Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required.
The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables.
The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care.
These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.
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.
The purpose of this study is twofold :(i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception ; and(ii) to comprehensive investigate socio-cultural backgrounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition, the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August, 1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis, taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's(1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse," "physical check-up," "physical good health," "praying," and so on. 2. When the married couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are: "having sex at specific time," "having sex in nice place," "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical, psychological, emotionmental, environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music," "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things," "to eat food in good shape," "to avoid drugs," "eating Korean herbal medicine," "sexual abstinence," "to avoid dangerous places," " to keep emotional tranquility," "moderate exercises and rest," "leading a pure life," "praying," "being aware of their words and behavior," "for the couple to keep a good relationship," "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition, the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the married couple, the supporting system, and the mass media. As the husband-and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, he family support, and her neighbor's support. The mass media specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits and leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the envelopment of the unborn child's intelligence and talents, the expectation of the unborn child's good features, shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.
This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, t -test, F- test and Scheffe post hoc contrasts, with the SAS program. Thr results of this study are summerized as follows; 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important"(3.31), "Think of family more than a individual"(2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45. 42)and Seoul(47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke(2.16) and psy-chosis (2.40), in which case almost no daily general tasks were expected, followed by arthritis 4. 06, peptic ulcer 4.79, headache 4.99 and cough 5. 58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64). peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban/rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.
Since the introduction of Western concept of nursing to Korea in late 1880s, Korean nursing practice has evolved into Korean culture. The purpose of this study was to explore and identify similarities and differences in hospital nursing practice between Korea and the United States using the grounded theory method. The data were gathered from 15 Korean nurses working in U.S. hospitals using semi-structured, in-depth interview method. Major similarities in nursing practice between Korea and U.S. existed in the 7 domains the Benner indicated in 1984. The nursing administration system was also similar in both countries. On the other hand, differences existed in how nurses execute these domains of nursing practice. These are the roles of nurses, nurse aides and family members, and the interpersonal relationships, and problem presentation and problem-solving strategies. American family members rarely participated in the patient's bedside nursing care, while Korean family members actively participated. American nurse aide participated in direct patient care, while Korean nurse aides did not. Also Korean nurses were participated more in administering and managing the patient's diagnostic and treatment modalities, while American nurses focused on the needs and demands of the patient. In terms of interpersonal relationships, American patients were more self-centered and demanding than Korean. American nurses focused more on the right of individuals while Korean nurses were more oriented to harmony with the coworkers. With inferiors and superiors, American members were more egalitarian, while Koreans tended to be hierarchical. In ways of suggesting problems, American nurses tended to pick out the problems more frequently than Korean nurses did. As to ways to solve the problems, American nurses relied heavily on explicit verbal explanations, while Korean nurses relied more on bodily action and behaviors. The results of this comparative study contribute to nursing by adding knowledge on the theory of culture care by describing the similarities and differences in nursing practice between Korea and the United States.
The purpose of this review is to explore cultural influences on the experiences of Korean, Korean American, and Caucasian American family caregivers caring for frail older adults in terms of the selection of a primary caregiver, caregiving motivation, support/help-seeking, and negative emotional responses(depression and burden).
Seven electronic databases were searched to retrieve studies from 1966 to 2005. Thirty-two studies were identified.
This review supported cultural influences on the selection of primary caregiver, caregiving motivation, and support/help-seeking among the three caregiver groups. In Korean caregivers, the major primary caregivers were daughters-in-law while among Korean American and Caucasian American caregivers, the major primary caregivers were daughters or spouses. As a major caregiving motivation, Caucasian American caregivers reported filial affection while Korean caregivers and Korean American caregivers reported filial obligation. Korean caregivers reported higher extended family support, while Caucasian American caregivers reported higher utilization of formal support. Korean caregivers showed the highest levels of depression followed by Korean American caregivers and Caucasian American caregivers.
