurses’ turnover intention in rehabilitation hospitals requires developing with effective measures to improve grit and organizational communication and allowing them to work as long as possible.

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.

The purpose of this study was to investigate the factors related to burnout of nurses working at intensive care units. Methods: The subjects of this study included 149 nurses in intensive care units at six general hospitals. The data was analyzed using the SPSS/WIN 23.0 program with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficient, and Stepwise multiple regression analysis were used. Results: The factors significantly affecting burnout included work stress ‘high to very high’ (β=.39, p<.001), communication skill (β=-.24, p=.001), subjective health status ‘normal’ (β=.22, p=.001) and ‘bad to very bad’ (β=.20, p=.002) and problem-driven coping (β=-.19, p=.010) in order, and the explanatory power of these factors to the burnout was 46.3%. Conclusion: Based on the results, effective interventions need to be provided to improve intensive care unit nurses’ health conditions and to relieve their work stress. It is necessary to develop practical strategies to improve nurses’ communication and stress coping skills to reduce their burnout.

Purpose: The purpose of this study was to identify the effects of ego-resilience, nursing professionalism and empathy on clinical competency and to suggest strategies for improving the clinical competency of general hospital nurses. Methods: Data collection was performed from Jan. 18th, 2019 to Feb. 14th. A total of 194 nurses from four general hospitals participated in this study. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Kruskal-Wallis test, Scheffe test, Pearson's correlation and stepwise multiple regression analysis using SPSS 23.0. Results: The factors affecting the clinical competency of general hospital nurses included ego-resilience (β=.28, p<.001), nursing professionalism (β=.20, p=.011), empathic concern (β=.19, p=.003), working department (β=-.17, p=.008), total clinical career (β=.15, p=.011), and number of beds (β=.13, p=.033). These factors accounted for 33.0% of the clinical competency (p<.001). Conclusion It is important to find ways to improve the level of empathy of general hospital nurses and there is a need to include education programs or practical interventions to strengthen empathy at the clinical level.

Purpose: The objective of this study was to identify whether spirituality mediates the relationship between empathy and elderly care performance among Long Term Care (LTC) hospitals nurses in Korea. Methods: The data collection was performed July 1st to August 31th, 2018. Participants were 119 nurses from three long-term care hospitals in Korea. Self-reported questionnaires were administered to assess general characteristics, empathy, spirituality and elderly care performance. The data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and three-stage simple and multiple regression analysis as proposed by Baron and Kenny. Results: The level of elderly care performance of participants was significantly different based on age (F=3.92, p=.010) and nurse's position (t=−2.18, p=.031). Spirituality had a significant mediating effect on the relationship between empathy and elderly care performance (Z=3.64, p<.001). Conclusion As spirituality completely mediates the relationship between empathy and elderly care performance, it is necessary to develop a nursing education program that applies spirituality and empathy and supports religious activities at an institutional level.

PURPOSE: The purpose of this study is to identify the effects of aromatherapy on agitation in patients with dementia using a meta-analysis and systemic literature review. METHODS: The EMBASE, CINAHL, MEDLINE, and other databases were searched up to November 2017. RESULTS: Of 419 publications identified, 12 met inclusion criteria, and 9 studies were used to estimate the effect size of aromatherapy. A total of 837 participants across all studies were included. The commonly applied methods were massage (50%), type of oil lavender (75%), and instrument Cohen-Mansfield Agitation Inventory (75%). A medium effect size of aromatherapy on agitation was identified (d=−0.56, I2=65.0%, p=.001). The massage group has lower effect size than the other group (d=−0.98, I2=0.0%, p=.001). CONCLUSION: Aromatherapy appears to be effective in improving agitation in patients with dementia. However, further studies for home-dwelling patients with dementia and with different types of aroma oil should be conducted in the future. In addition, research with well-designed are needed to assess the effects or aromatherapy on agitation.
Aromatherapy ; Dementia ; Dihydroergotamine ; Humans ; Lavandula ; Massage ; Psychomotor Agitation

