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Research Papers

Experiences of Patients and Their Families Receiving Medical Services Provided by Advanced Practice Nurses at Tertiary General Hospitals: Mi-Kyeong Jeon, Su Jung Choi, Ji Eun Han, Eun Kyung Kwon, Jeong Hee Park, Jeong Hye Kim; J Korean Acad Nurs 2024;54(4):594-606. Published online November 4, 2024; DOI: https://doi.org/10.4040/jkan.24069

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Purpose

This study aimed to understand and describe the experiences of patients and their families who have received medical services from advanced practice nurses in tertiary general hospitals in Korea.

Methods

Data were collected through four focus group interviews with 20 patients and their families who had received medical services from advanced practice nurses for more than six months at four tertiary hospitals from November 29 to December 28, 2023. Verbatim transcripts were analyzed using qualitative content analysis.

Results

The four themes extracted from the experiences of patients and their families were as follows: unfamiliar medical personnel encountered during the treatment process, healthcare professionals who exhibited excellence, companions to light my way through the tunnel of illness, and an advanced practice nurse system that must be activated urgently.

Conclusion

The study’s findings indicate that patients and their families view the care provided by advanced practice nurses as excellent, reliable, and holistic. Research suggests that advanced practice nurses are valuable healthcare professionals in team-based care. The findings suggest that hospitals should utilize an advanced practice nurse system to improve patient outcomes and ensure the quality of care.

Citations

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Legislation of Medical Support Tasks in the Nursing Act as a Foundation for Nursing Professionalism and Role Expansion
Su Jung Choi
Korean Journal of Adult Nursing.2025; 37(2): 69. CrossRef
Strategies for expanding the role of advanced practice providers in the Korean nursing workforce: a mixed-methods approach
Jeong Hye Kim, Mi-Kyeong Jeon, Suyoung Choi, Mimi Lee, Su Jung Choi
Journal of Korean Academy of Nursing.2025; 55(4): 568. CrossRef
Nurses' Patient Care Experiences in a Changing Healthcare Environment Following One Year of Healthcare Policy Conflict - A Focus Group Interview
Eun Hee Kang, Yunhyung Kim, Jeong Hye Kim
Journal of Korean Association for Qualitative Research.2025; 10(3): 280. CrossRef

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The Influence of Diversity Management of Nursing Organization on Organizational Commitment: Double Mediating Effect of Diversity Sensitivity Orientation and Positive Nursing Organizational Culture: Hwi Gon Jeon, Keum Seong Jang, Eun A Kim; J Korean Acad Nurs 2024;54(3):403-417. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.23120

Abstract PDF

Purpose
The aim of this study was to identify the double mediating effect of effect of diversity sensitivity orientation and positive nursing organizational culture between diversity management and organizational commitment.
Methods
Participants were 245 nurses working in six tertiary hospitals located in 3 different regions. Data collection was conducted from February 13, 2023 to March 6, 2023 through online self-reported questionnaire. The data were analyzed by IBM SPSS Statistics 27 and SPSS PROCESS Macro 4.2 program.
Results
The direct effect of diversity management on organizational commitment was significant (β = .21, p < .001). The indirect effect of diversity management on organization commitment was .34 (95% confidence interval [CI] = .23~.47). The double mediating effect of diversity sensitivity orientation and positive nursing organizational culture in the relationship between diversity management and organizational commitment was .02 (95% CI = .00~.05).
Conclusion
Diversity sensitivity orientation and positive nursing organizational culture show double mediating effect on the relationship between diversity management and organizational commitment. Education program and human resource management strategy for enhancing diversity management, diversity sensitivity orientation and positive nursing organizational culture should be provided to improve organizational commitment, and which are needed active support of the association and nursing organization.

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Impact of Resilience, Emotional Exhaustion, and Communication Competency on Organizational Commitment Among Nurses in a Tertiary Hospital Setting in South Korea: A Cross-Sectional Study
Ho Young Kim, Hee Jeong Kim, Eun Ja Yeun
Sage Open.2025;[Epub] CrossRef
Organizational commitment of nursing staff: Definition of the concept and specifics of measurement (review of foreign publications)
K. V. Kuzmin, L. E. Petrova, V. S. Kharchenko
Kuban Scientific Medical Bulletin.2025; 32(5): 96. CrossRef

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Development of the Hospital Nurses’ Silence Behavior Scale: Soojin Chung, Jee-In Hwang; J Korean Acad Nurs 2024;54(2):279-295. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23138

Abstract PDF

Purpose
This study aimed to develop a scale to measure hospital nurses’ silence behavior and examine its validity and reliability.
Methods
A total of 52 preliminary items on hospital nurses’ silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson’s correlation coefficient was used for assessing concurrent validity, and Cronbach’s alpha was used for the reliability test.
Results
The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the ‘Organizational Silence Scale (OSS)-the issues on which nurses remain silent’ (r = .60, p < .001) and ‘OSS-the reasons why nurses remain silent’ (r = .68, p < .001). Cronbach’s α of the scale was .92, and α of each subscale ranged from .71 to .90.
Conclusion
The Hospital Nurses’ Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.

Citations

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Mediating Effect of Emotional Labour on the Role Pressure and Silence Behaviour of Nurses
Lianci He, Jianhua Liu, Rong Sun, Yuan Deng, Ling Tang, Shaochuan Chen
Evaluation & the Health Professions.2026; 49(1): 3. CrossRef
Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study
Haengsuk Kim, Wanju Park
Journal of Korean Academy of Nursing.2025; 55(1): 81. CrossRef
Influence of Clinical Nurses’ Organizational Silence on Organizational Citizenship Behavior: Mediating Effect of Organizational Commitment Moderated by Organizational Justice
Shin Ae Hwang, Haeyoung Min
Journal of Korean Academy of Nursing Administration.2024; 30(4): 416. CrossRef
Psychometric evaluation and translation of the Persian version of the Organizational Silence Behavior Scale (OSBS-P) for clinical nurses
Alireza Mirzaei, Mobina Jamshidinia, Mehrzad Aghabarari, Pouya Dolat Abadi, Reza Nemati-Vakilabad, Ehsan Namaziandost
PLOS ONE.2024; 19(12): e0314155. CrossRef

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Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design: Hyun-Joo Kim, Sun-Hee Lee, Jai-Jung Lee, Sun-Suk Seong, Hee Yang, Hyang-Yuol Lee; J Korean Acad Nurs 2024;54(2):237-249. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.22142

Abstract PDF

Purpose
This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload.
Methods
The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively.
Results
The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload.
Conclusion
These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

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Nurses' Experience Working with Substitute Nurses
Hye Mi Kim, Yeon Hee Kim, Jeong Hye Kim
Journal of Korean Association for Qualitative Research.2025; 10(3): 208. CrossRef

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1 Crossref

Development of a Reward Scale for Hospital Nurses: Sun Hee Kim, Eun-Young Kim; J Korean Acad Nurs 2023;53(5):525-537. Published online October 31, 2023; DOI: https://doi.org/10.4040/jkan.23057

Abstract PDF

Purpose
This study aimed to develop and test a reward scale for hospital nurses.
Methods
The initial items were identified through a literature review and focus group interviews with ten hospital nurses. The content validity of the items was evaluated by ten experts. Fifty-one items were derived from the pilot survey. Four hundred eighty-eight nurses participated in the study: 248 for exploratory factor analysis (EFA) and 240 confirmatory factor analysis (CFA). Data were analyzed using item analysis, EFA, CFA, convergent validity, known-group validity, and internal consistency using IBM SPSS Statistics 29.0 and IBM SPSS AMOS 29.0.
Results
The final scale consisted of 31 items and eight factors (decent wage, opportunity to grow and develop, support for special situations, various benefits, flexibility of work, job-related achievement, reflecting career and performance, and recognition), which explained 67.3% of the total variance. The eight-subscale model was validated by CFA. Convergent validity was evaluated by analyzing correlation with intention to leave (r = - .63, p < .001) and job satisfaction (r = .54, p < .001). The known-group validity was evaluated by comparing the reward scales according to age, clinical career, income level and hospital type. The scale was found to be reliable with a Cronbach’s α of .89.
Conclusion
Both the validity and reliability of the reward scale for hospital nurses are verified, which can enhance the understanding of the range of rewards and may assist nurse managers in establishing an effective reward system.

