The purpose of this study was to assess the awareness of warning signs of stroke and identify the risk factors influencing such awareness among diabetics with hypertension who are at a high risk for stroke. Methods: Data from the 2017 Korea Community Health Survey were used. A total of 15,536 adults older than 30 years diagnosed with hypertension and diabetes mellitus were included in the final analysis. Data were analyzed using frequency, percentage, x 2 test, and logistic regression with SPSS/WIN 24.0 program. Results: Among the five warning signs of stroke, "sudden trouble in speaking or understanding" (79.0%) was the most commonly identified one and "sudden severe headache with an unknown cause" (65.2%) was the least. Only 48.8% participants identified all five warning signs and 11.8% could not identify any of them. In the logistic regression model, the risk of unawareness of warning signs of stroke was significantly higher among those aged 30~49 years and 70 years or older, with a lower educational level, without a spouse, and with a heavy alcohol consumption and current smoking status. Conclusion: The level of awareness of warning signs was low in hypertensive diabetic adults. To improve awareness of warning signs of stroke, a customized educational program should be provided to hypertensive diabetic adults considering the risk factors relevant to unawareness of warning signs of stroke. The education on warning signs of stroke can potentially lead to a reduction in morbidity in the survivors.
The aim of this study was to develop an Ethical Nursing Competence Self-rating Scale for Clinical Nurses. Methods: A scale-development study was applied that comprised eight stages of DeVellis. The scale verification involved a convenience sample of 423 nurses from September to October 2019 at three general hospitals located in Korea. The content validity, factorial structure validity, item-convergent/discriminant validity, known-group validity, convergent validity, internal consistency reliability, and test-retest reliability of the Ethical Nursing Competence Self-rating Scale for Clinical Nurses were evaluated. Data were analyzed using exploratory and confirmatory factor analyses, Pearson's correlation coefficient, Heterotrait-monotrait (HTMT), Cronbach's ⍺, and intraclass correlation coefficient. Results: Exploratory and confirmatory factor analyses yielded five-factors. Known-group validity was demonstrated by clinical experience and nursing ethics education experience. Convergent validity was demonstrated using measures of defining issue. Internal consistency reliability and test-retest reliability were found to be acceptable, as indicated by a Cronbach's ⍺ of .70~.85 and an intraclass correlation coefficient of .72~.89. Conclusion: The Ethical Nursing Competence Self-rating Scale for Clinical Nurses is a new instrument that comprehensively measures the aspects of ethical behavior, ethical decision-making and action, ethical sensitivity, ethical reflection, and ethical knowledge. It consists of 20 items scored on a 4-point Likert scale. The validity and reliability of the scale were verified. These findings indicate that the instrument can be applied in clinical practice, nursing education, and research.
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