Journal of Korean Academy of Nursing

Commemorating the 50th Anniversary of Korean Society of Nursing Science and Contemplating Direction to Move Forward: Cho, Kyung-Sook; J Korean Acad Nurs 2020;50(5):641-643. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.50501

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Nurses’ Voices: Autumn 2020: Kim, Jeung-Im; J Korean Acad Nurs 2020;50(5):644-645. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.50502

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Secondary Data Analysis on the Quality of Sleep and Related Factors of Novice and Experienced Shift Work Nurses: Yu, Minjeong , Smi, Choi-Kwon; J Korean Acad Nurs 2020;50(5):646-657. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.19238

Abstract PDF: Purpose
The purpose of this study was to identify the quality of sleep in novice and experienced shift work nurses and compare the factors associated with their quality of sleep.
Methods
We analyzed the data of 192 and 256 novice and experienced nurses, respectively. The quality of sleep, sleep hygiene, job stress, and fatigue were measured using Insomnia Severity Index, Sleep Hygiene Practice Scale, the Korean Occupational Stress Scale, and Fatigue Severity Scale. Data were analyzed using SPSS 25.0 to calculate descriptive statistics and logistic regression.
Results
Sleep quality was lower in experienced nurses (12.55 ± 5.71) than in novice nurses (11.18 ± 5.78). Fatigue was more severe in experienced nurses (4.47 ± 1.13) than in novice nurses (4.23 ± 1.12). In the logistic regression, factors related to sleep quality in novice nurses were sleep hygiene (odds ratio; OR = 1.06, p < .001) and fatigue (OR = 2.49, p < .001). Factors related to sleep quality in the experienced nurses were also sleep hygiene (OR = 1.04, p = .001) and fatigue (OR = 1.53, p = .012).
Conclusion
Sleep quality of experienced nurses is lower than those of novice nurses. Factors associated with sleep quality in novice and experienced nurses are equally identified as sleep hygiene and fatigue. Therefore, personal efforts to improve sleep hygiene, such as providing comfortable sleep environment, are needed. Furthermore, organized efforts to decrease fatigue, such as constructing a working environment with a bright light at night and providing a fatigue-decreasing program that includes meditation, are required.

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6 Web of Science

Predictors of Blood and Body Fluid Exposure and Mediating Effects of Infection Prevention Behavior in Shift-Working Nurses: Application of Analysis Method for Zero-Inflated Count Data: Ryu, Jae Geum , Smi, Choi-Kwon; J Korean Acad Nurs 2020;50(5):658-670. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20025

Abstract PDF: Purpose
This study aimed to identify the predictors of blood and body fluid exposure (BBFE) in multifaceted individual (sleep disturbance and fatigue), occupational (occupational stress), and organizational (hospital safety climate) factors, as well as infection prevention behavior. We also aimed to test the mediating effect of infection prevention behavior in relation to multifaceted factors and the frequency of BBFE.
Methods
This study was based on a secondary data analysis, using data of 246 nurses from the Shift Work Nurses’ Health and Turnover study. Based on the characteristics of zero-inflated and over-dispersed count data of frequencies of BBFE, the data were analyzed to calculate zero-inflated negative binomial regression within a generalized linear model and to test the mediating effect using SPSS 25.0, Stata 14.1, and PROCESS macro.
Results
We found that the frequency of BBFE increased in subjects with disturbed sleep (IRR = 1.87, p = .049), and the probability of non-BBFE increased in subjects showing higher infection prevention behavior (IRR = 15.05, p = .006) and a hospital safety climate (IRR = 28.46, p = .018). We also found that infection prevention behavior had mediating effects on the occupational stress-BBFE and hospital safety climate-BBFE relationships.
Conclusion
Sleep disturbance is an important risk factor related to frequency of BBFE, whereas preventive factors are infection prevention behavior and hospital safety climate. We suggest individual and systemic efforts to improve sleep, occupational stress, and hospital safety climate to prevent BBFE occurrence.

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Development of a Coping Scale for Infertility-Women (CSI-W): Kim, Miok , Ko, Jung-Mi; J Korean Acad Nurs 2020;50(5):671-685. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20038

Abstract PDF: Purpose
The purpose of this study was to develop a Coping Scale for Infertility-Women (CSI-W).
Methods
The initial items were based on an extensive literature review and in-depth interviews with seven infertile women. Forty-three items were derived from a pilot survey. Data were collected from 216 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale.
Results
Seven factors containing 28 items (four factors containing 17 items for active coping and three factors containing 11 items for passive coping) were extracted from the exploratory factor analysis to verify the construct validity. The four factors of active coping were confrontation, self-control, seeking social support (spouse), and seeking social support (colleagues and experts). The three factors of passive coping were distancing, escape, and avoidance. These items were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (active coping: Cronbach’s a = .78; passive coping: Cronbach’s a = .81).
Conclusion
As its validity and reliability have been verified through various methods, the CSI-W can contribute to assessing the coping strategies of infertile women.

