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Volume 43(4); August 2013
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Original Articles
Nurses' Experience of Incivility in General Hospitals
Se Young Kim, Kwang-Ok Park, Jong Kyung Kim
J Korean Acad Nurs 2013;43(4):453-467.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.453
AbstractAbstract PDF
Purpose

This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment.

Methods

Data were collected through in-depth interviews and analyzed using Colaizzi' phenomenological analysis methodology. Participants were seven experienced clinical nurses working on a general ward (2 nurses), or in an intensive care unit (2 nurses), emergency room (2 nurses), or operating room (1 nurse).

Results

The incivility that nurses experienced was categorized as follows: 'being afflicted as a weak person', 'being treated as less than a professional', 'being overwhelmed by shock and anger', 'experiencing an untenable situation', 'struggling to survive', and 'pursuing professional growth'.

Conclusion

Behavior guidelines should be developed to reduce incivility, and incivility cases should be continuously monitored by the nursing department. Also, to handle incivility problems in clinical nursing areas, a reporting and counseling system and education programs are needed.

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Development and Effects of a Simulation-based Education Program for Newborn Emergency Care
So Young Yoo
J Korean Acad Nurs 2013;43(4):468-477.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.468
AbstractAbstract PDF
Purpose

This study was conducted to develop a simulation-based education program for newborn emergency care based on most needed topics found from the needs assessment. This study consisted of two phases: developing the program and evaluating its effectiveness.

Methods

The effectiveness of the program was tested in July, 2012, with 49 junior nursing students from C Nursing College in Seoul, who did not have any clinical experience in newborn care. The experimental group was given a three-hour lecture, three hours of clinical training, and a two-hour simulation program, whereas the control group only had the three-hour lecture.

Results

There was significant improvement in knowledge in both groups, but no significant differences according to educational methods. The experiment group was more confident of their care (4.32±.29) than the control group (3.60±.29) with the difference being significant (t=8.85, p<.001), and the experimental group was also more satisfied with the program (χ2=4.60, p=.032).

Conclusion

As the results indicate 'the neonatal emergency care program' increased learners' knowledge, confidence and satisfaction with the program, it should be integrated into clinical training in pediatric nursing curriculum and in-service programs for nurses. To increase generalization further verification studies with various learner groups are needed.

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Development and Effects of a Health Education Program for North Korean Preschool Defectors
In Sook Lee, Ho Ran Park
J Korean Acad Nurs 2013;43(4):478-485.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.478
AbstractAbstract PDF
Purpose

This study was conducted to develop a health education program for preschoolers who have defected from North Korea with their mothers, and to evaluate the effects on health knowledge and behavior.

Methods

A non-equivalent control group pre-post test design was used with 58 preschoolers who were assigned to either the experimental or control group (29 for each group). The program was composed of five sessions in health education and contracts. To test the effectiveness of the intervention, health knowledge and behaviors, and total bacterial colony counts on hands were measured at one pretest and two post tests (1 week and 4 weeks after the intervention ended). Data were analyzed using the SAS program.

Results

Health knowledge and behavior in the experimental group increased significantly compared to the control group. The effects of the intervention were evident even at 4 weeks after the intervention ended. Total bacterial colony counts in the experimental group decreased significantly at the 1 and 4 week posttest intervention compared to the control group.

Conclusion

Results indicate that this program is effective in improving health knowledge and behavior in these children and therefore can be utilized to ensure efficient management their health care.

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Types of Child Rearing Behavior of Parents during Early Childhood: Q-Methodological Approach
Sun-Jung Park, Kyung-Ah Kang, Shin-Jeong Kim
J Korean Acad Nurs 2013;43(4):486-496.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.486
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the awareness of child rearing among parents of children in early childhood and to provide fundamental data for parent education programs according to child rearing type.

Methods

Q-methodology which provides a method of analyzing the subjectivity of each item was used. Forty Q items which were derived from a literature review and interviews with nurturing mothers were classified into a normal distribution using a 9-point scale. Collected data were analyzed using the QUANAL PC Program.

