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A Longitudinal Study on Moral Judgment Development in Nursing and Medical Students
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Yong Soon Kim, Jee Won Park, Youn Jung Son
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Journal of Korean Academy of Nursing 2003;33(6):820-828. Published online March 28, 2017
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DOI: https://doi.org/10.4040/jkan.2003.33.6.820
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Abstract
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Purpose
In this longitudinal study, we examined the moral judgment level and its related factors, such as individual characteristics. The result of this study will provide baseline data to establish policy of ethics education for college students and healthcare professionals.
Method
We enrolled 37 nursing students and 20 medical students as the subjects in a university in Suwon, Korea. We conducted a questionnaire on the subjects using Korean version of Defining Issues Test(DIT) to analyze the subjects' moral judgment level. Collected data was coded using ASCII document and scored using Fortran program for computer. Then the data was statistically analyzed by SPSS Version 10.0.
Result
Nursing students' moral development score at each stage were consistently higher at stage 5A across 4-years rather than other stages. On the other hand, medical students' moral development score were consistently higher at stage 4 than other stages. There was no significant difference in the change P(%) score at each academic year in both groups. In the perspective of the subjects' general characteristics, P(%) score showed no significant in both groups.
Conclusion
Based on the results of this study, further studies will examine the correlation between curriculum and moral judgment development in detail. Moreover, we suggest that the current ethics education should be developed and evaluated in more realistic manner.
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Citations
Citations to this article as recorded by 
- Development of critical thinking in health professions education: A meta-analysis of longitudinal studies
Matthew C. Reale, Daniel M. Riche, Benjamin A. Witt, William L. Baker, Michael J. Peeters Currents in Pharmacy Teaching and Learning.2018; 10(7): 826. CrossRef - Relationships among Cultural Disposition, Morality, and Psychological Health of Medical Students in a Province of Korea
Sunyoung Lee, Byungduck An Korean Medical Education Review.2016; 18(1): 26. CrossRef - Cross-sectional comparison on human rights sensitivity changes in nursing students and non-nursing students
Seong-Eun Kim Journal of Digital Convergence.2016; 14(4): 355. CrossRef - Volunteer activity, sociality, and morality in the dental hygiene students
Hye-Kyung Lee Journal of Korean society of Dental Hygiene.2014; 14(6): 927. CrossRef - Changes in Nursing Students' Moral Judgment and Ways to Evaluate the Effect of Ethics Education
MI-Aie Lee Journal of Korean Academy of Nursing Administration.2013; 19(3): 351. CrossRef - A Study of Moral Judgment and Ethical Decision Making and Ethical Dilemmas Experienced in Practice by Nursing Students
Yoon Goo Noh, Myun Sook Jung Journal of the Korea Academia-Industrial cooperation Society.2013; 14(6): 2915. CrossRef - Korean Medical Students' Cognitive, Emotional, and Social Characteristics
Sook Hee Ryue, Hae Bum Lee Korean Journal of Medical Education.2012; 24(2): 103. CrossRef - Validation of a Korean version of the Moral Sensitivity Questionnaire
Sung-Suk Han, Juhu Kim, Yong-Soon Kim, Sunghee Ahn Nursing Ethics.2010; 17(1): 99. CrossRef - Comparison of Career Choice Motivation and Moral Reasoning Ability between Students in Baccalaureate and Graduate-entry Programs
Min Kang Kim, Jin Oh Kang Korean Journal of Medical Education.2007; 19(2): 91. CrossRef
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Effectiveness of Indoor Environment Management Education for Prevention of Allergic Asthma
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Jee Won Park, Yong Soon Kim, Young Shin Song
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Journal of Korean Academy of Nursing 2002;32(7):1017-1023. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2002.32.7.1017
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Abstract
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PURPOSE: The objective of this research is to provide the indoor environment management education program for the asthma patients and their families and then analyze the effectiveness in education preventing allergic asthma. METHODS A pre-post single group quasi-experimental design was used to provide an education program about correct indoor environment management to a total of 58 households (29 patient households and 29 normal households). The performance rate of correct indoor environment management procedure, amount of house dust mite antigen, allergy subjective symptoms score and knowledge score about indoor environment management were compared before and after the education to test the effectiveness of the education. RESULTS Home-visit education in this research had effects in improving subject households' performance rate of indoor environment management procedures, reducing the amount of house dust mite antigen - an important inducing factor of allergy, and reducing perceived subjective symptoms of allergy.