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Optimized nursing management in the Central Sterile Supply Department and Gastroenterology Department: a retrospective controlled study
Dali Wang
American Journal of Translational Research.2024; 16(12): 7480. CrossRef

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

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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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Isolation and Recovery Experiences of COVID-19 Patients in South Korea: A Qualitative Study
Soo Jung Chang, Geun Myun Kim, So Hyeong Sim, Jeong Ah Kim
Korean Journal of Adult Nursing.2023; 35(3): 212. CrossRef
Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach
Bom-Mi Park, Mi Young Chon, Hyun-Jung Lee
Healthcare.2023; 11(20): 2732. CrossRef

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9 Download
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A Concept Analysis of Quality Nursing Care: I Gede Juanamasta, Yupin Aungsuroch, Joko Gunawan; J Korean Acad Nurs 2021;51(4):430-441. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21075

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Purpose
This study aimed to perform a concept analysis of quality nursing care.
Methods
Walker and Avant’s concept analysis method was used to carry out this study.
Results
The defining attributes identified were as follows: caring, the nurse-patient relationship, and patient needs. Antecedents included patient characteristics, individual factors (age, education, knowledge, competence, and experience), job position, and environmental factors. The consequences of quality nursing care have significant influence on both patients and nurses.
Conclusion
The findings can aid researchers in obtaining a better understanding of quality nursing care, and stakeholders can consider the factors related to quality nursing care and its consequences to improve the nursing process.

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CPD focus: importance of listening in developing therapeutic relationships
Sophie Louise Waters
Mental Health Practice.2025; 28(3): 37. CrossRef
Psychometric properties of the Chinese version of the quality of nursing care scale among hospital nurses: a bifactor exploratory structural equation modeling analysis
Chiu-Shu Fang, Cheng-Hsien Li, Shu-Ching Ma, Fang-Ming Hwang, Maria Manuela Martins, Fan-Hao Chou
BMC Nursing.2025;[Epub] CrossRef
Effects of high-quality nursing on surgical site wound infections after colostomy in patients with colorectal cancer
Yu Cheng, Yuan-Xing Chen
World Journal of Gastrointestinal Surgery.2024; 16(12): 3835. CrossRef
Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study
Leodoro J. Labrague
International Emergency Nursing.2024; 72: 101389. CrossRef
Prevalence of burnout and its determinants among Indonesian nurses: a multicentre study
I. Gede Juanamasta, Yupin Aungsuroch, Joko Gunawan, Michael Joseph Dino, Rapin Polsook
Scientific Reports.2024;[Epub] CrossRef
Current trends and issues in quality care and patient safety: A discussion with ChatGPT
Joko Gunawan
Journal of Healthcare Administration.2023; 2(1): 1. CrossRef
The ethical principles and caring behavior of Indonesian nurses
Ilkafah Ilkafah, Anestasia Pangestu Mei Tyas, Rini Rachmawaty
Healthcare in Low-resource Settings.2023;[Epub] CrossRef
L’expérience des soins des personnes qui vivent une transplantation hépatique. Recherche phénoménologique descriptive au sein d’un hôpital académique belge
Ivo Manuel Mateus Alves, Chantal Cara, Thierry Gustot, Hélène Lefebvre, Dan Lecocq
Recherche en soins infirmiers.2023; N° 152(1): 42. CrossRef
Strategies and challenges in addressing ethical issues in the hospital context: A phenomenological study of nurse team leaders
Ni Made Nopita Wati, I Gede Juanamasta, Jutharat Thongsalab, Jintana Yunibhand
Belitung Nursing Journal.2023; 9(2): 139. CrossRef
Causal Modelling of Factors Influencing Quality of Nursing Care in China
Xiaolu Xue, Wipada Kunaviktikul, Kulwadee Abhicharttibutra, Orn-Anong Wichaikhum
Pacific Rim International Journal of Nursing Research.2023; 27(3): 417. CrossRef
Reliability and Validity of the Indonesian Version of the McCloskey/Mueller Satisfaction Scale
I. Gede Juanamasta, Yupin Aungsuroch, Mary L. Fisher, Nursalam, Jose Luis Santos
Journal of Nursing Management.2023; 2023: 1. CrossRef
The Therapeutic Nurse–Patient Relationship in Hemodialysis: A Pilot Mixed-Method Study on the Perceived Quality of Nurses’ Attitudes and Caring Behaviors
Claudia Camedda, Gloria Bici, Camilla Elena Magi, Alice Guzzon, Yari Longobucco
Nursing Reports.2023; 13(3): 990. CrossRef
Translation and validation study of the Indonesian version of the practice environment scale of the nursing work index
I Gede Juanamasta, Yupin Aungsuroch, Mary L. Fisher, Siluh Nyoman Alit Nuryani, Ni Nyoman Ayuningsih
International Journal of Nursing Sciences.2023; 10(4): 511. CrossRef

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Review Paper

Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis: Jisu Seo, Rhayun Song; J Korean Acad Nurs 2021;51(4):414-429. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21046

Abstract PDF

Purpose
This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units.
Methods
PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types.
Results
In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92).
Conclusion
This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

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Effect of bathing with two percent chlorhexidine gluconate every other day on healthcare-associated infections in the medical intensive care unit
Shu-Fen Hsu, Pei-Jung Yu, Hsing-Yu Yang, Te-Yu Wu
Infection Prevention in Practice.2026; : 100521. CrossRef
Implementation of 2% Chlorhexidine Bathing to Reduce Healthcare-Associated Infections Among Patients in the Intensive Care Unit
Hsu-Liang Chang, Tzu-Ying Liu, Po-Shou Huang, Chin-Hwan Chen, Chia-Wen Yen, Hui-Zhu Chen, Shin-Huei Kuo, Tun-Chieh Chen, Shang-Yi Lin, Po-Liang Lu
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Can chlorhexidine gluconate baths reduce fungal colonisation in intensive care unit patients?
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Antimicrobial Resistance & Infection Control.2025;[Epub] CrossRef
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A Systematic Review of Antibiotic Resistance Trends and Treatment Options for Hospital-Acquired Multidrug-Resistant Infections
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Cureus.2022;[Epub] CrossRef

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Original Articles

Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department: Hyo-Jin Kim, Hee-Young Kang; J Korean Acad Nurs 2019;49(2):171-180. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.171

Abstract PDF

Purpose

The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses.

Methods

A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions.

Results

The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group.