Results

Four types of parents' child rearing were identified. Type I was named 'affection-respect type', type II, 'concern-rule compliant type', type III, 'solicitude-model type', and type IV, 'geniality-encouragement type'.

Conclusion

For proper growth and development during early childhood, parents should have rational information and awareness of their child rearing type. Results of this study can be used as essential data to develop child rearing education programs according to parents' child rearing attitude.

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Effects of a Family Education Program for Families of Pathological Gamblers
Jungah Hong, Soo Yang
J Korean Acad Nurs 2013;43(4):497-506.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.497
AbstractAbstract PDF
Purpose

This study was done to examine the intervention effects on the family of a family education program for pathological gamblers based on Community Reinforcement and Family Training (CRAFT).

Methods

A quasi-experimental, nonequivalent control group pretest-posttest design was used. The participants were 44 families of pathological gamblers from G center in Gyung-gi Province and 5 Gam-Anon groups in Seoul City and Gyung-gi Province. The experimental group (n=22) attended the 6 weekly 2 hour-long CRAFT family education program. The control group (n=22) attended the 12-step program of Gam-Anon. Data were collected from November, 2011 to May, 2012.

Results

Compared with the control group, the experimental group showed significant decrease in depression (p=.001) and state anger (p=.039). There were no significant differences between groups in the level of interpersonal communication, trait anger, the mode of anger expression and self-esteem.

Conclusion

Findings from this study suggest that the CRAFT family education program is effective in decreasing depression and state anger in families of pathological gamblers.

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Economic Evaluation of a Workplace Occupational Health Nursing Service: Based on Comparison with Atmospheric Environment Managing Engineer
Hye-Sun Jung, Bokim Lee
J Korean Acad Nurs 2013;43(4):507-516.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.507
AbstractAbstract PDF
Purpose

The purpose of this study was to use cost-benefit analysis of activity to clarify the economic effect of prepared nurses versus atmospheric environment managing engineers as healthcare managers.

Methods

For the study 111 workplaces were surveyed, workplaces in which nurses or atmospheric environment managing engineers were employed as healthcare managers. The survey content included annual gross salaries, participation in external job training, costs in joining association covered by the company, location and year of construction of the healthcare office, various kinds of healthcare expenditures, costs in operating healthcare office, health education, and activity performance in the work of environment management.

Results

In the case of the healthcare manager being a nurse, benefit was larger than input costs at a ratio of 2.31. On the other hand, in the case of healthcare manager being an atmospheric environment managing engineer, input costs were larger than benefits (benefit-cost ratio 0.88).

Conclusion

Results indicate that nurses are an effective healthcare human resource and can offer good quality healthcare service. Therefore companies should hire nurses and actively promote the economic efficiency of nurses in workplace.

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Effects of Nurses' Social Capital on Turnover Intention: Focused on the Mediating Effects Organizational Commitment and Organizational Cynicism
Jeongwon Han, Heeyoung Woo, Eunsil Ju, Sohee Lim, Sangsook Han
J Korean Acad Nurs 2013;43(4):517-525.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.517
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model.

Methods

This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0.

Results

Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment.

Conclusion

Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.

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Clinical Nurses’ Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis
Yun Jin Lee, Seungmi Park, Jung Yoon Kim, Chul-Gyu Kim, Sun Kyung Cha
J Korean Acad Nurs 2013;43(4):526-535.   Published online August 12, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.526
AbstractAbstract PDF
Abstract Purpose

This study was done to compare clinical nurses’ knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD).

Methods

A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information.

Results

The overall mean score for correct answers was 14.5 (± 3.2) in PUCS & IAD KT and 11.15 (± 4.9) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), un-stageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r= .48, p< .001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs.

Conclusion

Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.