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Nurse Managers' Moral Self Concept and Ethical Sensitivity
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Yong Soon Kim, Jee Won Park, Youn Jung Son, Sung Suk Han
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Journal of Korean Academy of Nursing 2002;32(7):1072-1078. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2002.32.7.1072
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Abstract
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PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers. METHODS Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers. RESULTS 1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00). CONCLUSION It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.
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Citations
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- Compassion fatigue and moral sensitivity in midwives in COVID-19
Reyhan Aydin Dogan, Sebahat Huseyinoglu, Saadet Yazici Nursing Ethics.2023; 30(6): 776. CrossRef - Ebelik ve Hemşirelik Öğrencilerinin Ahlaki Duyarlılığı
Pervin ŞAHİNER, Belgin BABADAĞLI, Nermin ERSOY Kocaeli Üniversitesi Sağlık Bilimleri Dergisi.2019; 5(2): 86. CrossRef - Chinese insurance agents in “bad barrels”: a multilevel analysis of the relationship between ethical leadership, ethical climate and business ethical sensitivity
Na Zhang, Jian Zhang SpringerPlus.2016;[Epub] CrossRef - Moral sensitivity and critical thinking disposition of nursing students in Korea
Sung‐Hee Ahn, Hye‐A Yeom International Journal of Nursing Practice.2014; 20(5): 482. CrossRef - Sensitivity to Ethical Issues Confronted by Korean Hospital Staff Nurses
Yong-Soon Kim, Jee-Won Park, Mi-Ae You, Ye-Suk Seo, Sung-Suk Han Nursing Ethics.2005; 12(6): 595. CrossRef
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Effects of a Occupational Health Promotion Program for Prevention of Cardiovascular Disease
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Jee Won Park, Yong Soon Kim, Gi Yon Kim
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Journal of Korean Academy of Nursing 2002;32(2):196-205. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2002.32.2.196
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Abstract
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PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease.
METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program.
RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program.
CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.
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Citations
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- Effects of a Comprehensive Lifestyle Improvement Program for Middle-aged Women with Cardio-cerebrovascular Disease-related Risk Factors
Mi-Kyoung Park, Jeong-Hee Kim Journal of Korean Academy of Community Health Nursing.2013; 24(2): 111. CrossRef - Effects of a Tailored Health Promotion Program to Reduce Cardiovascular Disease Risk Factors Among Middle-Aged and Advanced-Age Bus Drivers
Gyu-Seok Hwang, Jae-Wook Choi, Seoung-Hyung Choi, Seoung-Gil Lee, Kyung-Hee Kim, Yong-Min Cho, Chungsik Yoon Asia Pacific Journal of Public Health.2012; 24(1): 117. CrossRef - The Effects of a Worksite On-line Health Education Program on Metabolic Syndrome Risk Factors and Nutrient Intakes of Male Workers
Ji-Yeon Kang, Sang-Woon Cho, Ji-Young Lee, Sook-Hee Sung, Yoo-Kyoung Park, Yun-Mi Paek, Tae-In Choi The Korean Journal of Nutrition.2010; 43(1): 57. CrossRef
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Effect of Ethics Education on Nurse's Moral Judgement
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Yong Soon Kim
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Journal of Korean Academy of Nursing 2000;30(1):183-193. Published online March 29, 2017
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DOI: https://doi.org/10.4040/jkan.2000.30.1.183
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Abstract
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This main purpose of this study was to assess the effects of two different types of ethics education on the
moral judgement of clinical nurses. One type was free discussions among nurses with given specific moral
issues and the other type was discussions guided by experts on specific moral issues.