In order to develop culturally appropriate interventions and policies, more research is needed to further explain these differences among the three groups, especially regarding support/help-seeking and negative emotional responses.
The purposes of this methodologic paper are to (1) describe theoretical background in conducting research across different cultures; (2) address measurement issues related to instrument administration; and (3) provide strategies to deal with measurement issues.
A thorough review of the literature was conducted. A theoretical background is provided, and examples of administering instrument in studies are described.
When applying an instrument to different cultures, both equivalence and bias need to be established. Three levels of equivalence, i.e., construct equivalence, measurement unit equivalence, and full score comparability, need to be explained to maintain the same concept being measured. In this paper, sources of bias in construct, method, and item are discussed. Issues related to instrument administration in a cross-cultural study are described.
Researchers need to acknowledge various group differences in concept and/or language that include a specific set of symbols and norms. There is a need to question the philosophical and conceptual appropriateness of an assessment measure that has been conceptualized and operationalized in a different culture. Additionally, testing different response formats such as narrowing response range can be considered to reduce bias.
The purpose of this longitudinal study was to examine the relationship between postpartum care performance and postpartum health status.
The study subjects were 82 mothers who delivered full-term infants at 3 hospitals at P city. Data were collected for their health status at the postpartum unit and the sample was followed up to 6 weeks postpartum to collect postpartum care performance and health status.
Mothers rated postpartum care performance as moderate to high and especially rated the maternal role attainment the highest. Mothers experienced 4 physical symptoms and moderate levels of fatigue. In addition, they experienced moderate levels of positive affect and low levels of negative affect at both times. Canonical correlation revealed that postpartum care performance was related to postpartum health status with 2 significant canonical variables. The first variate indicated that mothers who performed hospitality, physical and emotional recovery, self-caring, and role attainment well showed higher positive affects, lower negative affects, fewer physical symptoms, and lower levels of fatigue. The second variate showed that the greater the performance of caring and physical and emotional recovery, the fewer physical symptoms and lower levels of fatigue.
Although Korean traditional postpartum care performance was related to postpartum health status, the further study is needed to identify the causal relationship between them. Nurses need to integrate the perspective of westernized postpartum care and Korean traditional views of postpartum approach to maintain and promote women's health better.
The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM).
A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses.
The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ2=586.03, χ2/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life.
The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.
This study was done to examine the effects of a multicultural education program on nursing students' cultural competence, empathy, and self-efficacy.
In this quasi-experimental study, the participants were assigned to an experimental group (n=40) or a control group (n=40). The data were analyzed using independent t-test, Chi-square or Fisher's exact test, and paired t-test with the SPSS windows 18.0 program.
After receiving the multicultural education program, the levels of cultural competence and self-efficacy in the experimental group were higher than in the control group. The level of empathy increased slightly in the experimental group while it decreased in the control group.
The results of this study indicate that multicultural education is effective in raising the level of cultural competence and self-efficacy in nursing students. Thus, there is a need for continuous effort to integrate multicultural education programs in the nursing curriculum. Repeated study to test effects of these multicultural education programs should be also necessary.
The purpose of this study was to develop a tool to evaluate patient safety culture in nursing homes and to test its validity and reliability.
A preliminary tool was developed through interviews with focus group, content validity tests, and a pilot study. A nationwide survey was conducted from February to April, 2011, using self-report questionnaires. Participants were 982 employees in nursing homes. Data were analyzed using Cronbach's alpha, item analysis, factor analysis, and multitrait/multi-Item analysis.
From the results of the analysis, 27 final items were selected from 49 items on the preliminary tool. Items with low correlation with total scale were excluded. The 4 factors sorted by factor analysis contributed 63.4% of the variance in the total scale. The factors were labeled as leadership, organizational system, working attitude, management practice. Cronbach's alpha for internal consistency was .95 and the range for the 4 factors was from .86 to .93.
