Purpose
This study examined the relationships of health literacy, physical activity, and grip strength with self-care compliance in older male patients with chronic heart failure.
Methods
A cross-sectional descriptive was conducted, and 106 older male outpatients with chronic HF were recruited from a veterans’ hospital in Seoul. Data were collected from February 7, 2022 to April 10, 2022 using a self-reported questionnaire and were analyzed using SPSS/WIN 23.0.
Results
The average age of the participants was 76.3±4.5 years, and the average time elapsed since the heart failure diagnosis was 3.22±2.01 years. The mean self-care compliance score was 42.21±6.03 out of 60 points. In the univariate analysis, grip strength was not significantly correlated with self-care compliance. The hierarchical regression analysis indicated that health literacy (β=.33, p<.001), physical activity (β=.32, p=.001), and alcohol drinking (β=-.28, p=.001) had statistically significant effects on self-care compliance, collectively explaining 34% of the variance (adjusted R² =.34, F=12.00, p<.001).
Conclusion
The study highlights the necessity of periodically assessing and considering health literacy and the level of physical activity when developing educational strategies to promote self-care compliance among older male patients with heart failure in outpatient nursing practice.

Purpose
The purposes of this study were to develop a prediction model for pressure injury using a machine learning algorithm and to integrate it into clinical practice.
Methods
This was a retrospective study of tertiary hospitals in Seoul, Korea. It analyzed patients in 12 departments where many pressure injuries occurred, including 8 general wards and 4 intensive care units from January 2018 to May 2022. In total, 182 variables were included in the model development. A pressure injury prediction model was developed using the gradient boosting algorithm, logistic regression, and decision tree methods, and it was compared to the Braden scale.
Results
Among the 1,389,660 general ward cases, there were 451 cases of pressure injuries, and among 139,897 intensive care unit cases, there were 297 cases of pressure injuries. Among the tested prediction models, the gradient boosting algorithm showed the highest predictive performance. The area under the receiver operating characteristic curve of the gradient boosting algorithm's pressure injury prediction model in the general ward and intensive care unit was 0.86 (95% confidence interval, 0.83~0.89) and 0.83 (95% confidence interval, 0.79~0.87), respectively. This model was integrated into the electronic health record system to show each patient's probability for pressure injury occurrence, and the risk factors calculated every hour.
Conclusion
The prediction model developed using the gradient boosting algorithm exhibited higher performance than the Braden scale. A clinical decision support system that automatically assesses pressure injury risk allows nurses to focus on patients at high risk for pressure injuries without increasing their workload.

Purpose
This study was performed to identify factors associated with nursing performance, classify potential profiles of nursing performance-related variables, and explain their effects on nursing performance.
Methods
The study involved 245 nurses at a University Hospital in South Korea from September 1 to 14, 2021. The participants were nurses in a ward who operated within a team and had at least 6 months of clinical experience. Structured questionnaires were used to measure variables, and data were collected online using Google Forms. Using latent profile analysis, the participants were classified into four human resource and job attitude profiles. Linear regression was used to identify relevant factors, and one-way analysis of variance was employed to examine the differences in nursing performance between the four profiles.
Results
Shared leadership (β=.30, p<.001) was most strongly associated with nursing performance, followed by authentic leadership (β=.16, p=.009), and education level (β=.15, p=.006). Significant differences in nursing performance (F=22.48, p<.001) were observed across profiles, with the groups deemed "excellent" and "best" scoring higher in nursing performance and authentic leadership compared to the "fair" and "worst" groups. However, no significant difference in education level was found across the latent profiles (p=.212).
Conclusion
This research examined the impact on nursing performance through variable-centered analysis and a person-centered approach. Accordingly, this study provides valuable insights for interpreting the results of linear regression analysis, highlighting the need to consider individual heterogeneity.

Purpose
The purpose of this study was to develop and validate a tool to evaluate slow nursing performance for older adults in long-term care hospitals.
Methods
The search period was set from March 2013, when the term "slow nursing" was first used in the literature, to October 2021. A slow nursing tool was developed in two phases: development and verification. In the tool development phase, 29 items were developed through an extensive literature review and in-depth interviews with seven long-term care hospital nurses. Construct validity testing was performed by a 10-member expert panel, and a pilot survey was conducted on long-term care hospital nurses. In the tool validation phase, the construct validity, criterion validity, and reliability of the tool were tested by applying it to 181 nurses in long-term care hospitals .
Results
The final tool comprised five factors and 23 items, with an overall explanatory power of 56.8%. Construct validity was examined using confirmatory factor analysis, and the model fit was good. Known-group validity was established by the observation of a significant difference in the slow nursing score between intensive care unit and long-term care hospital nurses, and criterion validity was established by a significant correlation between the slow nursing and person-centered assessment scores. Internal consistency reliability was shown by a Cronbach's ⍺ coefficient of .781.
Conclusion
The concept of slow nursing has been clarified, improving the understanding and implementation of slow nursing care by nurses in long-term care hospitals. The Slow Nursing Tool for Long-term Care Hospital Nurses (SNT-LCHN) is expected to increase interest in and contribute to the effectiveness of slow nursing practices. It will serve as a valuable tool for improving nursing performance in these settings.