The study employed a quasi-experimental, nonequivalent pre test-post test design using two different
control groups. The conceptual framework of the study was derived from the Kohlberg's Moral Development
Theory (1969) and the Greipp's Ethical Decision-Making Model (1992).
The data was collected during the period of October 14 through December 15, 1998. Sample consists of 32
nurses working in the ICU who met research criteria. 16 nurses were assigned to the free discussion group
and 16 nurses to the group for the guided discussion with experts group. For the pre-test, the DIT which
was developed by Rest (1984) and JAND by Ketefian (1998) were used with some modification by the
author. After the education, only JAND was used to assess the changes in moral judgement. The collected
data was analysed using SPSS PC program.
The findings are as follows:
1. There was no significant difference between two groups in their general characteristics. Only difference which
was statistically significant between two groups was that realistic score on Case 3/Medical Research and
Autopsy was higher in the free discussion group.
2. Hypothesis 1: "There will be a difference on the moral judgement of nurses before and after they receive an
ethics education". This hypothesis was supported partially. Those who had low scores on moral judgement
before the education tended to have higher scores after the education on the same issues. And, after the
education, the nurses tend to give lower scores on the dilemmas they had experienced frequently at work;
while giving higher scores on those dilemmas they had no prior experience.
3. Hypothesis 2: "The effect of education may differ depended upon the moral development index [P(%)] score of
nurses". The effect of education was different depend on moral development level. The group who's P(%)
scores was low at the pretest has higher scores in realistic moral judgement after the education, while the
groups with middle or high P(%) scores went down after the education. These changes were statistically
significant in some cases, thus, the Hypothesis 2 was partially supported
4. Hypothesis 3: "The method of ethics education will have different effects on the moral judgement of nurses".
Even though several nurses attended the guided discussion stated that the education program broadend their
perspectives the difference between two groups was not significant and this hypothesis was not supported.
In conclusion, both types of ethics education had helped the nurses to acquire the skills to deal some nursing
dilemmas. The effects of ethics education may differ according to the moral development index - P(%) score.
However, because of some of the limitations of this study, mainly small sample size, short term education,
unable to control other variables which may affect moral judgement of nurses, further research is warranted.
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Citations
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- Effects of ethics education on moral sensitivity of nursing students
Hye-A Yeom, Sung-Hee Ahn, Su-Jeong Kim Nursing Ethics.2017; 24(6): 644. CrossRef - The Effect of Biomedical Ethics Education Program for Nursing Students Freshman
Gye Seon Jeong The Journal of Korean Academic Society of Nursing Education.2016; 22(3): 376. CrossRef - Nursing Students' Awareness of Human Rights and Influencing Factors
Sun-Woo Hong, Ji-Soo Kim, Hye-Jin Hyun The Journal of the Korea Contents Association.2011; 11(6): 260. CrossRef - Performance Evaluation of Transmitting Brainwave Signals for Driver's Safety in Urban Area Vehicular Ad-Hoc Network
Jun-Mo Jo The Journal of the Korea Contents Association.2011; 11(6): 26. CrossRef - Validation of a Korean version of the Moral Sensitivity Questionnaire
Sung-Suk Han, Juhu Kim, Yong-Soon Kim, Sunghee Ahn Nursing Ethics.2010; 17(1): 99. CrossRef - Hospital Nurses' Experience of Do-Not-Resuscitate in Korea
Myungsun Yi, Sang Eun Oh, Eun Ok Choi, In Gak Kwon, Sungbok Kwon, Kyung-mi Cho, Youngah Kang, Jeonghui Ok Journal of Korean Academy of Nursing.2008; 38(2): 298. CrossRef
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A Correlation of the Computer Anxiety and the Variables Affecting the Application of a Hospital Computer System
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Yong Soon Kim, Jee Won Park
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Journal of Nurses Academic Society 1995;25(4):617-632. Published online March 30, 2017
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DOI: https://doi.org/10.4040/jnas.1995.25.4.617
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Abstract
