Purpose: The aim of this study was to investigate the effects of nutrition risk, physical activity, insomnia, anxiety, and depression on fatigue among breast cancer patients undergoing radiotherapy. Methods: The participants of this study were 160 breast cancer patients at Yeungnam University Medical Center in South Korea. The data were collected from September to November 2022 and analyzed using descriptive statistics, the t-test, analysis of variance, the Mann-Whitney test, the Kruskal-Wallis test, the Bonferroni correction, Pearson correlation coefficients, and multiple regression with SPSS version 28.0. Results: The mean fatigue score was 18.44±7.30 points, while the scores for nutrition risk, insomnia, anxiety, and depression were 2.03±1.52, 5.43±4.79, 6.79±2.81, and 8.17±3.36 points, respectively. Physical activity was measured at 1366.49±1617.87 METs. The general characteristics of the participants showed significant differences in fatigue concerning pain (F=13.97, p=.001), duration of illness (t=-2.37, p=.019), and total radiation dose (t=-2.13, p=.035). Fatigue exhibited significant positive correlations with nutrition risk (r=.35, p<.001), insomnia (r=.35, p<.001), and anxiety (r=.35, p<.001), and a significant negative correlation with physical activity (r=-.20, p=.012). In multiple regression analysis, the factors influencing fatigue were identified as nutrition risk (β=.28, p<.001), duration of illness (β=.19, p=.005), depression (β=.23, p=.006), total radiation dose (β=.19, p=.005), and physical activity (β=-.14, p=.036). Conclusion This study highlights the importance of addressing nutrition risk and depression in breast cancer patients undergoing radiotherapy. Encouraging physical activity may also play a crucial role in managing fatigue in these patients. These findings could guide the development of targeted interventions to improve the well-being of breast cancer patients during radiotherapy.

Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master’s-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

Purpose: The aim of this study was to investigatecomplementary therapiesprovided at hospice palliative care facilities in South Koreaas designated by the Ministry of Health and Welfare. Methods: The survey was conducted via e-mail from September 2 to September 23, 2020, with responsesfrom 109 therapists and 59 managers from 55 different hospice care facilities. Results: Hospices provided an average of 3.67 different types of therapies, ranging from 1 to 7 different types. The most common types of therapies were horticultural therapy (81.4%), music therapy (79.7%), art therapy (76.3%), and aromatherapy (57.6%).The average frequency of sessions was once a week, the median duration was 60 minutes.Most therapists (96.3%) had qualifications, but the certification-issuing organizations and training intensiveness varied greatly. None of the therapists were employed on a full-time basis, and their average monthly income was KRW 270,000. Therapists and managers gave average scores of 8.90 and 8.38 out of 10, respectively, regarding the positive impact of complementary therapies on patients. Conclusion In order for patients and their families to benefit from complementary therapiesat hospice care facilities, in addition tobetter terms of employment for therapists, evidence-based guidelines for different types of therapies are needed so that therapy sessions can be conducted according to the theoretical underpinnings and characteristics of the type of therapy. It is expected that the results of this study will be used for policy-making in support of therapy as an essential hospice service.

Purpose: The aim of this study was to investigatecomplementary therapiesprovided at hospice palliative care facilities in South Koreaas designated by the Ministry of Health and Welfare. Methods: The survey was conducted via e-mail from September 2 to September 23, 2020, with responsesfrom 109 therapists and 59 managers from 55 different hospice care facilities. Results: Hospices provided an average of 3.67 different types of therapies, ranging from 1 to 7 different types. The most common types of therapies were horticultural therapy (81.4%), music therapy (79.7%), art therapy (76.3%), and aromatherapy (57.6%).The average frequency of sessions was once a week, the median duration was 60 minutes.Most therapists (96.3%) had qualifications, but the certification-issuing organizations and training intensiveness varied greatly. None of the therapists were employed on a full-time basis, and their average monthly income was KRW 270,000. Therapists and managers gave average scores of 8.90 and 8.38 out of 10, respectively, regarding the positive impact of complementary therapies on patients. Conclusion In order for patients and their families to benefit from complementary therapiesat hospice care facilities, in addition tobetter terms of employment for therapists, evidence-based guidelines for different types of therapies are needed so that therapy sessions can be conducted according to the theoretical underpinnings and characteristics of the type of therapy. It is expected that the results of this study will be used for policy-making in support of therapy as an essential hospice service.

Purpose: The purpose of this study is to evaluate the validity and reliability of the Korean Bereavement Care Confidence Scale (K-BCCS). Methods: The Perinatal Bereavement Care Confidence Scale (PBCCS) was translated into Korean according to an algorithm of cultural adaptation process and excluded six items which were specific to perinatal bereavement. A total of 229 clinical nurses participated in the study. Construct validity, convergent validity, discriminant validity, and group comparison validity were evaluated, and Cronbach’s α was calculated to estimate the reliability of the K-BCCS. Results: The K-BCCS consisted of 31 items in 7 factors, including knowledge and skills for bereavement care (12 items), organizational support (6 items), awareness of the needs (3 items), interpersonal skills (3 items), workload influence (2 items), continuous education (2 items), and understanding the grief process (3 items). The factor loading of 31 items within the 7 factors ranged from .60 to .86. For the convergent validity, the construct reliability (CR) ranged from .74 to .94, and the average variance extracted (AVE) ranged from .49 to .73, which is considered acceptable. The discriminant validity showed that the AVEs of the subscales were greater than the square of the correlation coefficient r. The nurses who had experience providing bereavement care (t=4.94, p<.001) or had received bereavement education (t=6.64, p<.001) showed higher K-BCCS values those without experience. The Cronbach’s α of 31 items was .93 and ranged from .60 to .94 per subscale. Conclusion The K-BCCS is a valid and reliable tool for evaluating nurses' confidence in bereavement care.

