Journal of Korean Academy of Nursing

An Exploratory Study on Non-Contact Nursing Experiences of Clinical Nurses during the COVID-19 Pandemic: Byun, Hye Min , Yun, Eun Kyoung; J Korean Acad Nurs 2024;54(3):446-458. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24045

Abstract PDF: Purpose
This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic.
Methods
A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences.
Results
During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows: (1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism.
Conclusion
This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

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Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior: Heo, Yeon Jeong , Hyun, Hye-Jin; J Korean Acad Nurs 2024;54(2):178-192. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.24020

Abstract PDF: Purpose
This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior.
Methods
Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software.
Results
Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant.
Conclusion
Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.

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Perspectives of Frontline Nurses Working in South Korea during the COVID-19 Pandemic: A Combined Method of Text Network Analysis and Summative Content Analysis: Lee, SangA , Lee, Tae Wha , Lee, Seung Eun; J Korean Acad Nurs 2023;53(6):584-596. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23048

Abstract PDF: Purpose
This study aimed to explore the perspectives of frontline nurses working during the novel coronavirus disease 2019 (COVID-19) pandemic.
Methods
An online qualitative study was conducted using a pragmatic approach. The data were collected in August 2021. Registered Korean nurses who provided direct nursing care to patients with confirmed COVID-19 were eligible for this study. An online survey was used to gather free-text data, which were then analyzed using machine-based network analysis and summative content analysis.
Results
The analysis examined the responses of 126 participants and led to the identification of six prominent themes. These themes were further classified into three distinct levels: personal, task, and organizational. The identified themes are as follows: “collapse of personal life,” “being overwhelmed by the numerous roles required,” “personal protective equipment was sufficiently provided, but that is not enough,” “changes in interprofessional collaboration,” “inappropriate workforce management,” and “diverted allocation of healthcare services and resources.” Conclusion: Our findings highlight areas for improvement in resources, systems, and policies to enhance preparedness for future pandemics.

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The Impact of Self-Efficacy on Nurses’ Well-Being: Does Digital Competence Matter?: Li, Yali , Jing, Qi , Feng, Taiwen , Yang, Xiaoling; J Korean Acad Nurs 2023;53(4):385-396. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.23037

Abstract PDF: Purpose
Drawing on person–environment fit theory and social cognitive theory, this study aimed to examine how self-efficacy affects nurses’ workplace well-being via person-job fit and the moderating role of digital competence.
Methods
A two-wave survey was conducted to collect data. Data were collected from six hundred and ninety-five nurses at three Chinese hospitals between May 2022 and September 2022. We employed hierarchical regression analysis and bootstrapping to analyze the data.
Results
Self-efficacy positively influenced person-job fit (β = .55, p < .001), which positively affected nurses’ workplace well-being (β = .32, p < .001). Person-job fit mediated the effect of self-efficacy on nurses’ workplace well-being. Additionally, digital competence strengthened the positive impact of self-efficacy on person-job fit (β = .12, p < .001).
Conclusion
Recruiting nurses with both self-efficacy and digital competence benefits hospitals. It is critical for nurses to improve their digital competence for achieving person-job fit and attaining workplace well-being in the post-coronavirus disease 2019 (COVID-19) era.

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Effectiveness of Simulation-Based Education for Caring Patients with COVID-19: Lee, Min Hye , Noh, Eun-Young; J Korean Acad Nurs 2023;53(4):397-411. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.22151

Abstract PDF: Purpose
The role of medical staff gained immense significance in the context of the prolonged coronavirus disease (COVID-19) pandemic. However, few studies had explored the impact of simulation-based education on the ability of nursing students to care for the patients of COVID-19. This study provided nursing students with simulation-based education in caring for the patients of COVID-19 and confirmed its effectiveness.
Methods
This study used a non-equivalent control group pretest-posttest design. The participants were recruited from the nursing departments of two universities in Korea through convenience sampling. A total of 79 participants were included: 37 in the intervention group and 42 in the control group. The intervention group received four sessions of simulation training based on the National League for Nursing Jeffries simulation theory.
Results
The intervention group showed an improvement compared to the control group in terms of knowledge related to coronavirus, confidence in performing infection control skills, and perception of preparedness for caring for the patients of COVID-19, with a high-level of satisfaction and self-confidence in learning. There was no significant difference between the two groups in terms of anxiety.
Conclusion
This simulation is expected to be a significant strategy for alleviating the global burden in terms of staff safety and patient outcomes by improving the competencies of prospective medical staff in responding to pandemics.