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Nowadays, most big hospitals have a computer system to manage their administration. For maximum effectiveness in managing the computer system, an analysis of the variables affecting its implementation is necessary from the beginning. This study was done to analyze the variables influencing the operation of a hospital information system (HIS). The theoretical base for this study considered the combined effects of user expectations of computerization, and computer-anxiety. The relationship between variables in the theoretical base were analyzed and the individual characteristics influencing each variable were also analyzed. This study was done in two steps. First, 344 nurses were given an initial questionnaire developed to evaluate the reliability of the items. Based on the results, a second revised questionnaire was administered to 88 nurses who had been working in the areas where HIS was applied. The results of the first and second steps of the study are as follows: 1. The initial study was done with nurses who were trained on the computer system briefly before HIS was implemented. The individual characteristics influencing computer anxiety and expectation regarding computer system usage in that initial study included, length of career, type of degree or certification, previous experiences with a computer, training on a computer, desire for computer training, and level of acceptance of a computerized work environment. But in the second study with nurses working in areas of the hospital where HIS was introduced, the work site was the only influencing characteristics. Therefore, in applying a computer system, overcoming work-environment barriers will be more important than any individual characteristics. 2. The computer anxiety of the nurses in both groups, before and after the computer system application, was below the average level but the expectation of the effects of computerization was above average. The nurses using the computer program showed an above average level of satisfaction with the computer system itself, and with its effect on their efficiency. Therefore, the ability of nurses operating HIS will be positively predictive. 3. For the variables included in the theoretical framework of the study, all of the correlational coefficients were statistically significant in the analysis of variation correlation. Therefore, the theoretical base of the study, "expectation in conjunction with computer anxiety" can be considered an model which can be evaluated. According to our analysis, the higher the level of nurses' motivation to use the computer system and the lower the anxiety about computer usage, the higher the possibility of computer system acceptance by nurses. The results of this study showed that in applying a computer system in the hospital, the main characteristic influencing acceptance was where the individual worked rather than personal characteristics such as length of career, type of degree or certification, and previous experiences with a computer. Therefore, it is suggested that the first step in uncovering and eliminating hindrance factors in application of a computer system should be an analysis of working conditions in relation to the functional content of the computer system. The suitability of the theoretical model based on the hypothesis applied in this study should be further tested.
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The Validation of Standardized Nursing Care Plans Developed for Computerized Use in Clinical Practice
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Yong Soon Kim
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Journal of Nurses Academic Society 1991;21(3):349-364. Published online March 31, 2017
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DOI: https://doi.org/10.4040/jnas.1991.21.3.349
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Abstract
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Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care.
Developing standardized nursing care plans based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea.
Consequently, in the first stage of this research project, the ten nursing diagnoses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated.
The application of the standardized nursing care plans raised the nurses' confidence and proved to the effective in enhancing the quality of nursing care.
This study was initiated as the next stage, to develop, test and determine the validity of nursing care plans for the remaining nursing diagnoses.
Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project.
The following summarizes the results of the study :
1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to 'self care deficit', were combined into one.
Standardized nursing care plans were established for these 21 nursing diagnoses.
2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data.
The application rate distribution revealed that the majority were recorded less than 50% of the time.
For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics.
Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis.
3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity.
4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process.
Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to 'the ease of establishing the nursing goal', followed by 'improved professional advice and care for patients', 'the efficiency and systemization of charting', 'the definite recognition of the nursing problem', and 'the selection of effective and appropriate nursing interventions' in descending order.
The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.
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