PURPOSE: The purpose of this study is to examine and evaluate the effects of auricular acupressure on musculoskeletal pain, depression and sleep of the elderly who are institutionalized in long-term care facilities. METHODS: The research was conducted in a non-equivalent control group and non-synchronized design with data collected from October to December, 2016. The subjects were from long-term care facilities for the elderly in D city and divided into an experimental group (24 subjects) and a control group (25 subjects). RESULTS: After the intervention, the experimental group showed significant improvement in degree of musculoskeletal pain on time (χ2=23.89, p < .001) and degree of depression on time and group (χ2=37.42, p < .001, U=122.0, p < 001) and degree of sleep on time (χ2=33.62, p < .001). Thus, the suggested hypothesis is partially supported. CONCLUSION: Auricular acupressure therapy is expected to be a practical and efficient nursing intervention for the elderly institutionalized in long-term care facilities.
Acupressure ; Aged ; Depression ; Humans ; Long-Term Care ; Musculoskeletal Pain ; Nursing

PURPOSE: The purpose of this study was to investigate the effects of a self-esteem improvement program on self-esteem and peer attachment in elementary school children with observed problematic behaviors. METHODS: This study is a quasi-experimental study with a nonequivalent control group pretest-post-test design. A total of 47 fourth grade elementary school students participated in this study. The program was provided for 45 minutes once a week; a total of 12 sessions were completed with a group in the classroom for the experimental group. Child Problem-Behavior Screening Questionnaire was used to measure problematic behavior. Self-esteem was measured using the Rosenberg's Self-esteem Questionnaire, and peer attachment was measured using the Inventory of Parent and Attachment. Measuring was performed right after the program was done (post 1) and 1 month after the program was finished (post 2). To compare the differences in self-esteem and peer attachment between groups, repeated measures analysis of variance was used. RESULTS: Most participants in the experimental group were 10 years old (62.5%, range 10-11), male (52.0%) and with middle grade point average (64.0%). The self-esteem scores in the experimental group were significantly higher than those of the control group (F = 26.64, p < .001). The peer attachment scores in the experimental group were significantly higher than those of the control group (F = 6.48, p = .014). CONCLUSIONS: The self-esteem improvement program in this study improved the self-esteem and peer attachment in elementary school children. The self-esteem program helped acknowledge the peer's name and increased their connections. The program needs to be considered as a formal and consistent program.
Case-Control Studies ; Child ; Female ; Humans ; Male ; *Peer Group ; Problem Behavior/*psychology ; Republic of Korea ; *Self Concept ; Students/*psychology ; Surveys and Questionnaires

BACKGROUND/OBJECTIVES: Artemisinin (AT), an active compound in Arternisia annua, is well known as an anti-malaria drug. It is also known to have several effects including anti-oxidant, anti-inflammation, and anti-cancer activities. To date, the effect of AT on vascular disorders has not been studied. In this study, we investigated the effects of AT on the migration and proliferation of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor BB (PDGF-BB). MATERIALS/METHODS: Aortic smooth muscle cells were isolated from Sprague-Dawley rats. PDGF-BB stimulated VSMC migration was measured by the scratch wound healing assay and the Boyden chamber assay. Cell viability was determined by using an EZ-Cytox Cell Viability Assay Kit. The production of reactive oxygen species (ROS) in PDGF-BB stimulated VSMC was measured through H2DCF-DA staining. We also determined the expression levels of signal proteins relevant to ROS, including measures of extracellular signal-regulated kinase (ERK) 1/2 measured by western blot analysis and matrix metalloproteinase (MMP) 9 measured by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: AT (10 microM and 30 microM) significantly reduced the proliferation and migration of PDGF-BB stimulated VSMC in a dose-dependent manner. The production of ROS, normally induced by PDGF-BB, is reduced by treatment with AT at both concentrations. PDGF-BB stimulated VSMC treated with AT (10 microM and 30 microM) have reduced phosphorylation of ERK1/2 and inhibited MMP9 expression compared to untreated PDGF-BB stimulated VSMC. CONCLUSIONS: We suggest, based on these results, that AT may exert an anti-atherosclerotic effect on PDGF-BB stimulated VSMCs by inhibiting their proliferation and migration through down-regulation of ERK1/2 and MMP9 phosphorylation.
Blotting, Western ; Cell Survival ; Down-Regulation ; Muscle, Smooth, Vascular* ; Myocytes, Smooth Muscle ; Phosphorylation ; Phosphotransferases ; Platelet-Derived Growth Factor ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Wound Healing