Background and objectives: Delirium is an acute state that causes confusion and occurs frequently after surgery in elderly patients. Delirium is also related to various clinical complications. With increasing numbers of surgeries performed on elderly Koreans, the number of cases of delirium and associated complications will likely rise. The purpose of the present study was to determine whether postoperative delirium in elderly Korean patients negatively influenced other clinical outcomes and their long-term mortality. Materials and Methods: The medical records of 1016 elderly patients (65 years or older) who underwent major abdominal surgery from January 2014 to December 2016 were retrospectively investigated. To determine long-term mortality, patients were followed for up to 12 months post-operation. Results: Delirium occurred in 194 patients (18.3%). Postoperative delirium was significantly associated with the length of hospital stay (B = 2.72), length of ICU stay (B = 18.78), adverse medical events (OR = 2.26, CI = 1.45–3.52), reoperation (OR = 5.50, CI = 1.66–18.22), ICU readmission (OR = 14.10, CI = 2.97–66.90), medical costs (B = 2473.85), discharge to somewhere other than the patient’s home (OR = 6.01, CI = 3.35–10.76), hospital readmission (OR = 2.73, CI = 1.45–5.14), in-hospital mortality (OR = 3.34, CI = 1.21–9.19), three-month mortality (HR = 3.22, CI = 1.27–8.14), six-month mortality (HR = 2.85, CI = 1.28–6.36), and 12-month mortality (HR = 2.19, CI = 1.10–4.32). Conclusions: Postoperative delirium in elderly Korean patients was associated with negative clinical outcomes and mortality. For rapid recovery and increased survival rates in surgical patients, effective delirium-prevention care and active delirium treatments are necessary.

Background and objectives: Identifying factors that affect self-care according to low, middle, and high self-care levels among elderly patients with diabetes is the best way to prevent various life-threatening complications, and this can be accomplished by using an individualized approach to improve self-care. A quantile regression model is beneficial for estimating such factors because it allows the consideration of the entire conditional distribution of a dependent variable as it relates to independent variables. The objective of this study was to identify factors that affect self-care among elderly patients with diabetes using quantile regression. Materials and Methods: A cross-sectional survey of elderly patients with diabetes was conducted using the Self-Care Scale and six other related scales at three medical health centers in South Korea. Results: In the 10% quantile, the factors affecting self-care were age, smoking within the past six months, being educated about diabetes, depression, knowledge related to diabetes, self-efficacy, diabetes distress, and family support. Additional factors were as follows: age, smoking within the past six months, self-efficacy, and diabetes distress in the 25% quantile; age, self-efficacy, perceived health status, and diabetes distress in the 50% quantile; age, self-efficacy, perceived health status, and diabetes distress in the 75% quantile; and self-efficacy and perceived health status in the 90% quantile. Conclusions: Based on the results of this study, suggestions include providing education for sub-groups incapable of self-care, teaching stress management strategies, and increasing family support. In addition, for individuals capable of self-care, simplified programs that consist of self-efficacy improvement and stress control strategies are necessary.

The mental health of nurses participating in patient care is under threat amid the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify the mental health status (depression, anxiety, and stress) and its influencing factors on nurses who provided patient care at a specialized hospital for COVID-19 in South Korea. Of the 180 nurses who participated in this study, 30.6% had moderate or higher levels of depression, 41% had moderate or higher anxiety levels, and 19.4% had moderate or higher stress levels. In this study, stigma influenced nurses’ mental health, such that the higher the stigma, the higher the nurses’ depression, anxiety, and stress. Depression was higher in female nurses than in male nurses, and stress was higher in charge nurses than nurses in other job positions. Therefore, a management program should be designed to improve the mental health of nurses during the current pandemic. In particular, a solution to reduce stigma is required, and the mental health of female nurses and nurses in leadership roles requires special attention.

Sexual minorities are people with non-cis and non-heterosexual gender identities, including LGBT (lesbian, gay, bisexual, and transgender) identities. Korean society is prejudiced against sexual minorities—in our study, we will broadly label this prejudice homophobia. It is possible that sexual minorities do not receive appropriate health management owing to such prejudices. Therefore, it is necessary to reduce homophobia in nursing students. This study aims to measure the degree of homophobia in Korean nursing students and identify the factors that affect homophobia. Our study is a cross-sectional study, which surveys attitudes of 265 nursing students toward homophobia in five Korean cities in January to March, 2019. The average homophobia score was 74.5 out of a possible 120; 92.9% of the participants were classified as homophobic, and 42.3% as highly homophobic. We found that participants who were male, religious, had low self-esteem, and had no family members or acquaintances who might belong to a sexual minority group, were more likely to be homophobic. Nursing students in Korea still exhibit high levels of homophobia. As high levels of homophobia can negatively affect health management and nursing, especially in the case of sexual minorities, we suggest that educational programs should be set up to reduce homophobia in nursing students.

Purpose: This study was performed to identify the severity of after-fall injuries and the factors affecting moderate to severe injury among elderly individuals. Methods: The study included 340 patients aged 65 years and over who visited the emergency room after experiencing a fall incident. Data were retrospectively collected through electronic medical records. Results: Severity of injuries was moderate 80.9%, the most common injury type was fracture 56.2% and the most commonly injured body part was the upper limb 43.8%. After treatment at the emergency room, 51.5% individuals were hospitalized. Of those hospitalized, 32.6% patients received an operation. Analysis was done of risk factors affecting falls with moderate to severe injury. The results revealed that falls in patients aged 85 years or older were 2.72 times more likely than patients aged 65~74 years. Falls were 4.21 higher in patients taking 1~2 medicines compared to patients not taking medicine. Conclusion: Injury after the fall in the elders was severe. In order to minimize post-fall injuries, it is necessary to perform emergency treatment after falls, to visit the hospital facility promptly. It is also necessary to educate patients to be aware of the side effects of the drugs they are taking.

허예지, et al. Korean J Adult Nurs. 2020 Oct;32(5):539-549. https://doi.org/10.7475/kjan.2020.32.5.539