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Analysis of Subgroups with Lower Level of Patient Safety Perceptions Using Decision-Tree Analysis: Shin, Sun Hwa; J Korean Acad Nurs 2020;50(5):686-698. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20044

Abstract PDF: Purpose
This study was aimed to investigate experiences, perceptions, and educational needs related to patient safety and the factors affecting these perceptions.
Methods
Study design was a descriptive survey conducted in November 2019. A sample of 1,187 Koreans aged 20-80 years participated in the online survey. Based on previous research, the questionnaire used patient safety-related and educational requirement items, and the Patient Safety Perception Scale. Descriptive statistics and a decision tree analysis were performed using SPSS 25.0.
Results
The average patient safety perception was 71.71 (± 9.21). Approximately 95.9% of the participants reported a need for patient safety education, and 88.0% answered that they would participate in such education. The most influential factors in the group with low patient safety perceptions were the recognition of patient safety activities, age, preference of accredited hospitals, experience of patient safety problems, and willingness to participate in patient safety education.
Conclusion
It was confirmed that the vulnerable group for patient safety perception is not aware of patient safety activities and did not prefer an accredited hospital. To prevent patient safety accidents and establish a culture of patient safety, appropriate educational strategies must be provided to the general public.

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Qualitative Study on the Experience of Patients with Meniere Disease: Joung, Woo Joung; J Korean Acad Nurs 2020;50(5):699-713. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20115

Abstract PDF: Purpose
The purpose of this study was to understand and describe the experiences of patients with Meniere disease.
Methods
Data were collected from February 19, 2019, to February 5, 2020, through individual in-depth interviews with 13 Meniere patients. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results
The experiences of patients with Meniere disease were clustered into the following four themes from 22 meaning units: 1) Complex unfamiliar symptoms that shatter both balance of the body and peace of the heart; 2) A disease that medical treatment and health professionals cannot cure; 3) Suffering hardships that cannot be understood by non-Meniere sufferers; and 4) Making daily efforts to become healthier. Symptoms of Meniere disease are life-shattering and depressing because they are neither visible nor easily curable. Over time, as they accepted the reality of living with the disease, the participants would shift their focus from complete symptomatic cure to leading a healthy and more balanced life.
Conclusion
This study shows that Meniere disease has a pervasive impact on all aspects of the patients’ lives. Patients are prone to experiencing restrictions in their social functioning and activities. They also experience psychosocial problems due to the unseen nature of their symptoms. This study elucidates the experiences of Meniere patients and the need for nursing intervention to help improve their quality of life and ability to self-manage. Lastly, this study shows the need for a coordinated interdisciplinary approach to raising public awareness of the disease.

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The Disease Management Experience of Patients with Asthma: Grounded Theory Approach: Kim, Bohye , Kim, Oksoo; J Korean Acad Nurs 2020;50(5):714-727. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20139

Abstract PDF: Purpose
The aim of this study was to develop a situation-specific theory to explain the disease management experience of patients with asthma.
Methods
Twenty participants with asthma were selected using the theoretical sampling method. The data were acquired through in-depth interviews conducted from June to October 2018 and analyzed using the grounded theory approach of Strauss and Corbin.
Results
In total, 69 concepts, 30 subcategories, and 13 categories were generated to explain the disease management experience of patients with asthma. The core category of the disease management experience of patients with asthma was ‘management of the disease to prevent aggravation of symptoms over the lifetime’. The disease management process of asthma patients included three steps: the ‘cognition phase’, the ‘adjustment phase’, and the ‘maintenance phase’. However, some patients remained in the ‘stagnation phase’ of disease management, which represents the result of the continual pursuit of risky health behavior. There were three types of disease management experiences among patients with asthma: ‘self-managing’, ‘partially self-managing’, and ‘avoidant’.
Conclusion
This study shows that patients with asthma must lead their disease management process to prevent exacerbation of their symptoms. It is imperative to develop nursing strategies and establish policies for effective disease management of patients with asthma based on their individual disease management processes and types.

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Relationship of Workplace Violence to Turnover Intention in Hospital Nurses: Resilience as a Mediator: Kang, Hyun-Jung , Shin, Jaeyong , Lee, Eun-Hyun; J Korean Acad Nurs 2020;50(5):728-736. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20147

Abstract PDF: Purpose
This study aimed to identify the relationship between workplace violence and turnover intention, and the mediation effect of resilience on the relationship in hospital nurses.
Methods
This was a cross-sectional study. A total of 237 registered nurses were recruited from three hospitals in South Korea from April to May 2019. Participants were invited to complete self-reported questionnaires that measure workplace violence, turnover intention, resilience, and demographic information. The data obtained were analyzed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval (5,000 bootstrap resampling).
Results
After controlling demographic covariates, workplace violence significantly accounted for the variance of turnover intention. It was also demonstrated that resilience partially mediated the relationship between workplace violence and turnover intention in hospital nurses. A 73.8% of nurses had experienced workplace violence (such as attack on personality, attack on professional status, isolation from work, or direct attack). Conclusion: Workplace violence directly influences turnover intention of nurses and indirectly influences it through resilience. Therefore, hospital administrators need to develop and provide a workplace violence preventive program and resilience enhancement program to decrease nurses’ turnover intention, and leaving.

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4 Web of Science

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