Purpose: The purpose of this study is to evaluate the validity and reliability of the Korean Bereavement Care Confidence Scale (K-BCCS). Methods: The Perinatal Bereavement Care Confidence Scale (PBCCS) was translated into Korean according to an algorithm of cultural adaptation process and excluded six items which were specific to perinatal bereavement. A total of 229 clinical nurses participated in the study. Construct validity, convergent validity, discriminant validity, and group comparison validity were evaluated, and Cronbach’s α was calculated to estimate the reliability of the K-BCCS. Results: The K-BCCS consisted of 31 items in 7 factors, including knowledge and skills for bereavement care (12 items), organizational support (6 items), awareness of the needs (3 items), interpersonal skills (3 items), workload influence (2 items), continuous education (2 items), and understanding the grief process (3 items). The factor loading of 31 items within the 7 factors ranged from .60 to .86. For the convergent validity, the construct reliability (CR) ranged from .74 to .94, and the average variance extracted (AVE) ranged from .49 to .73, which is considered acceptable. The discriminant validity showed that the AVEs of the subscales were greater than the square of the correlation coefficient r. The nurses who had experience providing bereavement care (t=4.94, p<.001) or had received bereavement education (t=6.64, p<.001) showed higher K-BCCS values those without experience. The Cronbach’s α of 31 items was .93 and ranged from .60 to .94 per subscale. Conclusion The K-BCCS is a valid and reliable tool for evaluating nurses' confidence in bereavement care.

Purpose: The purpose of this study was to identify effects of Handoff Education using Concept mapping and PASS-BAR (HECPAR) on clinical reasoning competence, self-efficacy for handoff, and handoff performance of new nurses. Methods: Participants were randomly allocated into an experimental group (n=20) and control group (n=21). The experimental group received HECPAR which consisted of a one hour lecture, case based clinical practicum, and mentoring for a week. The control group received the usual informal handoffs education from senior nurses. Clinical reasoning competence, self-efficacy for handoff, and handoff performance were measured before and a week after HECPAR. Data were analyzed using Mann-Whitney U test, independent t-test, Fisher’s exact test, and chi-sqaure test. Results: The experimental group showed significant improvement in clinical reasoning competence (z=-2.29, p=.022), handoff performance (z=-2.23, p=.026), and self-efficacy of handoff (t=3.47, p=.001) compared to the control group. Conclusion The results indicate that HECPAR is effective in improving clinical reasoning competence, self-efficacy for handoff, and handoff performance by new nurses. In addition, integrating concept mapping, PASS-BAR, and mentoring proved beneficial for handoff education for new nurses.

PURPOSE: The aim of this study was to analyze the current status of end-of-life (EoL) care education of the undergraduate nursing curriculum and senior students' EoL care experience and competency.METHODS: A survey was conducted with 41 nursing schools and 622 senior nursing students on June 2018. The questionnaire consisted of 38 items on teaching regarding EoL care and 17 items on EoL care competencies based on the suggestions made by the American Nurses Association.RESULTS: Only 20% among 41 nursing schools opened an EoL care course as an elective, and the course was taken by 5.1% students. Of 622 students, 70.7% witnessed death of patients during their clinical training, but 74.8% received no or little education on EoL care from their clinical training instructors. Two of 38 education contents on EoL care were taught in class for over 80% of the students. All students scored below 3 points (2.31±0.66) for all 17 competencies, which means that they cannot perform EoL care.CONCLUSION: This study showed that there was a serious deficiency in undergraduate nursing education on EoL care. Accordingly, most nursing students who would graduate soon considered themselves incapable of performing EoL care. Nurses experience death and dying as a part of their practice and should be prepared to provide adequate EoL care. Therefore, it is urgent to improve EoL care training in the undergraduate nursing education.
American Nurses' Association ; Clinical Competence ; Curriculum ; Education ; Education, Nursing ; Humans ; Nursing ; Schools, Nursing ; Students, Nursing ; Terminal Care

A resolution adopted by the World Health Assembly in 2014 stated that all nurses should be equipped with palliative care skills in order to integrate palliative care into a day-to-day healthcare system. This article introduces the palliative nursing competency that was developed for the Korean environment by the Korean Hospice Palliative Nursing Research Network based on its study of overseas cases where this competency and competency-based training were developed. This is the first step towards the development of competency-based palliative nursing education, and active efforts should be made to integrate this competency into the undergraduate nursing curriculum.
Clinical Competence ; Curriculum ; Delivery of Health Care ; Education ; Global Health ; Hospice and Palliative Care Nursing ; Hospices ; Humans ; Korea ; Nursing ; Palliative Care ; Students, Nursing