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Volume 40(1); February 2010
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Original Articles
Evaluation of Nurses' Competency in Nurse-Patient Communication about Medications: Conversational Analysis Approach
Haeng-Mi Son
J Korean Acad Nurs 2010;40(1):1-13.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.1
AbstractAbstract PDF
Purpose

The purpose of this study was to develop evaluation criteria for conversations about medication and to demonstrate conversational analysis with actual dialogues on medication as examples.

Methods

This study was a secondary analysis of qualitative research using conversational analysis which showed functional phases and patterns of dialogue about medication (greeting, identifying the patient, medicating, finishing). Nurse-patient conversations were videotaped and transcribed and 75 conversations were used for analysis.

Results

Not all functional phases were showed in the conversations about medication. Therefore, conversations about medication can be considered as incomplete dialogues. The evaluation-criteria were represented in terms of the structure and content of the dialogues. Structural evaluation-criteria were the same as the functional phases, as functional stage is the standard for evaluation. The criteria of evaluation for content suggested 3 domains, content, expression, and interaction with 20 items scored on a Likert-type scale of 5-points. Finally, analysis of actual conversations about medication according to the evaluative criteria were provided.

Conclusion

The results provide the basic data to develop educational programs and strategies to improve nurses' competency in conversation about medication.

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A Comparative Study of Youth Health Risk Behaviors by Region: Focused on Metropolitan Areas, Medium Sized and Small City Areas, and Rural Areas
Eunok Park
J Korean Acad Nurs 2010;40(1):14-23.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.14
AbstractAbstract PDF
Purpose

This study was done to compare health risk behavior prevalence for youth living in metropolitan, medium sized and small cities or rural area, in order to enhance understanding regional differences.

Methods

For this study, data from the 2006 Youth Health Risk Behavior Online Survey collected by the Korean Center for Disease Control were analyzed using SPSS.

Results

In the metropolitan areas, prevalence for disease and perceived obesity were higher than in other areas. Lack of intense or moderate physical activity, obesity, fast food intake, and insufficient sleep showed higher prevalence than in rural areas. Prevalence of lifetime smoking, lifetime alcohol consumption, present alcohol use, fruit intake less than once a day, and not wearing a seat belt were higher in rural areas than in urban areas. Gender, smoking, and alcohol use were correlated. Spearman correlation between living with parent and skipping breakfast were significant. Smoking, alcohol use, and sexual behavior were correlated.

Conclusion

As significant differences in prevalence of youth health risk behaviors exist between regional areas, health education and health promotion programs considering these differences have to be developed and implemented for adolescents. Programs for prevention of smoking and alcohol use, programs for improvement of fruit intake and safety are suggested for adolescents in rural areas, whereas programs to enhance physical activity and obesity management are suggested for adolescents in metropolitan areas.

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Predictors of Sexual Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain in Women with Gynecologic Cancer
Nami Chun
J Korean Acad Nurs 2010;40(1):24-32.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.24
AbstractAbstract PDF
Purpose

This study was done to identify psychosocial factors that might be predictive of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain in women with gynecologic cancer.

Methods

Two hundred and twelve women with cervical, ovarian, or endometrial cancer completed questionnaires on the Female Sexual Function Index including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain, and data on their psychosocial factors including body image, sexual attitude, sexual information, depression, and marital intimacy. Stepwise multivariable regression analysis was performed to explore psychosocial predictors of women's sexual function domains.

Results

Predictors were identified as sexual attitude, depression, sexual information, and body image for sexual desire; sexual information, depression, and sexual attitude for sexual arousal; sexual information, marital intimacy, and depression for lubrication; sexual information, marital intimacy, depression, and body image for orgasm; marital intimacy, sexual information, sexual attitude, and depression for satisfaction; sexual information, depression, and marital intimacy for pain.

Conclusion

The results indicate that women's sexual function needs to be approached to domains of female sexual function psychosocially as well as to general sexual function. These factors should be considered in future interventions to positively promote sexual function in women with gynecologic cancer.

