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Volume 41(5); October 2011
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Original Articles
Nurses' Experience of Career Ladder Programs in a General Hospital
Kwang-Ok Park, Myungsun Yi
J Korean Acad Nurs 2011;41(5):581-592.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.581
AbstractAbstract PDF
Purpose

The purpose of this study was to identify and describe nurses' experience of a career ladder program (CLP) in a general hospital in Korea.

Methods

The data were collected from 15 nurses who participated in the CLP. Each nurse completed individual in-depth interviews, for which the main interview question was "How do you describe your experience of CLP?". All interview data were transcribed and were analyzed using the grounded theory method.

Results

The core category of the experience of CLP was identified as "challenging to rebirth as an expert". The participants used five action/interaction strategies such as "taking some time for introspection", "appreciating the essence of nursing", "making use of feedback positively", "throwing away doubts about their own capabilities", "exerting themselves with confidence". The consequence of the process of adjusting to CLP was "positioning a differentiated expert."

Conclusion

The results of this study show that participants recognized CLP as a powerful resource which leads them to professional growth and development. Thus, CLP could be utilized as a clinical career-promoting program and ultimately as a program for providing high-quality nursing services.

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Maternal and Hospital Factors Impacting the Utilization of Rooming-in Care in South Korea: Secondary Analysis of National Health Data
Yunmi Kim, Eun-Young Kim
J Korean Acad Nurs 2011;41(5):593-602.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.593
AbstractAbstract PDF
Purpose

Purpose: In this study analysis was done of utilization of rooming-in care in South Korean hospitals in order to examine the factors related to mothers and hospitals that affect rooming-in care.

Methods

With the involvement of 254,414 mothers who gave birth across 953 hospitals, the analysis used the health insurance qualification data of the National Health Insurance Corporations and Health Insurance Review and Assessment Service (2006). Factors associated with rooming-in care were analyzed using a GEE logistic regression analysis to consider factors related to both mothers and hospitals.

Results

Only 45.1% of the mothers used rooming-in care. The results of the regression analysis revealed that individual factors of the mothers were not associated with rooming-in care, whereas group factors of the hospitals were. Rooming-in care use was primarily related to small hospital, location of hospital, and higher nurse staffing level.

Conclusion

The findings of this study indicate that the utilization of rooming-in care is not associated with factors an individual mother, but rather with the group factors of the hospitals. Thus, a policy-based approach considering both of these types of factors is required to enhance the utilization of rooming-in care.

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Illness Experience of Adolescents with Hematologic Malignancies
Sun Young Son
J Korean Acad Nurs 2011;41(5):603-612.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.603
AbstractAbstract PDF
Purpose

The purpose of this study was to describe the experience process of adolescents with hematologic malignancies. The question for the study was "What is the experience of adolescents with hematologic malignancies like?".

Methods

The grounded theory methodology was used for this study. The data were collected through in-depth interview from 10 adolescents with hematologic malignancies. Data collection was done from January to June 2007. Theoretical sampling was used until the data reached saturation.

Results

As a result of the analysis, "Reconstructing self-image from deviated and suspended life" was identified as the core category. And 11 subcategories were identified and they were integrated to the core category. 'Establishment of expanded and matured self' was identified as the consequence.

Conclusion

The results of the study provide a frame for effective individualized nursing intervention strategies in helping adjustment of the adolescents with hematologic malignancies.

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Growth Patterns of Premature Infants Up to 40th Term Week of Corrected Age
Youngmee Ahn, Min Sohn, Sangmi Lee
J Korean Acad Nurs 2011;41(5):613-622.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.613
AbstractAbstract PDF
Purpose

Study purpose were to describe growth patterns of premature infants in weight, length and head circumference from birth to 40th week of corrected ages (CA) and to explore factors affecting patterns.

Methods

A longitudinal descriptive study was conducted with 267 premature infants. They were categorized into 2 groups; GA group with measurements at birth and the CA group with measurements at CA, which was categorized into 3 groups (group 1-3) by WHO guideline for gestational age (GA) at birth.

