Atrial fibrillation (AF) is a common cardiac arrhythmia associated with poor health-related quality of life (HRQoL). However, the factors influencing HRQoL in patients with AF are not well understood. The purpose of integrative review was to investigate the factors affecting HRQoL in patients with AF based on the six domains of Ferrans and colleagues’ HRQoL model. A total of 23 relevant articles published between January 2000 and March 2018 were identified using four databases and analyzed in this study. Our review showed that the HRQoL in patients with AF was consistently lower than both healthy individuals and patients with other cardiovascular diseases. The most common factor associated with HRQoL in patients with AF was anxiety-specific to AF in the symptoms domain, followed by frequency and severity of symptoms and the New York Heart Association functional class. This study highlights that monitoring and assessing patients’ symptoms is vital for improving HRQoL in patients with AF. Disease-specific and cross-culturally validated tools can allow healthcare professionals to provide tailored interventions for patients with AF.

INTRODUCTIONHypertension and dementia are common diseases in the elderly population. Approximately 8-10% of people age 65 or older suffer from dementia and 65% suffer from hypertension. 1,2 In recent epidemiological studies, vascular risk factors have been associated with Alzheimer's disease (AD) as well as vascular dementia. In particular, hypertension is a major vascular risk factor, and studies on the relationship between hypertension, cognitive dysfunction, and onset of dementia are actively underway. Some cross-sectional observational studies have reported cognitive decline occurs frequently when blood pressure (BP) is high, especially when uncontrolled.3 Other studies have reported hypertension and cognitive function are correlated as U-curves, and that both very high and very low BP increase cardiovascular disease and consequently cognitive decline. 4,5 In most follow-up studies, middle-aged hypertension was an independent risk factor for senile cognitive impairment and dementia. [6][7][8][9] However, little is known about the relationship between modifiable risk factors and neuropsychiatric symptoms (NPS) in AD. Vascular risk factors, such as hypertension, hyperlipidemia, and stroke, are of interest because they are risk factors for NPS among individuals without AD. 10 We investigated prevalence of NPS and the degree of Korean version of Neu- Background and Purpose Neuropsychiatric symptoms (NPS) such as anxiety, depression, and delusions affect up to 90% of all patients with Alzheimer's disease (AD). NPS is associated with significant caregiver burden and patient distress. Given the severe burden of NPS in AD, it is critical to know potential modifiable risk factors of NPS in AD. This study explores the association between hypertension and NPS in patients with drug-naïve AD.Methods We reviewed medical records of 149 patients with AD with (n=80) and without (n=69) hypertension. NPS were assessed using the Korean version of Neuropsychiatric Inventory (K-NPI). Affective, psychotic, and behavior symptom clusters were assessed separately.Results The total score of K-NPI was not significantly different between patients with AD with and without hypertension. Among K-NPI domains, scores of depression/dysphoria (p=0.045), anxiety (p=0.022), and apathy/indifference (p=0.037) were significantly higher in patients with AD with hypertension. Systolic blood pressure (BP) was associated with higher total K-NPI and affective symptom cluster scores. Diastolic BP was associated with affective symptom cluster scores.Conclusions Results suggest that hypertension increases risk of specific NPS in patients with AD. Among NPS, hypertension was associated with affective symptom cluster.

Background This pilot study aimed to investigate the effects of developing scenario learning (DSL) on team efficacy, systems thinking, and proactivity in problem-solving in a fundamental nursing course. Methods A total of 53 second-year nursing students were enrolled in the study; the DSL nursing education program was implemented for 15 weeks from March 4 to June 17, 2021. Data on team efficacy, systems thinking, and proactivity in problem-solving were measured before and after the DSL-based nursing education program. The collected data were analyzed using the IBM SPSS Statistics version 22.0. Results The results demonstrated that nursing students’ team efficacy (t = − 8.228, p < .001, Cohen’s d = 1.079), systems thinking (t = − 9.757, p < .001, Cohen’s d = .731), and proactivity in problem-solving (t = − 8.635, p < .001, Cohen’s d = .992) significantly increased after the program. Conclusions The findings of this study can contribute to the development of nursing competency in nursing students without experience in nursing practicum. The authors recommend incorporating DSL in the nursing curriculum to promote early adaptation in clinical settings.