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Analysis of Nursing-related Content Portrayed in Middle and High School Textbooks under the National Common Basic Curriculum in Korea
Myun Sook Jung, Hyeong Wook Choi, Dong Mei Li
J Korean Acad Nurs 2010;40(1):33-42.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.33
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze nursing-related content in middle, and high school textbooks under the National Common Basic Curriculum in Korea.

Methods

Nursing-related content from 43 middle school textbooks and 13 high school textbooks was analyzed.

Results

There were 28 items of nursing-related content in the selected textbooks. Among them, 13 items were in the 'nursing activity' area, 6 items were in the 'nurse as an occupation' area, 2 items were in the 'major and career choice' area, 6 items were 'just one word' and 1 item in 'others'.

Conclusion

The main nursing related content which portrayed in the middle and high school textbooks were caring for patients (7 items accounting for 46.5%), nurses working in hospitals (6 items accounting for 21.4%). In terms of gender perspective, female nurses (15 items accounting for 53.6%) were most prevalent.

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Sleep Patterns and Circadian Types of Nursing Students during Shift Schedules
Hyun Sook Kim, Mi-Ran Eom, Eun-Kyung Kim
J Korean Acad Nurs 2010;40(1):43-51.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.43
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate sleep habits, sleep disturbance, and circadian types, and to identify factors influencing sleep disturbance in nursing students.

Methods

Participants were 140 senior nursing students. The data were collected from May 19 to 27, 2008 using self-report questionnaires.

Results

1) Evening type delayed sleep-wake schedules were more frequent than for morning type, especially during weekend and evening shift duty. 2) In total sleep time, there were no significant statistical differences between morning type and evening type during weekdays, weekend, day or evening shift duty. 3) On weekdays and day shift duty, the mean score for sleep disturbance was significantly higher in the evening type compared to the morning type. 4) Sleep disturbance in weekday and day shift duty was influenced by circadian types, eating habits, and gender.

Conclusion

The circadian types are a very important factor for determining the sleep quantity and quality in nursing students.

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The Relationship between the Optimistic Bias about Cancer and Cancer Preventive Behavior of the Korean, Chinese, American, and Japanese Adult Residing in Korea
Sul Hee Lee, Eun Mi Ham
J Korean Acad Nurs 2010;40(1):52-59.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.52
AbstractAbstract PDF
Purpose

This study was conducted to provide basic data for developing education and health promotion programs for the prevention of cancer by identifying the relation between optimistic bias about cancer and cancer preventive behavior in Korean, Chinese, American, and Japanese residents in Korea.

Methods

Using a questionnaire administered by the researcher, data were collected from a convenience sample of 600, 19 to 64-yr-old male and female Korean, Chinese, American, and Japanese residents in Korea. Data was collected between February 6 and 28, 2009.

Results

Scores for optimistic bias about cancer by nationality were: Koreans, -1.03; Chinese, -0.43; Americans, -0.23; and Japanese, 0.05. The cancer preventive behavior scores were: Koreans, 43.17; Chinese, 71.84; Americans, 71.71; and Japanese, 73.97. Optimistic bias about cancer and cancer preventive behavior showed a significantly positive correlation in all participants: Koreans (r=.223, p=.006); Chinese (r=.178, p=.029); Americans (r=.225, p=.006); and Japanese (r=.402, p<.001).

Conclusion

The greater the optimistic bias about cancer is, the lower the cancer preventive behavior. The findings suggest that nursing interventions are needed to reduce optimistic bias about cancer and to form a positive attitude towards cancer prevention because an optimistic bias about cancer adversely affects cancer preventive behavior.

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The Effects of Music Therapy on Postpartum Blues and Maternal Attachment of Puerperal Women
Sun Mi Lee
J Korean Acad Nurs 2010;40(1):60-68.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.60
AbstractAbstract PDF
Purpose

The purpose of this study was to determine the effects of music therapy on postpartum blues and maternal attachment of puerperal women.