Results

GA group presented greater measures in all than CA group at same week of life. Among CA groups, group 3 showed the highest measurements, up to 37 weeks of life, though this disappeared at 38-40 weeks. Reversely, group 1 revealed the highest growth rates in all measures, followed by group 2 and group 3. Significant interaction was observed in all measures between week of life and any type of groups.

Conclusion

Higher measures in GA group, as well group 3 among CA groups, supported the superiority of intra-uterine environment overriding quality of regimen from NICU. Regardless of growth acceleration, smaller infants remain smaller, indicating that intra-uterine thrifty phenotype may continue at least up to the 40th week of CA.

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A Social Network Analysis of Research Topics in Korean Nursing Science
Soo-Kyoung Lee, Senator Jeong, Hong-Gee Kim, Young-Hee Yom
J Korean Acad Nurs 2011;41(5):623-632.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.623
AbstractAbstract PDF
Purpose

This study was done to explore the knowledge structure of Korean Nursing Science.

Methods

The main variables were key words from the research papers that were presented in the Journal of Korean Academy of Nursing and journals of the seven branches of the Korean Academy of Nursing. English titles and abstracts of the papers (n=5,936) published from 1995 through 2009 were included. Noun phrases were extracted from the corpora using an in-house program (BiKE Text Analyzer), and their co-occurrence networks were generated via a cosine similarity measure, and then the networks were analyzed and visualized using Pajek, a Social Network Analysis program.

Results

With the hub and authority measures, the most important research topics in Korean Nursing Science were identified. Newly emerging topics by three-year period units were observed as research trends.

Conclusion

This study provides a systematic overview on the knowledge structure of Korean Nursing Science. The Social Network Analysis for this study will be useful for identifying the knowledge structure in Nursing Science.

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A Predictive Model on Turnover Intention of Nurses in Korea
Sook Ja Moon, Sang Sook Han
J Korean Acad Nurs 2011;41(5):633-641.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.633
AbstractAbstract PDF
Purpose

The purpose of this study was to propose and test a predictive model that could explain and predict Korean nurses' turnover intentions.

Methods

A survey using a structured questionnaire was conducted with 445 nurses in Korea. Six instruments were used in this model. The data were analyzed using SPSS 15.0 and Amos 7.0 program.

Results

Based on the constructed model, organizational commitment, and burnout were found to have a significant direct effect on turnover intention of nurses. In addition, factors such as empowerment, job satisfaction, and organizational commitment were found to indirectly affect turnover intention of nurse. The final modified model yielded χ2=402.30, p<.001), χ2/df=2.94, RMSEA=0.07, RMR=0.03, GFI=0.90, AGF=0.87, NFI=0.88, CFI=0.92 and good fit indices.

Conclusion

This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with turnover intention in Korean nurses. Findings from this study can be used to design appropriate strategies to further decrease the nurses' turnover intention in Korea.

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Factors Influencing Resilience of Adult Children of Alcoholics among College Students
Hee Kyung Kim, Mi Hyoung Lee
J Korean Acad Nurs 2011;41(5):642-651.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.642
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the resilience of adult children of alcoholics (ACOA) who are college students, and examine factors contributing to their resilience.

Methods

A total of 459 college students from a university in Incheon, participated in this study. Data were collected between April 6 to 30, 2010 using the Korean version of the Children of Alcoholics Screening Test (CAST-K), CAGE, Social Support, Self-Esteem, Family Adaptability and Cohesion, and Resilience measurements. Data were analyzed using the SPSS/WIN 18.0 program.

Results

Overall, ACOA group showed lower scores of resilience, social support, self-esteem and family adaptability and cohesion compared to non-ACOA group. Resilience among the ACOA group showed significant relationships with self-esteem (r=.53, p<.001), social support (r=.43, p<.001), and family adaptability and cohesion (r=.25, p<.013). Multiple regression analysis showed that 45% of the variance for resilience in the ACOA group was accounted for by age, gender, social support, self-esteem, and religion.

Conclusion

The results of the study show that self-esteem and social support are important determinants of resilience in ACOA, thus it is recommend that further resilience training programs for ACOA be developed to enhance their social support and self-esteem, and ultimately to increase their resilience.

