This study aimed to introduce and elucidate changes in Strauss and Corbin's grounded theory and discuss its application to the field of nursing in South Korea.

The changes in grounded theory by Strauss and Corbin were examined through a literature review of grounded theory from its inception.

Strauss and Corbin acknowledged their philosophical backgrounds of symbolic interactionism and pragmatism; however, their methodology based on positivism overwhelmed their epistemology and ontology. This inconsistency has been represented by the coding paradigm and the premise of “emergent from the data.” In the revised version of Basics, Strauss and Corbin modified their theory to weaken the coding paradigm and strengthen the strategies for the development of substantive theory.

Strauss and Corbin's revised grounded theory did not fully address the inconsistency of their epistemology and ontology between their acknowledgement and methodology. However, these changes constitute a meaningful step toward resolving inconsistencies and highlight the development of substantive theory. This has implications for Korean nursing researchers who have utilized methodologies in grounded theory with dogmatic approaches; grounded theory, with its evolving nature, is not a finalized method and calls for open approaches for the development of a grounded theory that fits Korean nursing.

This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community.

A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes.

Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups.

The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.

The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI).

The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses’ preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis.

The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85.

The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis.

321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis.

In both Korean and international studies, the most important, core-keywords were “pain,” “patient,” “pain management,” “registered nurses,” “care,” “cancer,” “need,” “analgesia,” “assessment,” and “surgery.” While some keywords like “education,” “knowledge,” and “patient-controlled analgesia” found to be important in Korean studies; “treatment,” “hospice palliative care,” and “children” were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were “pain and accompanying symptoms,” “target groups of pain management,” and “RNs’ performance of pain management.” It is only in recent years (2016~17), that keywords such as “performance,” “attitude,” “depression,” and “sleep” have become more important in Korean studies than, while keywords such as “assessment,” “intervention,” “analgesia,” and “chronic pain” have become important in international studies.

It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients’ use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).

A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.

At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS.

The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

The purpose of this study was to identify the response patterns of nursing unit managers regarding workplace bullying.

Q methodology was used to identify the response patterns. Thirty-six Q samples were selected from the Q population of 210 that included literature reviews and in-depth interviews with clinical nurses and nursing managers. Participants were 30 nursing unit managers who had experience managing workplace bullying and they classified the Q samples into a normal distribution frame measured on a nine-point scale. The data were analyzed using the PC-QUANL program.

Five types of response patterns were identified: (1) sympathetic-understanding acceleration, (2) harmonious-team approach, (3) preventive-organizational management, (4) passive observation, and (5) leading-active intervention. The preventive-organizational management type was most frequently used by the nursing unit managers.

The results of this study indicated that nursing unit managers attempted to prevent and solve workplace bullying in various ways. Therefore, it is necessary to develop and conduct leadership training and intervention programs that appropriately address the response patterns of nursing unit managers, such as those identified in this study.

The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital.

A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale.

The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model.

Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program.

The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers.

The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group.

We found that the CMP-VNC can be an effective tool to increase visiting nurses’ competency of costing and enhance efficiencies of visiting nursing centers.

The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory.

The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed.

The goodness-of-fit of the final model was at a good level (χ ²/df=2.46, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability.

The nurses’ clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.

This study aimed to develop a scale measuring the Patient-Centered Nursing Culture (PCNC) and provide a basic tool to improve PCNC in Korea.

A conceptual framework and construct factors were extracted through extensive literature review and in-depth interviews with nursing professionals. In total, 59 items were derived based on the pilot survey. Data were collected from 357 nurses working at general hospitals and analyzed for verifying the reliability and validity of the scale.

Nine factors containing 54 items were extracted from the exploratory factor analysis to verify the construct validity. The nine factors were top management leadership, policy and procedure, education and training, middle management leadership, supportive teamwork, nursing workplace environment, professional competence, patient-centered nursing activity, and nurses’ values. These items were verified by convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α=.96).

The developed PCNC scale is expected to be used as the tool for the development of theory and improvement of PCNC, the empirical testing for cause and effect of PCNC, the development of interventions, education and training programs for improving PCNC, and indicators for evaluation or accreditation of hospital service quality.

This study aimed to predict the influencing factors and the consequences of near miss in nurses’ medication error based upon Salazar & Primomo's ecological system theory.

A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program.

For the fitness of the hypothetical model, the results showed that χ 2 (χ ²=258.50, p<.001) was not fit, but standardized χ ² (χ ²/df=2.35) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (β=-.29 p<.001), patient safety culture (β=-.20, p=.041), and work load (β=.18, p=.037) had a significant effect on the near miss experiences in nurses’ medication error, while fatigue (β=-.06, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (β=-.25, p=.001).

These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.

The purpose of this study was to develop and psychometrically test the Korean Geriatric Loneliness Scale (KGLS).

The initial items were based on in-depth interviews with 10 older adults. Psychometric testing was then conducted with 322 community-dwelling older adults aged 65 or older. Content, construct, and criterion-related validity, classification in cutoff point, internal consistency reliability, and test-retest reliability were used for the analysis.

Exploratory factor analysis showed three factors, including 15 items explaining 91.6% of the total variance. The three distinct factors were loneliness associated with family relationships (34.3%), social loneliness (32.4%), and a lack of belonging (24.9%). As a result of confirmatory factor analysis, 14 items in the three-factor structure were validated. Receiver operating characteristic analysis demonstrated that the KGLS’ cutoff point of 32 was associated with a sensitivity of 71.0%, specificity of 80.2%, and area under the curve of .83. Reliability, as verified by the test-retest intraclass correlation coefficient, was .89, and Cronbach's α was .90.

As its validity and reliability have been verified through various methods, the KGLS can contribute to assessing loneliness in South Korean older adults.