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A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19: An, Soo Young , Choi, Heejung; J Korean Acad Nurs 2023;53(3):309-323. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22118

Abstract PDF: Purpose
This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi’s Posttraumatic Growth model and a literature review.
Methods
The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Dis-closure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.
Results
The modified model showed appropriate goodness of fit (χ 2 = 369.90, χ 2 /degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.
Conclusion
This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

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Factors Influencing the COVID-19 Vaccination Intentions in Parents for Their Children Aged 5~11: Korea, April 2022: Choi, In Suk , Kim, Eun A; J Korean Acad Nurs 2023;53(2):208-221. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22096

Abstract PDF: Purpose
This study aimed to investigate COVID-19 vaccination intentions in Korean parents for their children aged 5 to 11 years and the factors influencing them.
Methods
A cross-sectional online survey of 363 parents of children aged 5 to 11 years was conducted in Korea in April 2022. Data were analyzed using independent t-test, χ2-test, Fisher’s exact test, and hierarchical logistic regression analysis using SPSS/WIN 26.0 and MedCalc software version 20.113.
Results
Of 363 Korean parents with children aged 5 to 11, 42.4% intended to vaccinate their children. Significant factors influencing vaccination intention were the second or third birth order of children (OR = 3.45, 95% CI = 1.45~8.21), vaccine hesitancy-confidence (OR = 2.00, 95% CI = 1.51~2.65), vaccine hesitancy-collective responsibility (OR = 1.57, 95% CI: 1.10~2.25), and COVID-19 anxiety-avoidance (OR = 1.55, 95% CI = 1.13~2.11).
Conclusion
Findings suggest that COVID-19 vaccine campaigns based on reliable information and evidence from health authorities are needed to increase COVID-19 vaccination. Well-designed health communications for the target population may help to increase parental vaccine acceptance.

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Factors Related to Clinical Competence among Graduating Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study: Chung, Su Kyoung , Kim, Jinsook , Bhandari, Pratibha; J Korean Acad Nurs 2023;53(2):145-154. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22087

Abstract PDF: Purpose
This study investigated clinical competency, COVID-19-related anxiety, coping strategies, self-efficacy, and perceived stress among graduating nursing students during the COVID-19 pandemic.
Methods
We conducted a cross-sectional survey. Participants were recruited from universities located in four major cities in South Korea. General demographic information, clinical competency, self-efficacy, perceived stress, COVID-19-related anxiety, and coping strategies were assessed using reliable questionnaires. Descriptive statistics, correlations, and multiple regression tests were used to analyze the data.
Results
The mean clinical competency, self-efficacy, perceived stress, adaptive coping, and maladaptive coping were 138.16 ± 18.34, 83.85 ±14.02, 21.37 ± 5.79, 53.15 ± 4.64, and 30.98 ± 6.73, respectively. COVID-19-related anxiety was reported by 4.3% of participants. Clinical competency was significantly positively correlated with self-efficacy (r = .44, p < .001) and adaptive coping (r = .20, p = .035) and was significantly negatively correlated with maladaptive coping (r = .20, p = .035). The predictors of clinical competency were self-efficacy (β = .434, p < .001) and adaptive coping (β = .173, p < .039), which explained 23% of the variance in clinical competency.
Conclusion
Self-efficacy and adaptive coping strategies are significant predictors of clinical competence during the pandemic. Planning and implementing various curricular and non-curricular activities to increase senior students' self-efficacy and adaptive coping strategies will help prepare competent nursing graduates for the pandemic when they enter the nursing workforce.

