Journal of Korean Academy of Nursing

Contribution of North Texas Korean Nurse Association COVID-19 Task Force Team to Promote the Health of Local Korean Immigrant Community Amid the Pandemic: Lee, Kyoung Eun , Lee, Mikyoung; J Korean Acad Nurs 2021;51(5):505-510. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21154

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Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review: Kim, Jeung-Im , Im, YeoJin , Song, Ju-Eun , Jang, Sun Joo; J Korean Acad Nurs 2021;51(5):511-524. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21156

Abstract PDF: The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.

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Validity and Reliability of the Turkish Version of the COVID Stress Scale: Meltem, Demirgöz Bal , Melike, Dişsiz , Fadime, Bayri Bingöl; J Korean Acad Nurs 2021;51(5):525-536. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21106

Abstract PDF: Purpose
The aim of this study was to assess the Turkish adaptation of the COVID Stress Scale (CSS) on the basis of determining the stress caused by the coronavirus disease (COVID-19) pandemic, and to test its validity and reliability.
Methods
The English CSS was translated into Turkish using forward and backward translation. Data were collected online from 360 participants. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach’s alpha reliability coefficient, and test-retest methods were used to evaluate reliability.
Results
The Turkish version of the CSS has 36 items consistent with the original scale and has five factors: COVID danger and contamination, socioeconomic consequences of COVID, COVID xenophobia, traumatic stress due to COVID, and compulsive checking for COVID. The construct validity of the Turkish version of the CSS was verified by the adjusted goodness of fit index > .85, and comparative fit index > .95. The content validity index of each item was 91%. The corrected item-total correlations of the scale ranged from .51 to .89. Internal consistency was reliable, with a Cronbach’s α of .93.
Conclusion
The Turkish version of the CSS is valid and reliable. It can be used as a measurement tool for the assessment of COVID-related stress.

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Factors Influencing the COVID-19 Vaccination Intentions in Nurses: Korea, February 2021: Park, Ju Young , Ha, Jiyeon; J Korean Acad Nurs 2021;51(5):537-548. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21110

Abstract PDF: Purpose
This study aimed to identify the factors influencing COVID-19 vaccination intentions in nurses.
Methods
The participants were 184 nurses in Korea. Data were collected using a Google Form online survey method in February, 2021, and analyzed using an independent t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis with the SPSS/WIN 26.0 program.
Results
COVID-19 vaccination intention in nurses was correlated significantly with vaccine hesitancy (r = .58, p < .001), risk perception of COVID-19 (r = .22, p = .003), perception of vaccination as a professional duty (r = .59, p < .001), and attitude towards workplace infection control policies (r = .20, p = .007). Vaccine hesitancy (β = .40, p < .001) and the perception of vaccination as a professional duty (β = .44, p < .001) significantly influenced COVID-19 vaccination intention. The model developed in this study explained 50% of the variation in COVID-19 vaccination intention.
Conclusion
Improving the perception of vaccination as a professional duty and lowering vaccine hesitancy may enhance nurses’ COVID-19 vaccination intention. Above all, it is necessary to provide programs to encourage voluntary recognition of vaccination as a professional duty and develop strategies to reduce hesitancy toward COVID-19 vaccinations.

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An Evaluation of the Validity and Reliability of the Face Mask Use Scale’s Korean Version among Community-Dwelling Adults: Lee, Kyungmi , Shin, Nayeon , Kang, Younhee; J Korean Acad Nurs 2021;51(5):549-560. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21111

Abstract PDF: Purpose
This study evaluated the validity and reliability of the Korean version of the Face Mask Use Scale (K-FMUS) among community-dwelling adults.
Methods
The participants of the study were community-dwelling adults in Korea using face masks during the COVID-19 pandemic. The English FMUS was translated into Korean using forward and backward translation procedures. The construct validity and reliability of the K-FMUS were evaluated using the exploratory and confirmatory factor analyses and the internal consistency reliability test.
Results
The K-FMUS comprised 6 items divided into 2 factors. The variance of the factors was approximately 79.1%, which suggested that the scale indicated the effectiveness of face mask usage. The two factors were labeled as face mask use in society (4 items) and face mask use at home (2 items). Cronbach’s α value for the overall scale was .88.
Conclusion
The K-FMUS is a valid and reliable scale that can be used to measure face mask usage among community-dwelling adults in Korea during the COVID-19 pandemic.

