Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: This study aimed to explore the relationship between nurses’ job stress, self-leadership, and the quality of nursing services in integrated nursing and care service wards. Additionally, this research sought to identify factors that may affect the quality of nursing care provided by nurses. Methods: This descriptive study was conducted in July 2023, targeting nurses from four general hospitals that provide comprehensive nursing services in Cheongju, Chungcheongnam-do. One hundred fifty-three participants working as nurses were recruited. The collected data were analyzed using descriptive statistics, an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression with IBM SPSS 27.0 software. Results: Job stress and quality of nursing service were found to have negative correlations, while self-leadership and quality of nursing service were found to have positive correlations. The research variables that showed a significant effect on nursing service quality were self-leadership (β=.48, p<.001) and job stress (β=-.26, p=.002), with an explanatory power of 33.0%. Conclusion Self-leadership and job stress significantly influence the quality of nursing services in integrated nursing and care service wards. Therefore, it is essential to develop and implement educational programs for nurses that foster self-leadership, alleviate job-related burdens, and create diverse interventions and professional environments aimed at reducing job stress.

Purpose: Despite the increasing use of immediate breast reconstruction (IBR), its oncologic safety in the setting of neoadjuvant chemotherapy (NACT) needs to be comprehensively clarified in breast cancer management. The objective of the present study was to analyze the oncologic safety of IBR following NACT. Methods: In total, 587 patients with breast cancer who underwent a total mastectomy (TM) with IBR after NACT between 2008 and 2017 at a single institution were retrospectively reviewed. The reviewed patients with IBR following skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) were matched 1:3 to patients who underwent TM alone after NACT. Matching variables included age, clinical T and N stages before NACT, response to NACT, pathologic T and N stages, and molecular subtypes. Results: After propensity score matching, 95 patients who underwent IBR following SSM/ NSM after NACT (IBR group) and 228 patients who underwent TM alone after NACT (TM group) were selected. The median follow-up period was 73 (range, 5–181) months after matching. After matching, there were no significant differences between the two groups in 5-year locoregional recurrence-free survival (88.8% vs. 91.2%, p = 0.516), disease-free survival (67.3% vs. 76.6%, p = 0.099), distant metastasis-free survival (71.9% vs. 81.9%, p = 0.057), or overall survival (84.1% vs. 91.5, p = 0.061) rates. In multivariate analyses, conducting IBR was not associated with increased risks for locoregional recurrence, any recurrence, distant metastasis, or overall death. Conclusion Our findings suggest that IBR following SSM/NSM elicits comparable long-term oncologic outcomes to those of TM alone in the setting of NACT.

Background: Despite the proven effectiveness of oral antivirals against severe acute respiratory syndrome coronavirus 2 in randomized trials, their clinical reevaluation is vital in the context of widespread immunity and milder prevalent variants. This study aimed to assess the effectiveness of oral antivirals for coronavirus disease 2019 (COVID-19). Methods: This retrospective cohort study utilized a target trial emulation framework to analyze patients with COVID-19 aged 60+ from January to December 2022. Data were obtained from the Korea Disease Control and Prevention Agency and Health Insurance Review and Assessment Service. The study involved 957,036 patients treated with nirmatrelvir/ritonavir and 243,360 treated with molnupiravir, each compared with the matched control groups. Primary outcome was progression to critical COVID-19 requiring advanced respiratory support. Secondary outcomes included progression to severe COVID-19, need for supplemental oxygen, and death within 30 days of the onset of COVID-19.Number needed to treat (NNT) derived from the absolute risk reduction. Results: Nirmatrelvir/ritonavir was significantly associated with a reduced risk of severe (adjusted odds ratio [aOR], 0.823; 95% confidence interval [CI], 0.803–0.843), critical (aOR, 0.560; 95% CI, 0.503–0.624), and fatal COVID-19 (aOR, 0.694; 95% CI, 0.647–0.744).Similarly, molnupiravir reduced the risk of severe (aOR, 0.895; 95% CI, 0.856–0.937), critical (aOR, 0.672; 95% CI, 0.559–0.807), and fatal cases (aOR, 0.679; 95% CI, 0.592–0.779).NNTs for nirmatrelvir/ritonavir were 203.71 (severe), 1,230.12 (critical), and 691.50 (death);for molnupiravir, they were 352.70 (severe), 1,398.62 (critical), and 862.98 (death). Higher effectiveness was associated with older adults, unvaccinated individuals, and the late pandemic phase. Conclusion Nirmatrelvir/ritonavir and molnupiravir are effective in preventing progression to severe disease in elderly adults with COVID-19.