Purpose
The aim of this study was to identify the coping profiles of patients with coronary artery disease and to examine their associations with cardiac health behavior.
Methods
In this cross-sectional study, data from 203 patients undergoing percutaneous coronary intervention for coronary artery disease were analyzed. Data collection occurred between September 2020 and June 2021, utilizing self-report questionnaires and electronic medical records at a cardiology outpatient clinic. Descriptive statistics, latent profile analysis, and logistic regression were employed for data analysis.
Results
The Type I coping profile was characterized by the greater use of most coping strategies, particularly problem-focused approaches, relative to the other profiles. The Type II coping profile exhibited below-average use of all coping strategies, except for substance use. The Type III coping profile displayed higher tendencies toward venting, self-blame, denial, behavioral disengagement, and substance use compared to the other profiles. Patients with the Type I coping profile displayed greater engagement in cardiac health behavior than those with Type II and Type III, as indicated by odds ratios of 2.57 (95% confidence interval=1.31~5.07) and 7.19 (95% confidence interval=2.10~24.56), respectively.
Conclusion
Participation in cardiac health behavior varies according to the coping profiles of patients with coronary artery disease. Healthcare providers should recognize and support appropriate coping strategies in these patients to promote healthy behaviors. A longitudinal study investigating how changes in coping profiles relate to cardiac health behavior could assist patients with coronary artery disease in maintaining such behaviors.

Purpose
This study identified the mediating effect of resilience on the relationship between job stress and the professional quality of life of hospice and palliative care nurses.
Methods
The participants included 136 hospice and palliative care nurses from 13 inpatient hospice and palliative care wards at a tertiary hospital in a metropolitan city in South Korea. Data were collected from February 2022 to March 2022. Hayes' PROCESS macro 3.5 was used to test the significance of the parameter's indirect effects. Professional quality of life was divided into three subdomains: compassion satisfaction, secondary traumatic stress, and burnout.
Results
As a mediator, resilience had both direct and indirect effects on the relationship between job stress and the compassion satisfaction of hospice and palliative care nurses. Furthermore, there were both direct and indirect effects on the relationship between job stress and secondary traumatic stress. Finally, although there was no direct effect on the relationship between job stress and burnout, there was an indirect mediating effect.
Conclusion
This study confirmed the direct effect of compassion satisfaction on job stress and the professional quality of life of hospice and palliative care nurses, as well as the mediating effect of resilience on job stress and burnout. To improve the professional quality of life of hospice and palliative care nurses, it is necessary to develop and apply programs that enhance resilience in order to promote its mediating effects on compassion satisfaction and burnout.

Purpose
This study investigated the mediating effect of sleep discomfort in the relationship between tinnitus distress and depression.
Methods
This cross-sectional study used the Tinnitus Handicap Inventory, the Korean Screening Tool for Depressive Disorders, and the Korean version of the Pittsburgh Sleep Quality Index to examine a convenience sample of 139 individuals with tinnitus who were selected from an online patient community in January 2023. Data were analyzed using the independent t-test, Pearson's correlation coefficients, and the PROCESS macro with 95% bootstrap confidence intervals. All statistical analyses were performed using IBM SPSS/WIN 25.0.
Results
Tinnitus distress exhibited a positive correlation with depression (r=.70, p<.001) and sleep discomfort (r=.33, p<.001), and depression showed a positive correlation with sleep discomfort (r=.52, p<.001). Further, sleep discomfort had a statistically significant partial mediating effect in the relationship between tinnitus distress and depression (β=.11; 95% CI, 0.05~0.18).
Conclusion
The findings of this study indicate that sleep discomfort plays a partial mediatory role in the relationship between tinnitus distress and depression. Intervention programs for improving sleep discomfort among individuals with tinnitus are recommended to reduce depression in this population. In addition, screenings for sleep discomfort and depression should be routinely carried out as part of the treatment strategy for individuals with tinnitus.