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A Phenomenological Study of the Lived Experience of Nurses Caring for Patients with COVID-19 in Korea: Oh, Hee , Lee, Na Kyoung; J Korean Acad Nurs 2021;51(5):561-572. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21112

Abstract PDF: Purpose
This study aimed to understand nurses’ lived experiences of caring for patients with COVID-19.
Methods
The phenomenological research method was used. The study participants were 16 Korean nurses who had experiences in caring for patients with COVID-19 in clinical settings. Data was collected using one-on-one in-depth interviews, from June 30 to September 30, 2020. During the interview, the quarantine rules were observed.
Results
The study derived four themes clusters and thirty-eight sub themes. Four theme clusters were identified, i.e., ‘a repetitive sense of crisis’, ‘enduring a drastic change,’ ‘sacrifice of personal life,’ and ‘pride in nursing’. The nurses’ experiences of caring for patients with COVID-19 were an uneasy, unfamiliar, and threatening experiences for an individual, but it is an opportunity for a nursing organization to renew. Accordingly, it was found that nurses faithfully fulfill their individual roles with a vocation and responsibility.
Conclusion
The study provides an in-depth understanding of the situational, psychological, and environmental aspects of challenges facing nurses in the pandemic situation. Based on the findings, institutional follow-up measures should be provided to establish support systems for better nursing care. In addition, studies are needed to track nurses' experiences in the prolonged COVID-19 situation.

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Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units: Woo, Dahae , Yu, Hanui , Kim, Hyo Jin , Choi, Minyoung , Kim, Dong Hee; J Korean Acad Nurs 2021;51(5):573-584. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21143

Abstract PDF: Purpose
This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19.
Methods
This study adopted the double diamond process of service design comprising the discovery, defining, and development stages.
Results
We developed an untact visit service based on an application that considered the child’s status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder.
Conclusion
Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child’s information in real-time, and provide one-stop service without increasing healthcare providers’ work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

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Nurses’ Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation: Noh, Eun-Young , Chai, Young Jun , Kim, Hyun Jeong , Kim, Eunjin , Park, Yeon-Hwan; J Korean Acad Nurs 2021;51(5):585-596. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21148

Abstract PDF: Purpose
The purpose of this study was to explore nurses’ experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic.
Methods
This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis.
Results
Two main themes emerged from the analysis: ‘Struggling in an isolated space’ and ’Limitations of nursing infrastructure and system’. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system.
Conclusion
The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

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The Effects of Programs on Body-Image Improvement in Adolescents: A Systematic Review and Meta-Analysis: Yun, Hyun Jung , Seo, Kyoungsan , Han, Dallong; J Korean Acad Nurs 2021;51(5):597-616. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21104

Abstract PDF: Purpose
This study’s objective was to investigate the effects of programs that improve adolescents’ body image, using a systematic review and meta-analysis.
Methods
A literature search was performed in eleven electronic databases, using preferred reporting items for systematic reviews and meta-analysis guidelines. Population characteristics, contents of the programs, and measured outcomes were systematically reviewed from 21 selected studies. To estimate the size of the effects, meta-analysis was conducted using Comprehensive Meta-Analysis software.
Results
The contents of the programs that aimed to improve body image included physical, psychological, interpersonal, and sociocultural interventions. Sixteen studies were meta-analyzed to estimate the effect size of body-image improvement programs. Results showed that the program for body-image improvement had significant effects on body satisfaction (effect size [ES] = 0.56, 95% confidence interval [CI] = 0.23 to 0.89), and body dissatisfaction (ES = - 0.15, 95% CI = - 0.23 to - 0.08).
Conclusion
The program for body image improvement in adolescents includes a combination of physical, psychological, interpersonal relationship, and socio-cultural dimensions. The program that seeks to improve body image appears to be effective at increasing body satisfaction, and at reducing body dissatisfaction in adolescents. Thus, it is necessary to develop and apply multidimensional programs for adolescents to have a positive body image.

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Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale: Kim, Sook-Nam , Lee, Hyun-Ju , Kim, So-Young , Lee, Nayoon; J Korean Acad Nurs 2021;51(5):617-629. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21069

Abstract PDF: Purpose
The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K).
Methods
The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software.
Results
The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent.
Conclusion
This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

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Structural Equation Modeling of the Interaction between Mothers and Preschool-Age Children: Chai, Hyun-Yi , Choi, Mi-Young; J Korean Acad Nurs 2021;51(5):630-642. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21096

Abstract PDF: Purpose
This study aimed to identify the factors influencing the interaction between mothers and preschool-age children and construct a structural equation model based on the factors identified.
Methods
The data were collected from the mothers of children aged three to six years enrolled in kindergartens in Seoul, Gyeonggi, Chungbuk, and Jeonbuk. A total of 328 questionnaires were used for the analysis. Analysis was performed using SPSS 26.0 and AMOS 26.0 programs.
Results
The child’s self-regulation (β = .42, p < .001) had the most significant influence on the interaction between mothers and preschool children, followed by the mother’s parenting stress (β = - .23, p = .008), social support (β = .17, p < .001), and the child’s active temperament (β = .15, p < .001). The child’s gender, emotional temperament, social temperament, and mother’s education level had indirect influences.
Conclusion
These results suggest that interventions considering the child’s temperament, mother’s parenting stress, and social support are required to promote the interaction between preschool-age children and mothers.

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