Background: Tixagevimab and cilgavimab (Evusheld) administration is a recommended strategy for unvaccinated patients with immunocompromised conditions and severe allergic reaction conditions to protect high-risk individuals and control the coronavirus disease 2019 (COVID-19) epidemic. We estimated the cost-effectiveness of Evusheld in key risk populations: 1) immunocompromised (vaccinated/unvaccinated), 2) severe allergic reaction, and 3) unvaccinated elderly high-risk groups. Methods: Based on the estimated target risk group population, we used a model of COVID-19 transmission to estimate the size of the risk group population for whom Evusheld treatment may help prevent symptomatic COVID-19 (and deaths) in 2022. We projected Evusheld intervention costs, quality-adjusted life year (QALY) lost, cost averted and QALY gained by reduced COVID-19 incidence, and incremental cost-effectiveness (cost per QALY gained) in each modeled population from the healthcare system perspective. Results: Our study demonstrated that Evusheld treatment for COVID-19 infection in South Korea is highly cost-effective for unvaccinated risk groups ($18,959 per QALY gained for immunocompromised and $23,978 per QALY gained for high-risk elderly groups) and moderately cost-effective among individuals who are vaccinated immunocompromised ($46,494 per QALY gained), or have severe allergic reactions ($45,996 per QALY gained).Evusheld’s cost-effectiveness may be subject to risk-group-specific COVID-19 disease progression and Evusheld efficacy and cost, which may change in future epidemic scenarios. Conclusion As the COVID-19 variants and risk group-specific durable efficacy, toxicity (and/ or resistance) and optimal dosing of Evusheld remain uncertain, better empirical estimates to inform these values in different epidemiological contexts are needed. These results may help decision-makers prioritize resources toward more equitable and effective COVID-19 control efforts.

Objective: This study investigated phubbing (the act of ignoring one’s companion or companions to pay attention to one’s smartphone) and examined the factors affecting phubbing among nursing students in South Korea. Methods: A cross-sectional survey design was adopted, and a self-reported questionnaire was used. Data were collected from 200 nursing students in two cities. Self-administered questionnaires included demographic data, smartphone addiction, media multitasking motivation, interpersonal competency, and phubbing. Results: Phubbing was positively correlated with smartphone addiction (r=0.41, p<0.001) and media multitasking motivation (r=0.16, p<0.05), and negatively correlated with interpersonal competence (r=-0.51, p<0.001). Factors influencing nursing students’ phubbing were interpersonal competency (β=-0.59, p<0.001), media multitasking motivation (β=0.24, p<0.001), smartphone addiction (β=0.19, p<0.01) and interpersonal relationships (β=0.14, p<0.05). The model including these variables accounted for 43% of variance in phubbing. Conclusion Nursing students showed a moderate level of phubbing, and interpersonal competency was an important factor for reducing their phubbing of nursing students. Since phubbing occurs frequently among nursing students, educators in nursing are required to develop and implement active interventional measures to help nursing students avoid phubbing and improve their interpersonal relationships by increasing their empathic ability and communication skills.

OBJECTIVES: Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system. METHODS: Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario. RESULTS: We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively. CONCLUSIONS In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.

Purpose: The aim of this study was to identify core keywords and topic groups in the ‘Gestational diabetes mellitus (GDM) and Breastfeeding’ field of research for better understanding research trends in the past 20 years. Methods: This was a text-mining and topic modeling study composed of four steps: 1) collecting abstracts, 2) extracting and cleaning semantic morphemes, 3) building a co-occurrence matrix, and 4) analyzing network features and clustering topic groups. Results: A total of 635 papers published between 2001 and 2020 were found in databases (Web of Science, CINAHL, RISS, DBPIA, RISS, KISS). Among them, 3,639 words extracted from 366 articles selected according to the conditions were analyzed by text network analysis and topic modeling. The most important keywords were 'exposure', ‘fetus’, ‘hypoglycemia’, 'prevention' and 'program'. Six topic groups were identified through topic modeling. The main topics of the study were ‘cardiovascular disease' and 'obesity'. Through the topic modeling analysis, six themes were derived: ‘cardiovascular disease’, ‘obesity’, ‘complication prevention strategy’, ‘support of breastfeeding’, ‘educational program’ and ‘management of GDM’. Conclusion This study showed that over the past 20 years many studies have been conducted on complications such as cardiovascular diseases and obesity related to gestational diabetes and breastfeeding. In order to prevent complications of gestational diabetes and promote breastfeeding, various nursing interventions, including gestational diabetes management and educational programs for GDM pregnancies, should be developed in nursing fields.

Purpose: The aim of this study was to identify core keywords and topic groups in the ‘Diabetes mellitus and mobile applications’ field of research for better understanding research trends in the past 20 years. Methods: This study was a text-mining and topic modeling study including four steps such as ‘collecting abstracts’, ‘extracting and cleaning semantic morphemes’, ‘building a co-occurrence matrix’, and ‘analyzing network features and clustering topic groups’. Results: A total of 789 papers published between 2002 and 2021 were found in databases (Springer). Among them, 435 words were extracted from 118 articles selected according to the conditions: ‘analyzed by text network analysis and topic modeling’. The core keywords were ‘self-management’, ‘intervention’, ‘health’, ‘support’, ‘technique’ and ‘system’. Through the topic modeling analysis, four themes were derived: ‘intervention’, ‘blood glucose level control’, ‘self-management’ and ‘mobile health’. The main topic of this study was ‘self-management’. Conclusion While more recent work has investigated mobile applications, the highest feature was related to self-management in the diabetes care and prevention. Nursing interventions utilizing mobile application are expected to not only effective and powerful glycemic control and self-management tools, but can be also used for patient-driven lifestyle modification.