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Factors on the Suicidal Attempt by Gender of Middle and High School Student
Sanggu Yi, Yunjeong Yi, Hye-Sun Jung
J Korean Acad Nurs 2011;41(5):652-662.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.652
AbstractAbstract PDF
Purpose

The suicide rate of adolescents in Korea is increasing annually. Therefore, this research was done to identify the suicide attempt rate of middle and high school students and to identify factors that influence suicidal attempts.

Methods

The Korea Youth Health Risk Behavior Web-based Survey (2007) was used as data. Discriminant analysis and logistic regression were performed to analyze the data depending on gender to consider the gender difference in assessing the influence of each independent variable on suicidal attempts.

Results

Discriminant analysis according on gender showed that 13 factors correlated with suicidal attempts for boys, and 20 factors for girls. The most highly correlated factors were smoking, depression and inhalation experience. For inhalation experience, boys had 2.7 times higher possibility of suicide attempts (95% CI 1.8-3.0) and girls, a 2.4 times higher possibility (95% CI 1.7-3.5).

Conclusion

The results of the study indicate a need to classify adolescents for expectation of suicide risk and high danger for suicidal attempts through, and introduce suicide prevention programs for these adolescents. In particular, it is necessary to start intervention with students who smoke, have sexual and inhalation experiences and high levels of depression.

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Depression Status of Academic High School Students in Seoul: Mediating Role of Entrapment
Young-Joo Park, Nah-Mee Shin, Kuem Sun Han, Hyun Cheol Kang, Sook-Hee Cheon, Hyunjeong Shin
J Korean Acad Nurs 2011;41(5):663-672.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.663
AbstractAbstract PDF
Purpose

Purpose of this study was to investigate the status of depression in academic high school students and path analysis model for exploring the mediating role of entrapment to depression in relation to academic stress and perceived social support.

Methods

Measurements were four reliable questionnaires measuring academic stress, social support, entrapment, and depression. Data were collected from students in 17 high schools in Seoul.

Results

Students (n=5,346) completing the questionnaires indicated depression & entrapment from academic stress. Depression was more prevalent in girls, those whose parents' household income was less than two million won, who did not live with father or mother or both due to divorce, separation, or death, and those who smoked or used alcohol. Entrapment was more prevalent in students similar to cases of depression and in seniors. According to the proposed path model, 48.6% of depression was explained by academic stress, social support, and entrapment. The indirect effect of entrapment as a mediator between academic stress and depression was verified and larger than the direct effect of academic stress on depression.

Conclusion

Considering levels of depression and entrapment demonstrated by these students, better mental health programs with diverse strategies should be developed for their psychological well-being.

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Development and Effectiveness of a Spiritual Care Education Program for Nursing Students - Based on the ASSET Model
Mi Ja Chung, Young Eun
J Korean Acad Nurs 2011;41(5):673-683.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.673
AbstractAbstract PDF
Purpose

This study was done to develop a spiritual care education program (SCEP) for nursing students to help increase their awareness of the essence of spirituality in care so as to enable them to promote spiritual well-being and spiritual care competence.

Methods

The participants were assigned to an experimental group (n=42) or a control group (n=39). From August to October 2009, the experimental group participated in the SCEP, which were held 2 hours a week for 6 weeks. The data were analyzed using χ2-test, Fisher's exact probability test, paired t-test, t-test with the SPSS WIN 17.0 statistics program.

Results

The experimental group had a higher mean score for spirituality, spiritual well-being and spiritual care competence than the control group. Significant differences were found between the experimental group and the control group.

Conclusion

The results of this study indicate that the SCEP was effective in improving spirituality, spiritual well-being and spiritual care competence for nursing students.

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The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home
Myung Sook Park, Smi Choi-Kwon
J Korean Acad Nurs 2011;41(5):684-693.   Published online October 12, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.684
AbstractAbstract PDF
Abstract Purpose

To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes.

Methods

In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0.

Results

1) Scores on caregivers’ knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers’ attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks.

Conclusion

Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregiv-ers’ knowledge, attitude, and behavioral change.