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Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students: Kim, Ye-Eun , Kang, Hee-Young; J Korean Acad Nurs 2023;53(1):87-100. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22130

Abstract PDF: Purpose
This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students.
Methods
A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ² -test, Fisher’s exact test, t-test, Wilcoxon signed-rank test, and Mann– Whitney U test.
Results
The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning.
Conclusion
The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students’ clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

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Factors Influencing Preventive Behaviors for COVID-19 in Undergraduate Nursing Students: A Cross-Sectional Descriptive Study: Choi, Jeong Sil , Kim, Kyung Mi; J Korean Acad Nurs 2022;52(6):554-563. Published online December 31, 2022; DOI: https://doi.org/10.4040/jkan.22047

Abstract PDF: Purpose
This study aimed to determine how undergraduate nursing students’ knowledge and health beliefs affected their COVID-19-related infection-prevention behaviors.
Methods
This study used a descriptive survey. A total of 188 undergraduate nursing students from two universities in South Korea participated in this study. The data were collected from June 2020 to August 2020. Factors influencing infection-prevention behaviors were identified using multiple regression analysis.
Results
The participants’ mean knowledge level regarding COVID-19 was 84.05 ± 11.78 out of 100. The average health belief score was 2.80 ± 0.32 points out of 5. COVID-19-related preventive health behaviors were correlated with experiences of searching for COVID-19 information (r = .22, p < .01), perceived severity (r = .24, p < .01), perceived benefits (r = .29, p < .01), cues to action (r = .30, p < .01), knowledge (r = .27, p < .01), and perceived barriers (r = - .19, p < .05). Factors that significantly affected COVID-19-related preventive health behaviors were the participants’ years of study, experiences regarding COVID-19 prevention education, perceived severity, perceived barriers, and cues to action.
Conclusion
COVID-19-related preventive health behaviors are promoted by increasing awareness about the disease and promoting COVID-19 education in nursing curriculums.

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Effects of Fear of Coronavirus Disease 2019 and Social Distancing on Women’s Suicidal Ideation: Mediating Effect of Depression: Kim, Hyo Yeon , Park, Hanjong; J Korean Acad Nurs 2022;52(4):464-475. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22078

Abstract PDF: Purpose
This study aimed to identify the mediating effects of depression amid the influence of fear and social distancing arising from Coronavirus disease 2019 (COVID-19) in Korean women’s suicidal ideation.
Methods
A descriptive correlation study was conducted. Study participants, recruited by Hankook Research from March 2 to March 5, 2021, included 300 women aged 19 to 49 living in South Korea, and 100 people were randomly allocated and enlisted for each age group out of 700,000 Hankook Research Panels recruited in advance from 17 cities and provinces nationwide. Data were collected through a self-reported questionnaire and analyzed using Pearson’s correlation coefficient and Hayes’ Process Macro Model 4 with 95% bias-corrected bootstrap confidence interval via SPSS statistics 27.0.
Results
Suicidal ideation was significantly correlated with fear of COVID-19 (r = .16, p = .006) and depression (r = .65, p < .001). The mediation effect of depression in the relationship between the fear of COVID-19 and suicidal ideation was found to be significant (B = 0.40, boot 95% CI: 0.21~0.61). However, social distancing did not significantly affect suicidal ideation via depression (B = - 0.79, boot 95% CI: - 1.94~0.26).
Conclusion
It is necessary to develop and apply interventions to prevent depression and suicidal behaviors by continuously observing and reducing the negative psychological responses caused by COVID-19.

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An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit: Jung, Minho , Kim, Moon-Sook , Lee, Joo-Yeon , Lee, Kyung Yi , Park, Yeon-Hwan; J Korean Acad Nurs 2022;52(4):391-406. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22056

Abstract PDF: Purpose
The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit.
Methods
This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis.
Results
Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are “Experiencing eventfulness in isolated settings,” “All-around player,” and “Reflections for solutions.” Conclusion: During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.

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Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling: Park, Min Young , Jeong, Seok Hee , Kim, Hee Sun , Lee, Eun Jee; J Korean Acad Nurs 2022;52(3):291-307. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.22002

Abstract PDF: Purpose
The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports.
Methods
Data were media articles related to the topic “nurse” reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are “a nurse who committed suicide because she could not withstand the Taewoom at work” andf “a nurse as a perpetrator of a newborn abuse case,” while post-COVID-19 examples are “a nurse as a victim of COVID-19,” “a nurse working with the support of the people,” and “a nurse as a top contributor and a warrior to protect from COVID-19.” Conclusion: Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses’ image.