Conclusion

The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

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Optimizing triage education for emergency room nurses: A scoping review
Hui Ju Shin, Subin Park, Hyun Joo Lee
Nurse Education Today.2025; 144: 106452. CrossRef
Strategies to improve the quality of nurse triage in emergency departments: A systematic review
Simon Ouellet, Maria Cécilia Gallani, Guillaume Fontaine, Éric Mercier, Alexandra Lapierre, Fabian Severino, Céline Gélinas, Mélanie Bérubé
International Emergency Nursing.2025; 81: 101639. CrossRef
Construction of learning objectives and content for emergency triage nurses in tertiary general hospitals: A Delphi study
Linyuan Zhang, Bo Gao, Fang He, Chao Wu, Juan Du, Li Zhang, Juan Liang, Hongjuan Lang
Nurse Education in Practice.2024; 80: 104145. CrossRef
Effectiveness of the Patient’s Severity Classification Competency Promotion Virtual Reality Program of Nursing Students during the COVID-19 Pandemic Period
Eunju Lee, Gyuli Baek, Yeonhui Hwang
Healthcare.2023; 11(8): 1122. CrossRef
Effects on Triage Competency Based on Nursing Task Performance and Self-Efficacy of Nurses in Regional Emergency Medical Institutions
Su Jin Kim, Su Ol Kim
Korean Journal of Adult Nursing.2022; 34(3): 304. CrossRef
The Effect of Competency-Based Triage Education Application on Emergency Nurses’ Triage Competency and Performance
Sun-Hee Moon, In-Young Cho
Healthcare.2022; 10(4): 596. CrossRef
Factors Influencing Patient Satisfaction in an Emergency Department Based on the Use of the Korea Triage and Acuity Scale
Keun Hee Park, Min Yoon, Myoung Soo Kim
Korean Journal of Adult Nursing.2022; 34(3): 338. CrossRef
Factors associated with the undertriage of patients with abdominal pain in an emergency room
Boo Young Oh, Kisook Kim
International Emergency Nursing.2021; 54: 100933. CrossRef
Facilitators and Barriers of the Triage Process based on Emergency Nurses’ Experience with the Korean Triage and Acuity Scale: A Qualitative Content Analysis
Sun-Hee Moon, Mi-Kyeong Jeon, Deok Ju
Asian Nursing Research.2021; 15(4): 255. CrossRef
Effect of problem-based learning on severity classification agreement by triage nurses
Kyeongmin Jang, Eunmi Jo, Kyoung Jun Song
BMC Nursing.2021;[Epub] CrossRef
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Yiqian Wang, Jing Zhu, Jun Cao, Dan Zheng, Lihua Wang, Yuvaraja Teekaraman
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Comparing the Effect of Web-based Networking Education and Lectures on Learning of Hospital Triage in Nursing Students in Armed Forces Universities of the Islamic Republic of Iran in the Covid-19 Pandemic
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Military Caring Sciences.2021; 8(2): 127. CrossRef

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Evaluation of Validity of the Korean Triage and Acuity Scale: Heejung Choi, Jong Sun Ok, Soo Young An; J Korean Acad Nurs 2019;49(1):26-35. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.26

Abstract PDF

Purpose

The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).

Methods

This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.

Conclusion

The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

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Sujin Koo, Seongeun Lee, Jae Young Park, JeongKyu Lee, Keon Yeup Kim, Hyunsun Oh, Jeonghoon Ahn, Bum Joon Kim
Journal of the Korean Neurological Association.2026; 44(1): 27. CrossRef
Factors Influencing Mistriage Based on the Korean Triage and Acuity Scale: A Retrospective Cross‐Sectional Study
Nayeon Yi, Dain Baik
Journal of Nursing Scholarship.2025; 57(5): 860. CrossRef
Clinical features and mortality risk factors in hospitalized heart failure patient during the COVID-19 pandemic: A South Korea national emergency department study
Soo Young An, Jong Sun Ok, Sung Hea Kim
Clinical Epidemiology and Global Health.2025; 35: 102144. CrossRef
Transfer versus direct-visit patients in medically underserved emergency departments: a retrospective cohort study
Kyongmin Sun, Youjin Lee, Jungsil Lee
BMC Emergency Medicine.2025;[Epub] CrossRef
Predictive validity of resource-adjusted Korean Triage and Acuity Scale in pediatric gastrointestinal tract foreign body patients
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Effect of storage duration on outcome of patients receiving red blood cell in emergency department
Yu-Kyung Koo, Sol Ji Choi, Soon Sung Kwon, Jinwoo Myung, Sinyoung Kim, Incheol Park, Hyun Soo Chung
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Ho Sub Chung, Myeong Namgung, Dong Hoon Lee, Yoon Hee Choi, Sung Jin Bae
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Junhyup Song, Sinyoung Kim, Hyun Soo Chung, Incheol Park, Soon Sung Kwon, Jinwoo Myung
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Seung Wook Kim, Yong Won Kim, Yong Hun Min, Kui Ja Lee, Hyo Ju Choi, Dong Won Kim, You Hwan Jo, Dong Keon Lee
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Seung Yeon Hwang, Jae Kwang Lee, Hyun Sik Ryu, Seong Soo Park, Jun Young Choi, Hye Ji Lee, Seung Ho Hur, Yeong Geun Park, Hyun Soo Choi
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Development of the Patient-Centered Nursing Culture Scale for Hospitals: Esther Shin, Sook-Hee Yoon; J Korean Acad Nurs 2019;49(5):613-630. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.613

Abstract PDF

Abstract Purpose

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

Methods

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.

Results

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).

Conclusion

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.

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The Effects of an Acceptance-Commitment Therapy Based Stress Management Program on Hospitalization Stress, Self-Efficacy and Psychological Well-Being of Inpatients with Schizophrenia: Jae Woon Lee, Jae Hyun Ha; J Korean Acad Nurs 2018;48(4):443-453. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.443

Abstract PDF

Abstract Purpose

The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test.

Results

The experimental group showed a significant decrease in hospitalization stress (t=5.09, p<.001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894).

Conclusion

The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.

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Usefulness of Korean Version of Behavioral Cue Checklist for Predicting of Patient Violence in Emergency Departments: Jang Mi Kim, Eun Nam Lee; J Korean Acad Nurs 2018;48(3):289-297. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.289

Abstract PDF: Abstract Purpose
This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments.
Methods
This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed.
Results
Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively.
Conclusion
The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.

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A Survey on the Performance of Surgical Hand Scrubs: Hae Sang Yoon; Journal of Nurses Academic Society 1996;26(3):591-604. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.3.591

Abstract PDF

The surgical hand scrub(SHS) is the single most important procedure in the prevention of postoperative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative theatre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative theatres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive statistics and Chi-squre test. The results of the study are summarized as follows: 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P= .005). 2. Nurses and doctors had some knowledge of slipping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included: 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses(56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest (nurses: 95.7%, doctors: 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.

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Status of and Factors Influencing Vaccination against the Pandemic (H1N1) 2009 Virus among University Students from the Fields of Nursing and Allied Health
Og Son Kim
Journal of Korean Academy of Nursing.2011; 41(3): 403. CrossRef

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An Analytical Study of the Professional Self-Concept of Hospital Nurses in Korea: Kyeong Yae Sohng, Choon Hee Noh; Journal of Nurses Academic Society 1996;26(1):94-106. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.94

Abstract PDF

Nursing literature suggests that the self-concept of nurses gives an important implications to educators and administrators as well as clinicians for their professional development. With a view to ex ploring how nurses view themselves, the Professional Self-Concept of Nurses Instrument (PSCNI) using 27 Likert items was developed by Arthur in Australia in 1990. This study is an extension of the PSCNI using Korean samples with some modifications. A convenience sample was drawn from 800 nurses working in three university hospitals in Seoul; three university hospitals in Kyonggi-do and a university hospital and a psychiatric hospital in Kangwon-do. Seven hundred questionnaires were analyzed using the statistical analysis system(SAS). The reliability of the scale was tested by test-retest and Cronbach's alpha. Differences in the PSCNI, which are closely related to demographic variables, were examined by t-test, ANOVA and the Duncan's multiple range test. Factor analysis was employed so as to examine component factors. The results are summarized as follows: 1. The test-retest reliability of the PSCNI was .79 and Cronbach's alpha was .85. Item correlations with total revealed consistent correlations and subscale reliability varied from .49 to .85. 2. The average score of PSCNI was 75.21 and average item score was 2.79. 3. Twenty four items were derived from the PSCNI 27 items and these items clustered in three component factors. The cumulative percent of variance was 38.12% and for factor 1 was 22.81%, for factor 2, 9.79% and for factor 3, 5.51% respectively. 4. A comparison of the scores for the dimensions of the PSCNI shows a relative difference in terms of mean item scores and in decending order, professional practice (m=2.83), communication (m=2.82) and satisfaction (m=2.70). 5. Professional self-concept of nurses was found to vary significantly according to age(P=.0001), re-ligion (P=,0001), academic background(P= .0109), marital status (P=. 0001), career (P= . 0001) and position (P=. 0001). In conclusion, there was a correlation between professional self-concept of nurses, and life and work variables. This study provides an important message for administrators and nurse educators by highlighting factors which can be addressed by education programs, staff development and appraisal. While the test results largely confirm the Australian and Canadian tests, further research is necessary to improve the cumulative percent of variance instead of applying Arthur's PSCNI directly to Korean nurses.

