Background: Palliative care is a patient-centred, integrated approach for improving quality of life for both patients facing life-threatening illnesses and for their families. Although there has been increased interest in palliative care for non-cancer patients, the palliative care competency of nurses who care for non-cancer patients has rarely been investigated. This study described the palliative care knowledge, attitude, confidence, and educational needs in nurses who care for patients with congestive heart failure, stroke, end-stage renal disease, and end-stage liver disease; explored the relationships between those variables; and identified factors affecting nurses' palliative care confidence. Methods: A cross-sectional, descriptive, correlational design was employed; data collection was conducted at a tertiary hospital in Seoul, Korea. Nurses who were working in general wards and intensive care units (N = 102) completed valid and reliable self-administered questionnaires. Descriptive statistics, frequencies, independent t-tests, one-way ANOVA, Pearson's correlations, and multiple regression were conducted to analyse the data. Results: Nurses' palliative care knowledge level was low (9.73 ± 2.10; range = 0-20) and their attitude toward palliative care was moderate (87.97 ± 6.93, range: 30-120). Knowledge was significantly correlated with attitude (r = .29, p = .003). Nurses were highly confident in pain and symptom management but demonstrated high educational needs for managing human and material resources to provide palliative care. Previous training in hospice, palliative, and EOL care was a significant and modifiable factor that affected nurses' confidence (std. β = 0.25, p = .010). Conclusions: To facilitate high-quality palliative care for non-cancer patients and families, nursing education programs should be developed to address nurses' knowledge level, confidence level, and educational needs. This study provides relevant information that can be utilised to develop palliative care educational programs for nurses who care for non-cancer patients.

Aims and objectivesThe purpose of this study was to examine the levels of symptom experiences and health‐related quality of life (HRQOL) among non‐small cell lung cancer (NSCLC) patients participating in clinical trials, and to identify the factors influencing their HRQOL.BackgroundIt has known that lung cancer patients experience more symptoms than other cancer patients. With the introduction of new treatment for NSCLC patients, the patients have experienced different types of symptoms and it could influence their HRQOL.DesignA cross‐sectional study design was adopted.MethodsOne hundred and eighteen NSCLC patients enrolled in clinical trials at two Korean tertiary hospitals participated in this study. Participants completed the Memorial Symptom Assessment Scale (MSAS) and the Short‐Form Health Survey 36 (SF‐36) version 2. Demographic, disease‐related and clinical trial‐related characteristics were collected. Descriptive statistics, t test, Mann–Whitney test, ANOVA, Pearson correlation and multiple regression were used for data analysis. STROBE checklist was applied as the reporting guideline for this study (see Supporting Information File S1).ResultsThe total MSAS score was relatively low, and “lack of energy” was the highest symptom level in frequency, severity and distress. The level of physical HRQOL was higher than the cut‐off score, and the level of mental HRQOL was lower than the cut‐off score. The factors affecting physical HRQOL were symptom experience, performance status and smoking history. The factors affecting mental HRQOL were symptom experiences and family income.ConclusionsSymptom experience was a main affecting factor of physical and mental HRQOL. Interventions for relieving symptom experiences should be developed, and performance status, smoking history and financial burden of lung cancer patients should be considered in clinical settings.Relevance to clinical practiceHRQOL may be improved by reducing the level of symptom experience. Healthcare professionals should assess patients’ symptom experience and develop patient‐centred symptom management programmes.

PurposeThe purpose of the study was to evaluate the construct validity and reliability of the Korean version of the revised Piper Fatigue Scale (PFS) in Koreans with chronic hepatitis B.MethodsA total of 146 chronic hepatitis B patients completed the Korean version of the revised PFS. A descriptive analysis was performed to determine the subjects’ demographic characteristics; the construct validity was examined using exploratory factor analysis; and internal consistency reliability of the scale was estimated for the meaningful total scale and factors.ResultsThe factor analysis supported the original four-factor structure based on Kaiser Criterion and Minimum Average Partial (MAP): Behavioral/Severity, Affective meaning, Sensory, & Cognitive/Mood. In the 22 items in the original instrument, patient/impatient, relaxed/tense, and exhilarated/depressed were re-identified from the cognitive/mood subscale and sensory subscale. The Cronbach’s alpha of the 22-item Korean version of the revised PFS was 0.96 for the total scale, and the range of Cronbach’s alpha for subscales was 0.90 to 0.93.ConclusionsThe results of the study revealed that the 22-item Korean version of the revised PFS is valid and reliable in Koreans with chronic hepatitis B. Further studies ascertaining the psychometric properties of the revised PFS need to be performed in Korean patients.

Background Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same requirements. Objective The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer. Methods A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions. Results A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%). Conclusions This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.

Background and PurposeThe ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model enables educators to create programs using a systematic approach designed to meet learner's needs. The purpose of this study was to develop and evaluate a clinical ethics education program for nurses to improve their ethical confidence, ethical competence, and moral sensitivity.MethodsThe study was conducted in three steps. In the first step, a seven-session ethics program was developed using the ADDIE model. The themes of each session were as follows: (a) sharing individual ethical issues in clinical settings; (b) understanding a process involved in ethical decision-making; (c) identifying ethical issues in end-of-life care; (d) identifying ethical issues in family caregiving; (e) learning communication skills; (f) developing ethical leadership skills; and (g) reflecting to build self-awareness of the significance of practicing clinical ethics. The second step involved the delivery of the program. In the third step, using a mixed methods design, the effects of the program were evaluated through a quantitative survey administered both before and after completion of the program and focus group interviews.ResultsThe seven-session ethics program based on the ADDIE model improved ethical confidence, ethical competence, and moral sensitivity in nurses.Implications for PracticeThe ADDIE model can be an effective tool in nursing education, offering an established structure for developing educational programs. In order to validate the effectiveness of the ethics program, it is necessary to conduct repeated measure studies and further studies at the institutional level.