The results of this study indicate that the Korean Patient Safety Culture Scale has reliability and validity and is suitable for evaluation of patient safety culture in Korean nursing homes.
This study was conducted to evaluate the validity and reliability of the Korean version of the Sexuality Attitudes and Beliefs Survey (SABS) and to assess SABS for Korean nurses.
The Korean version of SABS was developed through forward-backward translation techniques. Internal consistency reliability and construct validity using confirmatory factor analysis were conducted using PASW+ PC Win (18.0) and AMOS (18.0). Data were collected from 567 nurses who worked in one of six general hospitals across the country.
The Korean version of SABS showed a reliable internal consistency with Cronbach's α of subscales ranging from .59 to .73. Factor loadings of the 10 items of three subscales ranged from .38 to .83. The three subscales model were validated by confirmatory factor analysis (GFI>.97, RMSEA<.05). Sexuality attitudes and beliefs for Korean nurses were more negative than that of European or American nurses. The SABS scores for Korean nurses were significantly different according to age, marriage, education, clinical experiences, and feeling about sexuality.
The Korean version of SABS has satisfactory construct validity and reliability to measure Korean nurses' attitudes and belief toward sexuality. Education is essential to enhance importance and self-efficacy and to relieve barriers to addressing patients' sexuality.
The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use.
The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis.
Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed.
The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.
The purpose of this study was to examine the impact of strategies to promote reporting of errors on nurses' attitude to reporting errors, organizational culture related to patient safety, intention to report and reporting rate in hospital nurses.
A nonequivalent control group non-synchronized design was used for this study. The program was developed and then administered to the experimental group for 12 weeks. Data were analyzed using descriptive analysis, χ2-test, t-test, and ANCOVA with the SPSS 12.0 program.
After the intervention, the experimental group showed significantly higher scores for nurses' attitude to reporting errors (experimental: 20.73 vs control: 20.52, F=5.483,
The study findings indicate that strategies that promote reporting of errors play an important role in producing positive attitudes to reporting errors and improving behavior of reporting. Further advanced strategies for reporting errors that can lead to improved patient safety should be developed and applied in a broad range of hospitals.
The purpose of this study was to identify the moderating and mediating effects of self-leadership in the relationship between organizational culture and nurses' informatics competency.
Participants in this study were 297 nurses from the cities of Busan and Ulsan. The scales of organizational culture, self-leadership and informatics competency for nurses were used in this study. Descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were used for data analysis.
Nursing informatics competency of the participants was relatively low with a mean score 3.02. There were significant positive correlations between subcategories of perceived organizational culture, self-leadership and nursing informatics competency. Self-leadership was a moderator and a mediator between organizational culture and informatics competency.
Based on the results of this study, self-leadership promotion strategies to improve nursing informatics competency are needed.
The present study was done to discover the structure of universal actual experiences ‘Considering tomorrow’ of health and quality of life among North Korean refugees in terms of the socio-cultural context of South Korea.
The research question was ‘what is the structure of the actual experience of ‘Considering tomorrow?’, which was examined based on the Parse's human becoming research method. Five North Korean adult refugees were recruited from a National Reconciliation Committee in Seoul/Incheon. The data was gathered from dialogues and collected from February, 2006 to November, 2006.
The structures found in this study were: ‘hope for future life by taking responsibility and having harmony with South Koreans, by forming an integrated identification; having a chance for positive engagement, by attaining human freedom and hope; feeling respected, by assimilating self to the new world; getting freedom back, by facing a new challenge and preparing self for a new social role; overcoming cultural differences with fortified hardiness for survival, by making a decision for a life course with individual growth. In addition, conceptual integration was that ‘Considering tomorrow is transforming the enabling-limiting values’.
Health professionals need to know North Korean refugees' psychological difficulties, expectations of treatment, help seeking behavior, and expectations from mainstream culture. Additionally, understanding North Korean refugees' needs for reality, health education and a multi-disciplinary team approach are necessary to improve their health.