Despite the high prevalence of nurses’ turnover and the turnover intention of new nurses, there are insufficient studies examining turnover intention at the time when job orientation is completed and independent nursing commences. Thus, this study examined turnover intention levels and identified the factors affecting turnover intention of new Generation Z nurses, focusing on job stress and sleep disturbance, at the eighth week after completing job orientation. This was a cross-sectional descriptive correlational study. Using a convenient sampling method, 133 new nurses were recruited. Data were collected using a structured questionnaire consisting of demographic and occupational characteristics, job stress, sleep disturbance, and turnover intention. Descriptive statistics were computed to describe the sample and interest variables. Logistic regression analysis was performed to examine the association of job stress and sleep disturbance with turnover intention. Most nurses were women (91.7%) and approximately two-thirds worked in the surgical ward (n = 61, 45.9%). Turnover intention was 12.8%, average job stress was 40.11 ± 90.7, and average sleep disturbance was 42.39 ± 15.27. New graduate nurses’ turnover intention was associated with job stress (OR = 1.07, 95% CI = 1.02–1.12) and sleep disturbance (OR = 1.19, 95% CI = 1.05–1.35), and this model explained 47.7% of the variance. Study findings determine that job stress and sleep disturbance were significant predictors of turnover intention in new nurses at the eighth week after joining the hospital. Therefore, nursing administrators should focus on new nurses’ job stress and sleep disturbance, and provide them with timely assessment and management to reduce turnover intention.

Nursing burnout is associated with reduced nursing performance outcomes. Positive psychological capital is known to play an important role in improving workers’ job performance. However, the association among the three variables has rarely been addressed. The purpose of this cross-sectional descriptive study was to explore the association between burnout and nursing performance outcomes among Korean nurses working at a tertiary hospital and the mediating role of psychological capital in this relationship. Recruited through convenience sampling, a total of 285 nurses provided data on their demographic characteristics and completed a structured questionnaire consisting of items from the Professional Quality of Life Scale (burnout), Nursing Performance Scale, and Psychology Capital Questionnaire. Descriptive statistics, student’s t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and multiple linear regression analyses were used to analyze data. The significance of the mediation effect was obtained using a bootstrap approach with the PROCESS macro. The mean age of participants was 30.51 years, and most participants were females (94.0%) and unmarried (71.6%); more than half (57.5%) experienced a severe workload. The average (±standard deviation) scores of burnout, nursing performance outcomes, and positive psychological capital were 28.77 ± 4.93, 2.98 ± 0.32, and 3.19 ± 0.45, respectively. Burnout was associated with nursing performance among clinical nurses (β = −0.20, p < 0.001). Positive psychological capital mediated the association between burnout and nursing performance outcomes (β = 0.41, p < 0.001). These findings contribute to the understanding that burnout among nurses could be reduced by increased positive psychological capital, which results in improved performance outcomes. The findings also indicate that interventions to improve positive psychological capital should be developed and implemented for nurses’ burnout management and improvement in nursing performance outcomes.

Background: People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning. Purpose: The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases. Methods: An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants’ mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index. Results: Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = −0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity. Conclusions/Implications for Practice: Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.

BACKGROUND: Continuous femoral nerve block infusions (CFNBIs) have been found to both decrease patient postoperative pain and improve postoperative joint mobilization, both of which impact patient satisfaction, outcome, and length of stay. When we began the use of CFNBIs, we needed to create a policy, process, standing order form, and staff education plan as well as a means to maximize therapy efficacy and believed that a research study would best meet those needs. PURPOSE: To evaluate the patient response to the institution of CFNBI therapy, identify process improvement areas, and suggest areas for future study. METHODS: Through retrospective chart review, using a case–control research design with 27 pairs of patients matched by body mass index, American Society of Anesthesiologists patient physical status classification, and age, we examined whether patients receiving CFNBI therapy after total knee arthroplasty would report less postoperative pain, require less narcotics, and achieve mobilization goals earlier than patients receiving traditional narcotic analgesia only. RESULTS: The CFNBI case group reported significantly less pain over the first three postoperative days (p = .05), but findings revealed no significant differences between case and control groups in total narcotic use or achievement of mobility goals. On the basis of this study, we increased the CFNBI drug concentration and expect that this will allow us to meet all 3 patient goals. CONCLUSION: This study has added to previous research that supports CFNBI as a proven therapy to decrease postoperative pain in patients undergoing total knee arthroplasty. The structure of a research project facilitates the implementation, evaluation, and improvement of such new therapies. Evaluating patient data allows identification of process improvement areas—in our case, the change in drug concentration—as well as the need for staff education aimed at facilitating their active participation in CFNBI therapy.

An estimated 10 million Americans age 50 and older have osteoporosis, and many experience associated fractures. Although several interventions have been shown to be effective in preventing osteoporosis, their impact on bone health among older adults was limited. The aim of this study was, therefore, to examine the effects of a theory-based online bone health program (Bone Power program) for a large number of older adults. The 8-week program included learning modules, discussion boards, and other resources. Participants (N = 866; M age = 62.5 years) were recruited online and randomized into a Bone Power or control group. At the end of the intervention, the Bone Power group showed significantly greater improvement over the control group in osteoporosis knowledge, self-efficacy/outcome expectations for calcium intake and exercise, and calcium intake and exercise behaviors. This study’s findings suggest that online health programs can be effective in improving older adults’ knowledge, beliefs, and health behaviors.