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Anxiety after Acute Myocardial Infarction and In-Hospital Complications: Kyungeh An; Journal of Korean Academy of Nursing 2002;32(7):999-1008. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.999

Abstract PDF

PURPOSE OF THE STUDY: A retrospective and descriptive survey was conducted to investigate the level of anxiety that patients experience in early stage of AMI and to examine whether anxiety independently predict inhospital complications. SIGNIFICANCE OF THE STUDY: AMI is a major cause of death and disability. Anxiety may contribute to developing complications and mortality. However, the association between anxiety and complications has not been examined.
RESULTS
Data were analyzed for 424 AMI patients enrolled for MICA (Myocardial Infarotion Complication and Anxiety) project. The mean score of the state anxiety inventory (SAI) measured within 72 hours after admission for the whole sample was 39.14 (+/-12.77) and ranged from 18 to 80. Overall, 161 patients (38.0%) experienced at least one episode of in-hospital complication (i.e. VT, VF, reinfarction, recurrent ischemia or cardiac death). Incidence of in-hospital complications was higher in the high anxiety group than in the low anxiety group (45.4% vs. 31.2%). There were significant differences in the incidence of recurrent ischemia between groups with low level of anxiety and high level of anxiety (27.5% vs. 18.9%). According to the Ward criterion from the logistic regression, anxiety reliably predicted the occurrence of in-hospital complications. Anxiety (odds ratio = 1.75, 95% CI 1.01-3.01, p= 0.04) significantly contributed to the model. Patients who were in the high anxiety group were 1.8 times more likely to have in-hospital complications than those who were in the low anxiety group.
CONCLUSION
AND SUGGESTION: This finding confirms that patients experience significant level of anxiety early after AMI, and this anxiety, after controlling other risk factors for the complications, is a reliable predictor of in-hospital complications.

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Reliability and Validity of the Mental Health Questionnaire for Adult
Jin Woong Yoon, Chung Yeub Chung, Dong Woo Lee, Jae Hyun Shin, Jang Won Cho, Chong Ki Kim, Seul Ki Choi, Jae Ock Kim
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Responses to Symptoms of Acute Myocardial Infarction: Reasons for Delay and Bystanders' Role: Debra K Moser, Kyungeh An; Journal of Korean Academy of Nursing 2002;32(7):1063-1071. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.1063

Abstract PDF

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death in Korea. Delay in seeking treatment may cause unnecessary exacerbation of the disease and early mortality from AMI. Patients' recognition of symptoms of an AMI and response to those symptoms may influence the delay time. Bystanders' role in patients' seeking treatment after AMI has not been studied in previous research. Understanding reasons for delay in seeking treatment is important in developing interventions for reducing these delays and increasing survival rate from AMI. PURPOSE OF THE STUDY: A retrospective survey was conducted with 144 AMI patients to: (1) investigate time from symptom onset to arrival at the first hospital for treatment of AMI; (2) describe patient's and bystander's response to the patient's symptoms; (3)examine whether patient's and bystander's responses affect delay time.
RESULTS
The mean of overall pre-hospital delay time was 13.64 (21.86) hours and it consisted of patients' delay of 13.64 (22.32) hours and transportation time of 24.86 (19.41) minutes. People living in rural area delayed longer than people living in urban area. Pre-hospital delay time was associated with the bystander: patients delayed longer when they were with their spouse, family and friends than when with colleagues at work. Calling 119 saved transportation time, but did not reduce overall pre-hospital delay time.
CONCLUSION
AND SUGGESTIONS: Patients delay longer than the time window for a successful reperfusion therapy when they experience symptoms of AMI; and calling 119 does not diminish this delay. Bystanders' adequate response to the patients' symptom may reduce the delay time in seeking treatment. Findings from this study may suggest that health education and public campaigns are needed to increase people's recognition of symptoms of an AMI and to promote adequate response from bystanders to the AMI symptoms. In addition, public campaigns urging car operators to yield to the emergency vehicle are needed in order to reduce transportation time.

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Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome
Seon Young Hwang
Journal of Korean Academy of Nursing.2009; 39(6): 888. CrossRef

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A study of the Nursing Service Quality and Satisfaction that Admitted Patients Perceived: being used SERVQUAL: Mi Aie Lee; Journal of Korean Academy of Nursing 2002;32(4):506-518. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.4.506

Abstract PDF

PURPOSE: This study was performed to measure the nursing service quality being used SERVQUAL model and satisfaction that the admitted patients perceived. METHOD: The questionnaire founded on the SERVQUAL was developed and distributed to 300 patients at the three general hospitals in three provincial city, Korea. For data analysis, Cronbach's alpha frequencies, percentages, paired t-test, Pearson Correlation Coefficient were used. RESULT: In expectation, patients most highly perceived the assurance factor that was one among the 5 factors being constituted nursing service. In performance, patients most highly perceived the responsiveness factor. The performance degrees of the 5 factors and 20 attributes being constituted nursing service did not exceed the expectation degree of those. So the calculated figures for nursing service quality of the three subjected hospitals were all minus. In relation of the patients' demographics and nursing service characteristics to their general satisfaction, patients' sex, age, income and the all factors and attributes of nursing service had relation to their general satisfaction. CONCLUSION: It could be concluded that the nursing service quality of the three subjected hospitals was poor and the patients' demographic and nursing service characteristics had relation to their general satisfaction.

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Pre-hospital Delay in Treatment after Acute Myocardial Infarction: Kyungeh An; Journal of Korean Academy of Nursing 2001;31(7):1141-1150. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.7.1141

Abstract PDF

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death. Most of the deaths from AMI, if diagnosed and treated early enough, can be prevented. Delay in treatment may cause unnecessary exacerbation of the disease and even death in AMI patients. PURPOSE OF THE STUDY: A retrospective survey was conducted to (1) investigate the delay time in AMI patients' seeking treatment from symptom onset to arrival at the first hospital (overall pre-hospital delay), the length of time taken for decision-making (patients' delay) and transport (transportation time); (2) to identify factors associated with delay times; (3) to compare delay times between the group who called 119 and the group who did not.
RESULTS
The mean of overall pre-hospital delay time was 17.42 (+/-24.03) hours and it was consisted of patients' delay, 17.07(+/-24.45), and transportation time, .84 (+/-2.34). None of socio-demographic variables such as age, sex, marital status, monthly income, education, and living environment was associated with either the patients' delay or the overall delay time. Living rural area (F=4.483, p=.016), having previous MI (F=35.252, p=.000), and other heart disease (F=69.435, p=.000) decreased transportation time; having previous heart disease decreased overall pre-hospital delay(F=4.489, p=.039); and having angina (F=92.907, p=.000) and CAD (F=9.724, p=.003) increased transportation time. Place of symptom attack, bystander, whether patients or bystander called 119, modes of transportation, intensity of pain, presence of typical chest pain and anxiety perceived by patients were not associated with any of delay times. No significant differences appeared between the group who called 119 and the group who did not in any of delay times.
CONCLUSION
AND SUGGESTIONS: Although number of patients who arrive at the hospital early enough for treatment tend to be increasing, considerable number of patients still delayed longer than desired when they experienced symptoms of AMI, and calling 119 did not diminish this delay because patients delayed mostly before they decided to call. Living urban area, having previous MI, and heart disease decreased transportation time whereas having previous heart disease decreased the overall pre-hospital delay time and having previous angina and CAD increased transportation time. Further studies to identify reasons for real late arrivals as well as public campaigns to reduce delay time in treatment are needed.