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Experience of Nurses in Charge of COVID-19 Screening at General Hospitals in Korea: Ha, Boo Young , Bae, Yun-Sook , Ryu, Han Sol , Jeon, Mi-Kyeong; J Korean Acad Nurs 2022;52(1):66-79. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21166

Abstract PDF: Purpose
The purpose of this study was to understand and describe the experiences of nurses in charge of COVID-19 screening at general hospitals in South Korea.
Methods
Data were collected through individual in-depth interviews with 14 nurses who had been working for more than a month at a screening clinic operated by two general hospitals from May 11 to July 20, 2021. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results
As a result of analysis, four theme clusters were extracted from nurses’ experiences, as follow: the role of the hospital gatekeeper entrusted with managing the COVID-19 pandemic, struggling to maintain the protective barrier, boundlessness like a Mobius strip, and driving force to endure as a nurse in charge of COVID-19 screening.
Conclusion
The results of this study provide a deeper understanding of the lives of screening clinic nurses who are struggling with the COVID-19 situation. The results are expected to be useful in providing basic data for improving the infection control system and response strategies that can be applied to nursing practice in other pandemic situations.

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Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic: Park, Wanju , Cho, Mina , Park, Shinjeong; J Korean Acad Nurs 2022;52(1):36-51. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21155

Abstract PDF: Purpose
The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation.
Methods
A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform.
Results
Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = - 5.02, p < .001), self-regulation mode (t = - 4.74, p < .001), and volitional inhibition mode (t = - 2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = - 166.00, p < .001).
Conclusion
The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.

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Effectiveness of the Infectious Disease (COVID-19) Simulation Module Program on Nursing Students: Disaster Nursing Scenarios: Hwang, Won Ju , Lee, Jungyeon; J Korean Acad Nurs 2021;51(6):648-660. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21164

Abstract PDF: Purpose
This study aimed to develop an emerging infectious disease (COVID-19) simulation module for nursing students and verify its effectiveness.
Methods
A one-group pretest–posttest quasi-experimental study was conducted with 78 under-graduate nursing students. A simulation module was developed based on the Jeffries simulation model. It consisted of pre-simulation lectures on disaster nursing including infectious disease pandemics, practice, and debriefings with serial tests. The scenarios contained pre-hospital settings, home visits, arrival to the emergency department, and follow-up home visits for rehabilitation.
Results
Disaster preparedness showed a statistically significant improvement, as did competencies in disaster nursing. Confidence in disaster nursing increased, as did willingness to participate in disaster response. However, critical thinking did not show significant differences between time points, and neither did triage scores.
Conclusion
The developed simulation program targeting an infectious disease disaster positively impacts disaster preparedness, disaster nursing competency, and confidence in disaster nursing, among nursing students. Further studies are required to develop a high-fidelity module for nursing students and medical personnel. Based on the current pandemic, we suggest developing more scenarios with virtual reality simulations, as disaster simulation nursing education is required now more than ever.

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Collaborative Disaster Governance Recognized by Nurses during a Pandemic: Rim, Dahae , Shin, Hyunsook , Jeon, Hyejin , Kim, Jieun , Chun, Hyojin , Oh, Hee , Shon, Soonyoung , Shim, Kaka , Kim, Kyung Mi; J Korean Acad Nurs 2021;51(6):703-719. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21163

Abstract PDF: Purpose
We aimed to identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic.
Methods
We used a descriptive study design with an online survey technique for data collection. The survey questions were developed based on focus group interviews with nurses responding to COVID-19 and expert validity testing. A 42-question online survey focusing on disaster governance was sent to nurses working in COVID-19 designated hospitals, public health offices, and schools. A total of 630 nurses participated in the survey. Demand and supply analysis was used to identify the specific components of disaster governance during a pandemic situation and analyze priority areas in disaster governance, as reported by nurses.
Results
Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply quadrant, indicating a strong need in those areas of disaster governance among nurses. The nurses practicing at the public health offices and schools showed major components of disaster governance plotted in the second quadrant, indicating weak collaborative disaster governance.
Conclusion
These findings show that there is an unbalanced distribution among nurses, resulting in major challenges in collaborative disaster governance during COVID-19. In the future and current pandemic, collaborative disaster governance, through improved distribution, will be useful for helping nurses to access more required resources and achieve effective pandemic response.