Methods

The research design was a nonequivalent control group non-synchronized design. The participants were puerperal women who agreed to participate in this study and through a convenience sampling, 60 puerperal women were recruited (30 in the experimental group, 30 in the control group). After measuring postpartum blues and maternal attachment, music therapy was provided to the experimental group over 40 min, once a day, and for 8 days. Then, postpartum blues and maternal attachment for the experimental and control group were measured again on the 8th day. The data were analyzed using the SPSS WIN 12.0 Program.

Results

The first hypothesis that "the degree of postpartum blues for the experimental group who participated in music therapy would be lower than that of the control group" was accepted (t=4.350, p<.001). The second hypothesis that "the degree of maternal attachment of the experimental group who participated in music therapy would be higher than that of the control group" was accepted (t=4.828, p<.001).

Conclusion

These findings indicate that music therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women.

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Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives
Eun Hwa Lee, Sung Hee Ahn
J Korean Acad Nurs 2010;40(1):69-77.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.69
AbstractAbstract PDF
Purpose

This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses.

Methods

The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using χ2-test, factor analysis, and the Analytical Hierarchy Process.

Results

Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order.

Conclusion

PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

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Effects of an Educational Program of Pregnancy and Delivery on Pregnancy related Knowledge, Newborn Care Knowledge, and Postpartum Care Self-efficacy of Marriage Immigrant Women
Eun Hee Kim, Eunjoo Lee, Mi-Jo Kim, Dong Young Park, Sung Hee Lee
J Korean Acad Nurs 2010;40(1):78-87.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.78
AbstractAbstract PDF
Purpose

This study was designed to evaluate the effects of an educational program on pregnancy and delivery including pregnancy related knowledge, newborn care knowledge, and postpartum care self-efficacy for married immigrant women.

Methods

A nonequivalent control group quasi-experimental design was used. The educational program was developed by though an educational need assessment of married immigrant women and an expert opinion. The program was provided for 3 weeks, once a week for two hours. The data were analyzed with SPSS program using Kolmogorov-Smirnov, χ2-test, Fisher's exact test, and t-test.

Results

The program significantly improved pregnancy related knowledge, newborn care knowledge, and postpartum care self-efficacy for the married immigrant women who participated in the program compared to the women who did not.

Conclusion

The results indicate that the educational program has an affirmative effect on pregnancy related knowledge, knowledge of newborn care, and postpartum care self-efficacy in these women. It is suggested, therefore, that the educational program be used to every married immigrant woman at the public health centers or delivery clinics help them to adjust to the childbearing and childrearing experience and this will ultimately enhance the quality of family life of married immigrant women in Korea.

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Correlation of Social Network Types on Health Status of Korean Elders
Eui-Young Cheon
J Korean Acad Nurs 2010;40(1):88-98.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.88
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the social network types of elders and to identify differences among latent classes by social network.

Methods

The data of 312 elders used in this study were collected from health, welfare, and other facilities and from elders living in the community. The interviews were conducted from July 16 to September 30, 2007 using a standard, structured questionnaire. Descriptive statistics, one way ANOVA with the SPSS 15.0 program and latent class analysis using Maximum Likelihood Latent Structure Analysis (MLLSA) program were used to analyze the data.

Results

Using latent class analysis, social network types among older adults were identified as diverse for 58.0% of the sample, as family for 34.0%, and as isolated for 8.0%. The health status of respondents differed significantly by network type. Elders in diverse networks had significantly higher health status and elders in isolated networks had significantly lower physical health status on average than those in all other networks.

Conclusion

The results of this study suggest that these network types have important practical implications for health status of elders. Social service programs should focus on different groups based on social network type and promote social support and social integration.

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Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department
Eun Jung Kim
J Korean Acad Nurs 2010;40(1):99-109.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.99
AbstractAbstract PDF
Purpose

The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department.