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Ziyu Wang, Yurong Tang, Yu Cui, Hanwen Guan, Xiaoqian Cui, Yuan Liu, Yanni Liu, Zheng Kang, Qunhong Wu, Yanhua Hao, Chaojie Liu
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A Study of the Perception Gap on Nursing Service between Consumers and Providers: Mi Aie Lee; Journal of Korean Academy of Nursing 2001;31(5):871-884. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.5.871

Abstract PDF

PURPOSE: this study was to investigate the perception gap on nursing service between consumers and providers.
METHOD
the questionnaire founded on the SERVQUAL was developed and distributed to 300 patients and 210 nurses at the three subjected general hospitals in three provincial city, Korea during February to March, 2001. For data analysis, Cronbachs' Alpha, frequency, t-test, and paired t-test were used.
RESULT
1. In the gap analysis on the 20 properties constituting nursing service, providers almost all perceived higher than consumer in quality. Among them, the number of properties being statistically significant was 7 in the expectation, 18 in the important and 7 in the performance. 2. In the comparison analysis of the perception gap on the expectation-performance and the important-performance, it turned out that the subjected hospitals had to improve their equipment and facilities immediately. It was suggested a good strategy to strengthen the responsiveness factor and the assurance factor of nursing service.
CONCLUSION
it could be concluded that nurses have to recognize the blind spot of their perception and endeavor to take away the perception gap between consumers and providers.

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Nursing Intensive‐Care Satisfaction Scale [NICSS]: Development and validation of a patient‐centred instrument
Marta Romero‐García, Laura de la Cueva‐Ariza, Llucia Benito‐Aracil, Teresa Lluch‐Canut, Joan Trujols‐Albet, Maria Antonia Martínez‐Momblan, Maria‐Eulàlia Juvé‐Udina, Pilar Delgado‐Hito
Journal of Advanced Nursing.2018; 74(6): 1423. CrossRef
Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals
Hae Sagong, Ga Eon Lee
Journal of Korean Academy of Community Health Nursing.2016; 27(4): 309. CrossRef
A comparative study of patients’ and nurses’ perceptions of the quality of nursing services, satisfaction and intent to revisit the hospital: A questionnaire survey
Mi Aie Lee, Young-Hee Yom
International Journal of Nursing Studies.2007; 44(4): 545. CrossRef

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Effects of a Sensory Stimulation on Weight Gain, Behavioral State, and Physiological Responses in Premature Infants: Hee Seung Song, Hee Sun Shin; Journal of Korean Academy of Nursing 2001;31(4):703-711. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.4.703

Abstract PDF

PURPOSE: The purpose of this study was to examine the effects of sensory stimulation on premature infants.
METHOD
Thirty three premature infants admitted to NICU of D University Hospital in C city were randomly assigned in two groups (Experimental group: 16, Control group:17). For the experimental group, tactile and kinesthetic stimulation developed by Dr. Field was applied 2 times a day for 10 days. Behavioral state was measured using the Anderson Behavioral State Scale (ABSS). Heart rate, respiration, and oxygen saturation were obtained for each infant before and after sensory stimulation. Hypothesis testing was done using the X2- test, student t-test, and repeated measures of ANOVA.
Result
Hypothesis 1: There was a significant difference in the daily body weight gain between experimental and control group (F= 40.77, p= .0001). Hypothesis 2: There was a significant difference in the frequency of 'inactive awake state' between two groups (X2= 39.778, p= .001). Hypothesis 3: There were significant differences in the mean of heart rate and O2 saturation between two groups (t= -2.174, p= .037; t= 3.080, p= .005). However, there was no significant difference in the mean of respiration rate between two groups (t= -1.966, p= .581).
CONCLUSION
The effectiveness of a sensory stimulation on weight gain and behavioral state in premature infants was supported. Further study is recommended to develop a sensory stimulation method as an independent nursing intervention for premature infant.

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Effects of Neonatal Massage on Newborn's Weight & Height, and Mothering Role Confidence and Satisfaction
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JOURNAL OF THE KOREAN SOCIETY OF MATERNAL AND CHILD HEALTH.2014; 18(2): 218. CrossRef
Effects of Hearing Recorded Mother's Voice on Physiological Reactions and Behavioral State of Sleep, Weight of Very Low Birth Weight Infants.
Mi Hyang Choi, In Soon Kang, Young Hae Kim
Child Health Nursing Research.2014; 20(3): 185. CrossRef
Effects of Infant Massage on Physical Growth and Stress Response in Preterm Babies
Namyoun Cheung, Youngshin Song
Journal of Korean Academy of Child Health Nursing.2009; 15(1): 71. CrossRef
Development and Evaluation of an e-Learning Program for Mothers of Premature Infants
Nae-Young Lee, Young-Hae Kim
Journal of Korean Academy of Nursing.2008; 38(1): 152. CrossRef

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A Grounded Theory Approach to the Comfort Experience of Hospitalized Patients: Kyung Hee Kim, Keum Soon Kim, Kyu Sook Kang, Hyun Sook Kang, Won Ock Kim, Hoon Jung Paik, Jong Soon Won, Nan Young Lim, Ihn Sook Jeong, Hye Jin Kwon; Journal of Korean Academy of Nursing 2000;30(3):750-763. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.3.750

Abstract PDF

This study is based on grounded theory methodology by Strauss & Corbin(1998). Ten hospitalized subjects were interviewed for data collection. In the process of data analysis, 'acceptance' is found to be the causal condition, while 'health professionals' skillfulness', 'ward environment', 'history of hospitalization', and 'general conditions' were identified as context, 'felling of relief' as the core phenomenon, 'self-efficacy', 'support of others', and 'life style' as the intermediate situation, 'passive reaction', 'alternative reaction' and 'active reaction' as the strategy and 'stabilization', 'satisfaction', 'hope' and 'carrying out' as consequences. 'Feeling of relief' is found to go through the three stages of recognition-generation-maintenance after the five different patterns. 1) In case the health professionals are skillful, the ward environment is favorable, the general conditions of the patients improved and as a result the feeling of relief is strong, during the first hospitalization, the self-efficacy of the subjects tends to be strong. They proceed toward the goal set for themselves with a renewed hope and active or alternative reaction toward the feeling of relief. 2) The subjects tend to proceed toward the goal set for themselves with a renewed hope and active and alternative reaction toward the feeling of relief in case health professionals are skillful, the ward environment is favorable the general conditions of the subjects improved, self-efficacy is strong, and lifestyle is autonomous, during the second hospitalization even though support of others is merely superficial. 3) The subjects tend to stabilize, and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are skillful and the ward environment is favorable but the general conditions worsened and accordingly the feeling of relief, is weak and life style is dependent during the second hospitalization although the subjects' self-efficacy is strong and support of others is specific. 4) The subjects tend to stabilize and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are unskillful the ward environment is unfavorable, the general conditions improved, support of others is specific but life style is dependent and self-efficacy is weak during the first hospitalization. 5) The subjects tend to stabilize and satisfy themselves with the given situation in case health professionals are unskillful the ward environment is unfavorable but the general conditions improved support of others is specific and as a result self-efficacy is strong but life style is dependent.

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Nesrin Nural, Semiha Alkan
Holistic Nursing Practice.2018; 32(1): 35. CrossRef
Comfort and Quality of Life of Cancer Patients
Keum-Soon Kim, So-Hi Kwon
Asian Nursing Research.2007; 1(2): 125. CrossRef

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Elderly Sleep Pattern and Disturbing Factors Before and After Hospitalization: Mi Young Kim, Sung Hee Cho, Sang Mi Lee, Su Jung Jung, Kyung Sook Park; Journal of Korean Academy of Nursing 1999;29(1):61-71. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.1.61

Abstract PDF

Sleep is a necessity for survival, Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of 60 and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparison between before and after admission of their sleep pattern, "sleep onset" tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics : 37.5%), physiological factor(snoring : 59.4%) environmental factor(pillow : 78.1%), emotional factor(anxiety related to disease : 37.5%), and illness factor(fatigue : 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop intervention strategies to promote sleep and to prevent sleep problems.