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Nurses’ Experiences of the COVID-19 Crisis: Lee, Jung-Hoon , Song, Yeoungsuk; J Korean Acad Nurs 2021;51(6):689-702. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21160

Abstract PDF: Purpose
This study aimed to develop a situation-specific theory to explain nurses’ experiences of the COVID-19 crisis.
Methods
The participants were 16 hospital nurses who experienced the COVID-19 crisis. Data were collected through in-depth individual interviews from September 2, 2020 to January 20, 2021. Transcribed interview contents were analyzed using Corbin and Strauss’s grounded theory method.
Results
A total of 38 concepts and 13 categories were identified through an open coding process. The core category found was becoming a pioneering nurse who turns crises into opportunities. The causal conditions were the chaos of being exposed defenselessly to an unexpected pandemic, fear caused by a nursing care field reminiscent of a battlefield, and moral distress from failing to protect patients’ human dignity. The contextual conditions were feeling like the scapegoat of the hospital organization, increasing uncertainty due to the unpredictable state of COVID-19, and relative deprivation due to inappropriate treatment. The central phenomenon was suffering alone while experiencing the dedication of the COVID-19 hero image. The action/interactional strategy were efforts to find a breakthrough and getting the nurse’s mind right, and the intervening conditions were gratitude for those who care for broken hearts and getting used to myself with repetitive work. The Consequences were becoming an independent nurse and frustration with the unchanging reality.
Conclusion
This study provides the foundation for the nurse's situation-specific theory of the COVID-19 crisis by defining the crisis perceived by nurses who cared for COVID-19 patients and suggesting types of coping with the crisis.

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Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19: Kim, Geun Myun , Lee, Jung Un , Jung, Hae Kyung , Nam, Soo Gyung , Sim, So Hyeong , Chang, Soo Jung; J Korean Acad Nurs 2021;51(6):661-677. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21141

Abstract PDF: Purpose
This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19.
Methods
This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program.
Results
The perception of subjects toward quarantine measures was classified into the following six types: ‘passive acceptance’, ‘social stigma perception’, ‘appreciation of daily life through awareness of the realities of illness’, ‘why me?’, ‘fearful perception’, and ‘positive meaning’.
Conclusion
The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.

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Factors Influencing Nurses’ Performance of Care in COVID-19 Wards: Kim, Yoon Sun , Kim, Mi-Ae; J Korean Acad Nurs 2021;51(6):678-688. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21131

Abstract PDF: Purpose
The purpose of this study was to identify factors influencing nurses’ performance of care in COVID-19 wards.
Methods
The participants were 132 nurses who worked in COVID-19 wards at three hospitals, and were recruited from April 1 to May 31, 2021. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with SPSS/WIN 24.0 program.
Results
Nursing performance was significantly and positively correlated with ethical sensitivity (r = .75, p < .001), nursing professionalism (r = .67, p < .001), and social support (r = .67, p < .001). Nursing professionalism was positively correlated with ethical sensitivity (r = .64, p < .001) and social support (r = .55, p < .001). Multiple regression analysis for nursing performance revealed that the most significant factor was ethical sensitivity (β = .47, p < .001). Ethical sensitivity, nursing professionalism, and social support explained 66.0% of total variance in nursing performance.
Conclusion
Ethical sensitiviy, nursing professionalism, and social support significantly influence nurses’ performace of care in COVID-19 wards. It suggests that intervention programs should be directed at improving nurses’ ethical sensitivity, bolstering social support, and enhancing nursing professionalism.

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1 Web of Science

Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review: Kim, Jeung-Im , Im, YeoJin , Song, Ju-Eun , Jang, Sun Joo; J Korean Acad Nurs 2021;51(5):511-524. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21156

Abstract PDF: The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.