Methods

For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction.

Results

Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern.

Conclusion

The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals
Ju Young Yoon, Ji Yun Lee
J Korean Acad Nurs 2010;40(1):110-118.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.110
AbstractAbstract PDF
Purpose

To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.

Methods

The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.

Results

The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.

Conclusion

This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

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Factors Influencing Sleep of Elderly Women
Sohyune R. Sok, Jin Yi Choi
J Korean Acad Nurs 2010;40(1):119-126.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.119
AbstractAbstract PDF
Purpose

The study was done to identify factors influencing the sleep of elderly women.

Methods

Data were collected by questionnaires from 203 elderly women in Seoul and Gyeong-gi province. Measures were physical health state, family support, life satisfaction, sleep, depression, and quality of life. Data were analyzed using Pearson correlation coefficients, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 13.0 version.

Results

The mean score for sleep for elderly women was 39.04. Sleep for elderly women according to religion, education level, spouses, and monthly income showed significant differences. Sleep for elderly women showed significantly positive correlations to physical health state, family support, life satisfaction, and quality of life. The significant factors influencing sleep of elderly women were physical health state, family support, depression, and quality of life, which explained about 70.4% of the variance. The strongest factors influencing the sleep was physical health state.

Conclusion

The results suggest that in developing nursing interventions and practice for sleep pattern of elderly women spouses and family support should be considered.

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Development of a Structural Equation Model for Children's Adaptation in Divorced Families
Sung Hee Shin
J Korean Acad Nurs 2010;40(1):127-138.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.127
AbstractAbstract PDF
Purpose

This study was designed to develop and test a structural model for children's adaptation in divorced families. The hypothetical model was constructed based on the Family Resilience Model by McCubbin and McCubbin.

Methods

Data were collected using self-report questionnaires from 219 children (3-6th grade) in divorced families. The children attended one of 22 community agencies, 8 after-school programs, 3 elementary schools in three cities in South Korea. The collected data were analyzed using LISREL program to test the hypothetical model.

Results

The modified model was constructed by deleting four paths in accordance with the statistical and theoretical criteria. Compared to the hypothetical model, the revised one had a better fit to the data. Self-esteem, and beliefs about parental divorce had direct effects, and family communication and internal control had indirect effects on children's adaptation in divorced families. These variables explained 56% of the variance in children's adaptation.

Conclusion

The modified model was supported by empirical data. This model could be applied to family nursing interventions with divorced families or any other suffering family transition. When working with children experiencing parental divorce, it is important for nurses to enhance children's self-esteem, family communication and to decrease children's negative beliefs about parental divorce to help in their adaptation.

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Analysis of Research Papers Published in the Journal of the Korean Academy of Nursing-Focused on Research Trends, Intervention Studies, and Level of Evidence in the Research
Hyun-Sook Shin, Myung-Sun Hyun, Mi-Ok Ku, Myung-Ok Cho, Sook-Young Kim, Jea-Sim Jeong, Geum-Hee Jeong, Gyeong-Ae Seomoon, Youn-Jung Son
J Korean Acad Nurs 2010;40(1):139-149.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.139
AbstractAbstract PDF
Purpose

This study aimed was done to analyze recent trends in nursing research published in the Journal of Korean Academy of Nursing by focusing on the content of nursing interventions and their level of evidence.

Methods

A total of 209 studies published between 2007 and 2008 were reviewed using analysis criteria developed by the researchers.

Results

The number of quantitative studies was greater than that of qualitative studies. There was a slight increase in the number of qualitative studies and studies including elderly populations, which reflects the recent population trend in Korea. More randomized controlled trials with a low risk of bias were needed to support more evidence-based nursing practice. Concerning the low rate of ethical consideration, stricter application of research ethics needs to be encouraged.

Conclusion

The findings of this study suggest the recent trends in nursing research and the direction of nursing research and review in the Journal.

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