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Hyo-Yoel Jang, Tae-Im Kim
Journal of the Korean Data and Information Science Society.2016; 27(3): 773. CrossRef
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Mi-Ryon Lee, Mun-Hee Nam
Journal of Korean Clinical Health Science.2014; 2(3): 176. CrossRef
Factors Influencing Sleep of Elderly Women
Sohyune R. Sok, Jin Yi Choi
Journal of Korean Academy of Nursing.2010; 40(1): 119. CrossRef
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Journal of Korean Academy of Nursing.2008; 38(4): 582. CrossRef

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A Comparison of Hospitals Nursing Practice in Korea and the U.S. as Experienced by Korean Nurses: Myung Sun Yi; Journal of Korean Academy of Nursing 1998;28(1):60-69. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.60

Abstract PDF

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.

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Kumsook Seo, Miyoung Kim
Journal of Korean Academy of Nursing.2016; 46(2): 238. CrossRef
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Young Im Kim, Hyo Geun Geun
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Factors Related to Nurse Staffing Levels in Tertiary and General Hospitals: Yun Mi Kim, Kyung Ja June, Sung Hyun Cho; Journal of Korean Academy of Nursing 2005;35(8):1493-1499. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.8.1493

Abstract PDF

Background

Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services.

Purpose

To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics.

Methods

A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals.

Results

None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing.

Conclusions

The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

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Bohyun Park, Sukyung Seo, Taejin Lee
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Sung‐Hyun Cho, Kyung Ja June, Yun Mi Kim, Yong Ae Cho, Cheong Suk Yoo, Sung‐Cheol Yun, Young Hee Sung
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Nurse Staffing and Patient Mortality in Intensive Care Units
Sung-Hyun Cho, Jeong Hae Hwang, Jaiyong Kim
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Working Conditions in Home Health Care Nursing: A Survey of Home Care Nurses in Hospitals in Korea: Hosihn Ryu, Heasook Jo, Yoonok Kim, Youngmi Yoon, Jongrae Song, Ji Young Lim, Soonyong Khim, In A Kim; Journal of Korean Academy of Nursing 2005;35(7):1229-1237. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.7.1229

Abstract PDF

Purpose

The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals.

Methods

The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of 71.8%.

Results

(a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid penalties (65.9%). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain (61.5%), lower back pain (54.1%), knee pain (39.4%), and gastrointestinal problems (33.0%).

Conclusion

These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.

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A Comparative Study of how Subjects' Characteristics and Nursing Service Quality Influence on Hospital Revisiting Intent between Patients and Nurses: Mi Aie Lee; Journal of Korean Academy of Nursing 2005;35(7):1210-1220. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.7.1210

Abstract PDF

Purpose

This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses.

Methods

The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea. For data analysis, the SPSS/PC program was used.

Results

The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at 3.6%. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at 3.3%. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at 17.8% and 2 factors explain it at 16.5%; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at 15.3% and 3 factors explain it at 12.2%.

Conclusions

There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.

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Eun Jeong Hwang, In Ok Sim
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The Differences in Quality Perceptions, Expectations, Evaluation, and Satisfaction for Nursing Service between Patients and Nurses: Small-medium Sized General Hospitals: Jeong Hee Kim, In Sook Lee; Journal of Korean Academy of Nursing 2004;34(7):1243-1254. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1243

Abstract PDF

Purpose

This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds.

Method

The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale.

Result

There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was ‘the responsiveness’, and in the perceived performance, the highest was the ‘assurance’. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction.

Conclusion

To improve the nursing service quality at small-medium hospitals, strengthening the ‘assurance’ factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.

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Sherry Y. Chen, Boren You
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Eun Jeong Hwang, In Ok Sim
Journal of Korean Academy of Nursing.2016; 46(1): 118. CrossRef
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Hae Sagong, Ga Eon Lee
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Journal of Korean Academy of Nursing Administration.2015; 21(5): 469. CrossRef
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The Development of a Program Promoting the Adjustment and its Effectiveness for School aged Children's Hospital Life: Jina Oh; Journal of Korean Academy of Nursing 2004;34(3):525-533. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.3.525

Abstract PDF

Purpose

The purpose of this study was to develop a program promoting adjustment to hospital life and determining its effectiveness for school aged children.

Method

The sample group consisted of 76 hospitalized children in 2 University Hospitals located in Busan. The experimental group was given the program on admission and feedback was obtained on the 3rd day and again 24 hours later. Data was analyzed using t-test and ANOVA in the SPSS program package.

Result

There were significant differences, in information(t=4.235, p=0.000) and coping effort criteria (t=2.922, p=0.005) between the experimental and control groups. There was a non-significant difference in attitude criteria between the two groups(t=1.009, p=0.316).

Conclusion

It was found that the adjustment promoting program for hospital life for school aged children was effective, but not enough to promote self-esteem. The program, based on a learning theory, was improved and shown to be an effective and strong method to promote adjustment of school-aged children.

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Soyoun Yim
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Effect of the Exchange of Saline Used in Surgical Procedures on Surgical Site Infection: Ok Yeon Cho, Hae Sang Yoon; Journal of Korean Academy of Nursing 2004;34(3):467-476. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.3.467

Abstract PDF

Purpose

The purpose of this study was to identify the effect of the exchange of saline used in surgical procedures on surgical site infections.

METHOD

Patients with stomach cancer were assigned to the experimental group or to the control group by random sampling, respectively. The experimental group received an exchange of saline during the operation right after the excision of the stomach in a gastrectomy but the control group did not. Data were collected from the medical charts of 34 patients from Dec. 1, 2002 through May 31, 2003.

RESULT

The surgical site infection rate of the experimental group was 5.9% while surgical site infection rate of the control group was 17.6%. In total, the surgical site infection rate was 11.8%. The experimental group maintained a normal level of WBC on post operative day 3; however, the control group, showed an increase of WBC on post operative day 3.

Conclusion

The exchange of saline used in an operation immediately after the excision of the stomach in a gastrectomy decreases the contamination level of saline used in the operation, and can prevent surgical patients from a surgical site infection.

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Eun Mi Ham, Sul Hee Lee
Journal of Surgical Research.2017; 214: 176. CrossRef
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A Study of the Nursing Service Quality and Gap Perceived by Consumers: Mi Aie Lee; Journal of Korean Academy of Nursing 2004;34(2):225-234. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.2.225

Abstract PDF

Purpose

The purpose of this study was to develop a tool that measures the quality of nursing service, to measure the quality of nursing service perceived by consumers, and to identify the gaps between ideal and actual nursing services.

Method

A questionnaire was developed and distributed to 300 people who had been hospitalized in one of six general hospitals with quality of nursing services in five provincial cities in Korea. For data analysis, the SPSS/WIN(ver 10.0) program was used.

Result

The 20 attributes included in the instrument of quality of nursing service is abstracted into 2 factors : tangibility and intangibility. In quality analysis, 15 of 20 attributes are minus scores, meaning that those nursing services are perceived as generally low. However among the minus scores' attributes, only two attributes are significant statistically. Gaps between importance and performance of the nursing service exists in 19 among 20 attributes.

Conclusion

Nursing service quality (performance-expectation) needs to be improved, and Gaps (importance-performance) reduced. In addition, a tool measuring nursing service quality has to be developed so nurses can deal successfully with the quality and gaps of nursing service perceived by consumers.

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Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals
Hae Sagong, Ga Eon Lee
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Hye Young Joung, Do Hwa Byeon
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The Study for Development of Day Hospital Program of Eating Disorders: Seong Sook Kong; Journal of Korean Academy of Nursing 2004;34(1):25-34. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.1.25

Abstract PDF

Purpose

The purpose of this study was to develop the day hospital program for Korean eating disorders patients and to examine the effect of the day hospital program on improving frequency of binging and purging, eating disorders symptoms, self-esteem, and depression.