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1 Web of Science

Nurses’ Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation: Noh, Eun-Young , Chai, Young Jun , Kim, Hyun Jeong , Kim, Eunjin , Park, Yeon-Hwan; J Korean Acad Nurs 2021;51(5):585-596. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21148

Abstract PDF: Purpose
The purpose of this study was to explore nurses’ experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic.
Methods
This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis.
Results
Two main themes emerged from the analysis: ‘Struggling in an isolated space’ and ’Limitations of nursing infrastructure and system’. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system.
Conclusion
The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

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15 Web of Science

A Phenomenological Study of the Lived Experience of Nurses Caring for Patients with COVID-19 in Korea: Oh, Hee , Lee, Na Kyoung; J Korean Acad Nurs 2021;51(5):561-572. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21112

Abstract PDF: Purpose
This study aimed to understand nurses’ lived experiences of caring for patients with COVID-19.
Methods
The phenomenological research method was used. The study participants were 16 Korean nurses who had experiences in caring for patients with COVID-19 in clinical settings. Data was collected using one-on-one in-depth interviews, from June 30 to September 30, 2020. During the interview, the quarantine rules were observed.
Results
The study derived four themes clusters and thirty-eight sub themes. Four theme clusters were identified, i.e., ‘a repetitive sense of crisis’, ‘enduring a drastic change,’ ‘sacrifice of personal life,’ and ‘pride in nursing’. The nurses’ experiences of caring for patients with COVID-19 were an uneasy, unfamiliar, and threatening experiences for an individual, but it is an opportunity for a nursing organization to renew. Accordingly, it was found that nurses faithfully fulfill their individual roles with a vocation and responsibility.
Conclusion
The study provides an in-depth understanding of the situational, psychological, and environmental aspects of challenges facing nurses in the pandemic situation. Based on the findings, institutional follow-up measures should be provided to establish support systems for better nursing care. In addition, studies are needed to track nurses' experiences in the prolonged COVID-19 situation.

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12 Web of Science

Factors Influencing the COVID-19 Vaccination Intentions in Nurses: Korea, February 2021: Park, Ju Young , Ha, Jiyeon; J Korean Acad Nurs 2021;51(5):537-548. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21110

Abstract PDF: Purpose
This study aimed to identify the factors influencing COVID-19 vaccination intentions in nurses.
Methods
The participants were 184 nurses in Korea. Data were collected using a Google Form online survey method in February, 2021, and analyzed using an independent t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis with the SPSS/WIN 26.0 program.
Results
COVID-19 vaccination intention in nurses was correlated significantly with vaccine hesitancy (r = .58, p < .001), risk perception of COVID-19 (r = .22, p = .003), perception of vaccination as a professional duty (r = .59, p < .001), and attitude towards workplace infection control policies (r = .20, p = .007). Vaccine hesitancy (β = .40, p < .001) and the perception of vaccination as a professional duty (β = .44, p < .001) significantly influenced COVID-19 vaccination intention. The model developed in this study explained 50% of the variation in COVID-19 vaccination intention.
Conclusion
Improving the perception of vaccination as a professional duty and lowering vaccine hesitancy may enhance nurses’ COVID-19 vaccination intention. Above all, it is necessary to provide programs to encourage voluntary recognition of vaccination as a professional duty and develop strategies to reduce hesitancy toward COVID-19 vaccinations.

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5 Web of Science

Validity and Reliability of the Turkish Version of the COVID Stress Scale: Meltem, Demirgöz Bal , Melike, Dişsiz , Fadime, Bayri Bingöl; J Korean Acad Nurs 2021;51(5):525-536. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21106

Abstract PDF: Purpose
The aim of this study was to assess the Turkish adaptation of the COVID Stress Scale (CSS) on the basis of determining the stress caused by the coronavirus disease (COVID-19) pandemic, and to test its validity and reliability.
Methods
The English CSS was translated into Turkish using forward and backward translation. Data were collected online from 360 participants. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach’s alpha reliability coefficient, and test-retest methods were used to evaluate reliability.
Results
The Turkish version of the CSS has 36 items consistent with the original scale and has five factors: COVID danger and contamination, socioeconomic consequences of COVID, COVID xenophobia, traumatic stress due to COVID, and compulsive checking for COVID. The construct validity of the Turkish version of the CSS was verified by the adjusted goodness of fit index > .85, and comparative fit index > .95. The content validity index of each item was 91%. The corrected item-total correlations of the scale ranged from .51 to .89. Internal consistency was reliable, with a Cronbach’s α of .93.
Conclusion
The Turkish version of the CSS is valid and reliable. It can be used as a measurement tool for the assessment of COVID-related stress.