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A Meta-analysis of the Effect of Walking Exercise on Lower Limb Muscle Endurance, Whole Body Endurance and Upper Body Flexibility in Elders
Kook-Hee Roh, Hyeoun-Ae Park
J Korean Acad Nurs 2013;43(4):536-546.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.536
AbstractAbstract PDF
Purpose

The purpose of this study was to determine whether walking exercise improved physical function in elderly people using meta-analysis.

Methods

Medical and nursing literature databases were searched to identify the studies on the effectiveness of walking exercise on physical function. In the databases, there were 16 articles reporting 21 interventions. Overall effect sizes for three outcome variables, elders' physical function in lower limb muscle endurance, whole body endurance and upper body flexibility, were calculated. Effects of study characteristics on outcome variables were analyzed.

Results

The meta-analysis showed that walking exercise generally had positive effects on CST (chair stand test), 6MW (6 min walking), and SRT (standing or sitting reach test) with overall weighted effect sizes of 1.06, 0.41 and 0.29 respectively. This study also showed that the chronic disease status of the elders, intervention methods, and type of residence had different effects on CST, 6MW and SRT.

Conclusion

The results indicate that walking exercise improves physical function in elders. Walking exercise which can be done at any time and any location is indeed a very effective exercise for elderly people.

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Effects of Gout Web based Self-management Program on Knowledge Related to Disease, Medication Adherence, and Self-management
Hyun Soo Oh, Won Park, Seong Ryul Kwon, Mie Jin Lim, Yeon Ok Suh, Wha Sook Seo, Jong Suk Park
J Korean Acad Nurs 2013;43(4):547-556.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.547
AbstractAbstract PDF
Purpose

This study was conducted to examine the changing patterns of knowledge related to disease, medication adherence, and self-management and to determine if outcomes were more favorable in the experimental group than in the comparison group through 6 months after providing a web-based self-management intervention.

Methods

A non-equivalent control group quasi-experimental design was used and 65 patients with gout, 34 in experimental group and 31 in comparison group, were selected from the rheumatic clinics of two university hospitals. Data were collected four times, at baseline, at 1 month, 3 months, and 6 months after the intervention.

Results

According to the study results, the changing patterns of knowledge and self-management were more positive in the experimental group than in the control group, whereas difference in the changing pattern of medication adherence between two groups was not significant.

Conclusion

The results indicate that the web-based self-management program has significant effect on improving knowledge and self-management for middle aged male patients with gout. However, in order to enhance medication adherence, the web-based intervention might not be sufficient and other strategies need to be added.

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Effects of a Smoking Cessation Program including Telephone Counseling and Text Messaging using Stages of Change for Outpatients after a Myocardial Infarction
Jung-Hyeon Kong, Yeongmi Ha
J Korean Acad Nurs 2013;43(4):557-567.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.557
AbstractAbstract PDF
Purpose

This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI).

Methods

This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks.

Results

At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001).

Conclusion

The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

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Accessing Factor Structure and Construct Validity of the Successful Aging Inventory
Eun Joo Kim
J Korean Acad Nurs 2013;43(4):568-578.   Published online August 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.4.568
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the reliability and validity of the Korean version of the Successful Aging Inventory (SAI-K) to determine its suitability for use with older Korean adults.

Methods

Exploratory and confirmatory factor analyses were utilized to assess the factor structure and the construct validity of the SAI-K. First- and second-order Confirmatory Factor Analysis (CFA) were conducted to identify the most adequate model. Cronbach's alpha was used to test the reliability.

Results

Using a second-order CFA, a four-factor structure was validated (χ2=122.82, p<.001, GFI=.92, AGFI=.88, SRMR=.06 RMSEA=.07, 90% CI=.05-.09, CFI=.93). The four-factor SAI-K showed reliable internal consistency with a Cronbach's alpha for the total scale of .86.

Conclusion

The four-factor, 13-item SAI-K showed satisfactory reliability and validity and, thus, has the potential to be an appropriate instrument for measuring successful aging in older Korean adults.

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