Method

The subjects were 24 binge eaters visited at eating disorders clinic “M”. They participated in a modified day hospital program based on the Toronto Day Hospital Program. All subjects completed the Eating Disorders Inventory(EDI)-2, Rosenberg Self-Eesteem Scale, Beck Depression Inventory(BDI) at pre and post intervention, and recorded daily food records.

Result

In paired t-test analysis, frequency of binging and purging, self-esteem, depression, and 11 sub-scales of EDI-2(drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness, perfectionism, interpersonal distrust, maturity fear, asceticism, impulse regulation, social insecurity) were significantly improved after treatment.

Conclusion

The results of this study suggest that the day hospital program for Korean eating disorders patients may be an effective initial approach to overcoming various eating disorders symptoms. Further studies should investigate longer term outcome data using a larger sample.

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A Study of the Nursing Service Perceived by Consumers and Providers, and the Tool that Measures Nursing Service: Mi Aie Lee; Journal of Korean Academy of Nursing 2003;33(6):772-783. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.6.772

Abstract PDF

Purpose

This study was performed to measure the nursing service perceived value by consumer and providers, and to investigate the relationship among nursing service, general satisfaction and hospital revisiting intent, and to examinate the tools that measures nursing service's reliability, construct validity and usefulness.

Method

The questionnaire was developed and distributed to 300 patients and 210 nurses at three general hospitals. For data analysis, SPSS/PC program was used.

Result

The nursing service perceived value by providers is higher than that by consumers. There are distinctive difference in the expectation, and importance and performance values of the nursing service perceived. In examination of the relationship among nursing service, general satisfaction and hospital revisiting intent, nursing service has a deep relationship with general satisfaction, but doesn't have relationship with hospital revisiting intent. The tool that measures nursing service has a good reliability and construct validity. In analysis on the usefulness between the tools, SERVPERF tool is more useful than SERVQUAL tool.

Conclusion

The nursing service perceived value by consumer is different that by providers, and the tool that measures nursing service has a good reliability and construct validity. The SERVPERF tool is more useful than SERVQUAL tool.

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Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications: Yunmi Kim, Sunju You, Jinhyun Kim; J Korean Acad Nurs 2017;47(6):828-841. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.6.828

Abstract PDF

Abstract Purpose

This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014.

Methods

Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression.

Results

An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870).

Conclusion

To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.

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Effects on Stress, Problem Solving Ability and Quality of Life of as a Stress Management Program for Hospitalized Schizophrenic Patients: Based on the Stress, Appraisal-Coping Model of Lazarus & Folkman: Sun Ah Park, Kyung Mi Sung; J Korean Acad Nurs 2016;46(4):583-597. Published online August 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.4.583

Abstract PDF

Purpose

The study was done to evaluate the effects a Stress Management Program (SMP) on stress, problem solving skills, and quality of life for hospitalized patients with Schizophrenia.

Methods

A mixed method design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 40 patients with schizophrenia admitted in three psychiatric hospitals. The experimental group (n=20) received the SMP twice a week for a total of 8 weeks.

Results

Study results revealed that the SMP was effective for stress (F=321.02, p<.001), problem solving ability (F=246.28, p<.001), and quality of life (F=63.35,p<.001) for hospitalized persons with schizophrenia.

Conclusion

The results suggest that a SMP can be an effective strategy to reduce patients' hospitalization stress, and improve problem solving skills and quality of life. Therefore, it is recommended that mental health nurses use this stress management program in clinical practice to assist adaptation to hospitalization for persons with schizophrenia.

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A Study on the Classification of Nursing Management Competencies and Development of related Behavioral Indicators in Hospitals: Seong Yeol Kim, Jong Kyung Kim; J Korean Acad Nurs 2016;46(3):375-389. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.375

Abstract PDF

Purpose

The aim of this study was to classify nursing management competencies and develop behavioral indicators for nurse managers in hospitals. Also, levels of importance and performance based on developed criteria were to be identified and compared.

Methods

Using expert survey we classified nursing management competencies and behavioral indicators with data from 34 nurse managers and professors. Subsequently, data from a survey of 216 nurse managers in 7 cities was used to analyze the importance-performance comparison of the classified nursing management competencies and behavioral indicators.

Results

Forty-two nursing management competencies were identified together with 181 behavioral indicators. The mean score for importance of nursing management competency was higher than the mean score for performance. According to the importance-performance analysis, 5 of the 42 nursing management competencies require further development: vision-building, analysis, change management, human resource development, and self-management competency.

Conclusion

The classification of nursing management competencies and behavioral indicators for nurse managers in hospitals provides basic data for the development and evaluation of programs designed to increase the competency of nurse managers in hospitals

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Structural Equation Modeling for Public Hospital Quality of Care, Image, Role Performance, Satisfaction, Intent to (Re)visit, and Intent to Recommend Hospital as Perceived by Community Residents: Eun Jeong Hwang, In Ok Sim; J Korean Acad Nurs 2016;46(1):118-127. Published online February 29, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.1.118

Abstract PDF

Purpose

The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital.

Methods

A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0.

Results

Model fit indices for the hypothetical model were suitable for the recommended level: χ²=796.40 (df=79, p <.001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors.

Conclusion

Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

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Operating Room Nurses' Experiences of Securing for Patient Safety: Kwang-Ok Park, Jong Kyung Kim, Myoung-Sook Kim; J Korean Acad Nurs 2015;45(5):761-772. Published online October 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.5.761

Abstract PDF

Purpose

This study was done to evaluate the experience of securing patient safety in hospital operating rooms.

Methods

Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology.

Results

The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'.

Conclusion

The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

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Analysis of Mission Statements and Organizational Performance of Hospitals in South Korea: Eun-Kyung Kim, Se Young Kim, Eunpyo Lee; J Korean Acad Nurs 2015;45(4):565-575. Published online August 31, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.4.565

Abstract PDF

Purpose

The purpose of the study was to examine mission statements and their elements and to investigate correlations between mission statements and organizational performance.

Methods

The current research was a descriptive study based on the examination of mission statements of 353 hospitals that posted mission statements on their webpage and 92 hospitals that made their income statements public.

Results

The most common mission element was 'identification of principal services', which accounted for 92.6%. Mission statements of hospitals included the average of 4.82 mission elements out of 9, and the objective of medical quality improvement was 0.81 among 6 objectives of IOM (Institute of Medicine). Net profit of hospitals with mission statements that have above average number of mission elements were significantly higher (t=2.71, p =.008) than those of other hospitals. Net profit was significantly correlated with mission statements (r=.26, p <.001), and mission elements (r=.29, p <.001).

Conclusion

The results of the study empirically reveal that mission statements in the hospital affect organizational performance. That is, better organizational performance is shown for hospitals with better, more diversified, and more firmly stated mission statements which include identification of target customers, identification of principal services, contribution to society as a non-profit organization, and concern for employees.

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Review Article

Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis: Yoon Lee Kim, Seok Hee Jeong; J Korean Acad Nurs 2015;45(4):469-482. Published online August 31, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.4.469

Abstract PDF

Purpose

The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients.

Methods

From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g.

Results

Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p <.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p =.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p <.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p <.001) showed the largest effect size among outcome variables.

Conclusion

Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

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Original Articles

Development and Application of a Performance Prediction Model for Home Care Nursing Based on a Balanced Scorecard using the Bayesian Belief Network: Wonjung Noh, GyeongAe Seomun; J Korean Acad Nurs 2015;45(3):429-438. Published online June 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.3.429

Abstract PDF

Purpose

This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN).

Methods

This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0.

Results

We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit.

Conclusion

KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.

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Predictors of Hospitalization for Alcohol Use Disorder in Korean Men: Hae-Sook Hong, Jeong-Eun Park, Wan-Ju Park; J Korean Acad Nurs 2014;44(5):552-562. Published online October 31, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.5.552

Abstract PDF

Purpose

This study was done to identify the patterns and significant predictors influencing hospitalization of Korean men for alcohol use disorder.