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6 Web of Science

Information and General Guidance for Healthcare Professionals in the Fourth Wave of COVID-19: Kim, Jeung-Im , Yu, Mi , Yu, Soyoung , Park, Jin-Hee; J Korean Acad Nurs 2021;51(4):395-407. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21137

Abstract PDF: The COVID-19 curve seesawed and reached the fourth pandemic in July 2021. Since the first three waves, the focus has been on achieving herd immunity through vaccination while a lot of manpower is used for quarantine. However, we have not been able to prevent the fourth wave. The causes are thought to be related to people who doubt the safety of the vaccine and refuse it or violate quarantine guidelines such as social distancing. This study examined guidelines for preventing and controlling COVID-19, the accuracy of vaccination-related information, and described quarantine measures including for those who completed vaccination. In conclusion, prevention and vaccination are the most effective countermeasures against COVID-19. We recommend people vaccination with self-quarantine. Also, it is necessary to make large investments to protect and support nurses in future pandemics.

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6 Web of Science

Topic Modeling and Keyword Network Analysis of News Articles Related to Nurses before and after “the Thanks to You Challenge” during the COVID-19 Pandemic: Yun, Eun Kyoung , Kim, Jung Ok , Byun, Hye Min , Lee, Guk Geun; J Korean Acad Nurs 2021;51(4):442-453. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.20287

Abstract PDF: Purpose
This study was conducted to assess public awareness and policy challenges faced by practicing nurses.
Methods
After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles.
Results
Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic.
Conclusion
The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

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6 Web of Science

Face Mask Usage, Knowledge and Behavior of Face Mask Usage in Older Adults Living Alone in the COVID-19 Era: Han, A-Reum , Park, Yeon-Hwan; J Korean Acad Nurs 2021;51(2):203-216. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20252

Abstract PDF: Purpose
This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic.
Methods
This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho’s Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach’s α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson’s correlation coefficient, and multiple linear regression.
Results
Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior.
Conclusion
Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.

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1 Web of Science

Sub-Health Status Survey and Influential Factor Analysis in Chinese during Coronavirus Disease 2019 Pandemic: Pan, Yanbin , Yan, Jianlong , Lu, Wanxian , Shan, Miaohang; J Korean Acad Nurs 2021;51(1):5-14. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20241

Abstract PDF: Purpose
This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term.
Methods
From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS.
Results
In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree.
Conclusion
It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization.

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5 Web of Science

Disease Prevention Knowledge, Anxiety, and Professional Identity during COVID-19 Pandemic in Nursing Students in Zhengzhou, China: Sun, Yuyan , Wang, Dongyang , Han, Ziting , Gao, Jie , Zhu, Shanshan , Zhang, Huimin; J Korean Acad Nurs 2020;50(4):533-540. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.20125

Abstract PDF: Purpose
This study aimed to evaluate nursing students’ understanding of the prevention of COVID-19, as well as their anxiety towards the disease and their perception of their professional identity in the wake of the pandemic, in Zhengzhou, China.
Methods
A cross-sectional study was designed to investigate 474 nursing students by cluster sampling using a stratified questionnaire from February 15 to March 31, 2020. Multiple linear regression was used to identify the factors affecting professional identity. Binary and multiple logistic regression were used to identify the factors affecting anxiety.
Results
Responders with a high level of understanding of COVID-19 and frequent use of behavioral strategies for its prevention comprised 93.2% and 30.0% of the cohort, respectively. Professional identity was significantly associated with gender and anxiety (p < .050). The prevalence of anxiety among nursing students was 12.4%. Male (odds ratio [OR] = 2.39; 95% confidence interval [CI] = 1.26~4.52), sophomores (OR = 5.30; 95% CI = 1.61~7.45), and infrequent use of prevention measures (OR = 3.49; 95% CI = 1.16~5.19) had a significant effect on anxiety.
Conclusion
Anxiety during the COVID-19 epidemic gives an adverse effect on the professional identity of nursing in students. Nursing education institutions need to provide psychological counseling services for nursing students, in addition to improving their teaching of COVID-19 prevention strategies.

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43 Web of Science

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