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Effects of a Group Counseling Integration Program on Self-determination and Internet Addiction in High School Students with Tendency to Internet Addiction
Gyeong Ran Park, Hee Sook Kim
J Korean Acad Nurs 2011;41(5):694-703.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.694
AbstractAbstract PDF
Purpose

In this study the effects of a Group Counseling Integration Program for students with a tendency to internet addiction were examined.

Methods

Thirty-seven students who were in a vocational high school in G city participated in a survey, which was carried out from October 12 to November 12, 2009. To test the effects of the Group Counseling Integration Program, the participants were divided into two groups, an experimental group (18) and a control group (19). The research design used in this study was a nonequivalent control group non-synchronized pre-posttest quasi-experimental research design. The research tools included a self-determination scale and an internet addiction scale. Data were analyzed using Chi-square test, t-test, and ANCOVA with the SPSS/WIN 14.0 program.

Results

Significant differences were found in self-determination scores and internet addiction scores between the experimental group and the control group (F=5.99, p=.020) (t=-2.53, p=.016).

Conclusion

The results indicate that Group Counseling Integration Programs are an effective nursing intervention for improving self-determination and decreasing internet addiction in students with a tendency to internet addiction.

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A Systematic Review of Psychological Distress as a Risk Factor for Recurrent Cardiac Events in Patients with Coronary Artery Disease
Jin-Hee Park, Sun Hyoung Bae
J Korean Acad Nurs 2011;41(5):704-714.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.704
AbstractAbstract PDF
Purpose

The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD).

Methods

A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events.

Results

Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events.

Conclusion

Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.

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Effects of Human Papillomavirus Vaccination Education on College Women's Knowledge, Health Belief, and Preventive Behavior Intention
Eun-Jee Lee, Hyeon-Ok Kim
J Korean Acad Nurs 2011;41(5):715-723.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.715
AbstractAbstract PDF
Purpose

This study was done to evaluated the effects of Human Papillomavirus (HPV) vaccination education on college women's knowledge of HPV, health beliefs (perceived severity and perceived susceptibility), and preventive behavior intention.

Methods

A nonequivalent control group pretest-posttest design with repeated measures was used. Participants were 125 female college students in one university, assigned to an experimental group (72 students) and control group (53 students).

Results

Two weeks after the intervention, the experimental group reported higher scores of knowledge, perceived severity, perceived susceptibility, and preventive behavior intention than the control group. All follow-up scores except intention measured at 5 weeks after the intervention from the experimental group remained still higher than those from the control group.

Conclusion

The results suggest that the variable of preventive behavior intention which is believed to be the closest predictor of real vaccination rate could be affected by the education, but did not remain at the same level at 5 weeks. Therefore, additional interventions may need to be provided before the educational effect on preventive behavior intention is greatly diminished.

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Effects of Web-based Health Education on Blood Glucose and Blood Pressure Improvement in Postmenopausal Women with Impaired Fasting Blood Glucose
Jeong-Ah Oh, Hee-Seung Kim, Min-Jeong Park, Hye-Sun Shim
J Korean Acad Nurs 2011;41(5):724-731.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.724
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effectiveness of an educational intervention that used both cellular phones and the Internet to provide a short messaging service (SMS) relating to blood glucose, blood pressure, and serum lipid levels in postmenopausal women with impaired fasting glucose (IFG).

Methods

Twenty-eight postmenopausal women were assigned to an intervention group and twenty-one postmenopausal women to a control group. The intervention was provided for 12 weeks. Patients in the intervention group were asked to access a web site by using a cellular phone or to use the Internet directly and input their blood glucose and blood pressure levels weekly. Participants were sent the optimal recommendations weekly by both cellular phone and Internet.

Results

The intervention group had a mean decrease in systolic blood pressure (SBP) level of 8.1 mmHg but changes for the control group were not significant. There was a significant mean change in diastolic blood pressure (DBP) level for the intervention group (-7.7 mmHg). The mean change in the control group was not significant.

Conclusion

This educational intervention using the Internet and a SMS by cellular phone improved levels of SBP and DBP in postmenopausal women with IFG.

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Corrigendum
Corrigendum
J Korean Acad Nurs 2011;41(5):732-732.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.732
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