Methods

A descriptive study design was utilized. Data were collected using self-report questionnaires from 143 inpatients who met the DSM-5 alcohol use disorder criteria and were receiving treatment and 157 social drinkers living in the community. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Alcohol Problems, Alcohol Expectancy Questionnaire (AEQ), Life Position, and The Korean version of the Children of Alcoholics Screening Test (CAST-K). Data were analyzed using descriptive statistics, t-test, χ²-test, F-test, Pearson correlation coefficients, and logistic regression with forward stepwise.

Results

AUDIT had significant correlations with alcohol problems, alcohol expectancy, and parents' alcoholism. In logistic regression, factors significantly affecting hospitalization were divorced (OR=4.18, 95% CI: 1.28-13.71), graduation from elementary school (OR=28.50, 95% CI: 8.07-100.69), middle school (OR=6.66, 95% CI: 2.21-20.09), high school (OR=6.31, 95% CI: 2.59-15.36), drinking alone (OR=9.07, 95% CI: 1.78-46.17), family history of alcoholism (OR=2.41, 95% CI: 1.11-5.25), interpersonal relationship problems (OR=1.28, 95% CI:1.17-1.41), and sexual enhancement of alcohol expectancy (OR=0.83, 95% CI: 0.72-0.94), which accounted for 53% of the variance.

Conclusion

Results suggest that interpersonal relationship programs and customized cognitive programs for social drinkers in the community are needed to decreased alcohol related hospitalization in Korean men.

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Mi Nam Bae, Mihyoung Lee, Sihyun Park, Eun Jin Lee
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Hee Jung Son, Won Kee Lee, Young Shin Park, Hae Sook Hong
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Association between Efficiency and Quality of Health Care in South Korea Long-term Care Hospitals: Using the Data Envelopment Analysis and Matrix Analysis: Minsung Sohn, Mankyu Choi; J Korean Acad Nurs 2014;44(4):418-427. Published online August 29, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.4.418

Abstract PDF

Purpose

Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time.

Methods

Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors.

Results

First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency.

Conclusion

It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

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Development of a Measurement of Stress for Hospitalized Schizophrenic Patient: Sun Ah Park, Kyung Mi Sung; J Korean Acad Nurs 2014;44(3):339-349. Published online June 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.3.339

Abstract PDF

Purpose

This study was done to develop a measurement for stress experienced by patients with schizophrenia during hospitalization.

Methods

The preliminary tool was developed through in-depth interviews and a validity verification test of content. For data collection, 15 inpatients with schizophrenia were selected as participants for in-depth interviews and 195 patients admitted to one of eight psychiatric hospitals in four provinces were recruited as participants to test reliability and validity of the preliminary tool.

Results

The questionnaire was developed as a four-point Likert-type scale in a self-report form with 28 items. Factor analysis showed 28 items in six factors. Factors were named 'Unjust human rights infringement', 'Futureless life', 'Alienation from other family members', 'Infringement of basic needs', 'Infringement of personal preference' and 'Inconvenience of shared living'. The six factors explained 63.5% of the total variance. Cronbach's alpha for the total items was .93 and for the factors ranged from .65 to .87.

Conclusion

A tool to measure stress in patients hospitalized with schizophrenic was developed based on identified hospitalization stress experiences. Study results indicate that this tool can be used to evaluate hospitalization stress in these patients and will contribute to establishing nursing interventions for relief of hospitalization stress.

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Validation of a Modified Early Warning Score to Predict ICU Transfer for Patients with Severe Sepsis or Septic Shock on General Wards: Ju Ry Lee, Hye Ran Choi; J Korean Acad Nurs 2014;44(2):219-227. Published online April 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.2.219

Abstract PDF

Purpose

To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards.

Methods

A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program.

Results

Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer.

Conclusion

MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

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Girum Tesfaye Kiya, Zeleke Mekonnen, Elsah Tegene Asefa, Edosa Kejela, Edosa Tadasa, Esayas Kebede Gudina, Tilahun Yemane, Gemeda Abebe
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Nurses' Experience of Incivility in General Hospitals: Se Young Kim, Kwang-Ok Park, Jong Kyung Kim; J Korean Acad Nurs 2013;43(4):453-467. Published online August 30, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.4.453

Abstract PDF

Purpose

This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment.

Methods

Data were collected through in-depth interviews and analyzed using Colaizzi' phenomenological analysis methodology. Participants were seven experienced clinical nurses working on a general ward (2 nurses), or in an intensive care unit (2 nurses), emergency room (2 nurses), or operating room (1 nurse).

Results

The incivility that nurses experienced was categorized as follows: 'being afflicted as a weak person', 'being treated as less than a professional', 'being overwhelmed by shock and anger', 'experiencing an untenable situation', 'struggling to survive', and 'pursuing professional growth'.

Conclusion

Behavior guidelines should be developed to reduce incivility, and incivility cases should be continuously monitored by the nursing department. Also, to handle incivility problems in clinical nursing areas, a reporting and counseling system and education programs are needed.

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Structure of Nurse Labor Market and Determinants of Hospital Nurse Staffing Levels: Bohyun Park, Sukyung Seo, Taejin Lee; J Korean Acad Nurs 2013;43(1):39-49. Published online February 28, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.1.39

Abstract PDF

Purpose

To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing.

Methods

Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions.

Results

For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable.

Conclusion

The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

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A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance: Sungjae Kim, Jinhyun Kim; J Korean Acad Nurs 2012;42(3):351-360. Published online June 29, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.3.351

Abstract PDF

Purpose

The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy.

Methods

A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance.

Results

The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades.

Conclusion

Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

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Changes in Nursing Grades and Nurse Staffing Levels following the 2024 Revision of Nursing Management Fee Standards: A Focus on Tertiary Hospitals and Medical Institutions in Seoul
Hyeyoung Choi, Kiyoung Kim, Su-Jin Cho, Suyong Jeong
Health Insurance Review & Assessment Service Research.2025; 5(1): 58. CrossRef
Impact evaluation of nurse staffing policy reform in Korea: A quasi‐experimental study
Jinseon Yi, Jinhyun Kim
Journal of Nursing Management.2022; 30(7): 3457. CrossRef
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Sujin Shin, Jong Duck Park, Juh Hyun Shin
Asian Nursing Research.2020; 14(2): 57. CrossRef
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Yu Kyung Ko, Bo-Hyun Park
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Study on Factors Associated with the Rise in Grade of Nursing Management Fee among Korean Hospitals
Hyun-Min Choi, Nam-Kyung Han, Sang-Kyu Lee, Han-Sung Kim, Sungkyoung Choi, Woojin Chung
Health Policy and Management.2015; 25(1): 40. CrossRef
Financial Projection of the Nursing Fee Differentiation Policy Improvement Proposal in the National Health Insurance: Using a Break-even Analysis Model for the Optimal Nursing Fee
Sungjae Kim, Jinhyun Kim
Journal of Korean Academy of Nursing Administration.2013; 19(5): 565. CrossRef

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

Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

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Neonatal seizures and white matter injury: Role of rotavirus infection and probiotics
Jung Sook Yeom, Ji Sook Park, Young-Soo Kim, Rock Bum Kim, Dae-Sup Choi, Ju-Young Chung, Tae-Hee Han, Ji-Hyun Seo, Eun Sil Park, Jae-Young Lim, Hyang-Ok Woo, Hee-Shang Youn, Chan-Hoo Park
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Hospital Workers' Experience with Hospital Evaluation Program: A Focus Group Study: Myungsun Yi, Ji Hyeon Oh, Hye Min Hwang, Eun Jin Kwon, Jeong-hee Lee, Eun Young Park; J Korean Acad Nurs 2011;41(4):568-579. Published online August 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.4.568

Abstract PDF

Purpose

The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009.

Methods

During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.

Results

Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility.

Conclusion

The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.

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