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Original Articles
Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis
Chan Sook Park, Eun-Jun Park
J Korean Acad Nurs 2019;49(5):538-549.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.5.538
AbstractAbstract PDF
Abstract Purpose

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

Methods

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

Results

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

Conclusion

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

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Changes in Nutritional Status of General Medical Patients During Hospitalization
Young Hee Yang, S Mi Choi-Kwon, Eun Kyung Kim
Journal of Nurses Academic Society 1997;27(1):49-60.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.49
AbstractAbstract PDF

The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular, renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment ; patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of day of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements, including weight, body mass index, lean body mass, body fat, and skin fold thickness, were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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Development of An Instrument to Measure Hope for the Cancer Patients
Dal Sook Kim, So Woo Lee
Journal of Korean Academy of Nursing 1998;28(2):441-456.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.441
AbstractAbstract PDF

The purpose of this study was to develop a reliable and valid instrument to measure hope for cancer patients in Korea. This Hope Scale(Kim and Lee Hope Scale : KLHS) was developed based on not only critical universal attributes explaining both basic hope (generalized hope) and specific hope but also particular characteristics varying from culture and situation, which were revealed in a comprehensive review of the literature. Initially 60 items were generated from three sources : 36 items from the Q-sample used in the Kim's study, 1992, 21 representative items(statements) from the rest Q-population of the above study, 3 items related to the newly discovered category in the new qualitative study using 10 open ended question(death and dying) from the new qualitative study on the 20 cancer patients. At first 3 items were eliminated by the critique of the content validity experts, who were high experienced nurse, nursing professors. And then 4 items were eliminated in consideration of corrected item total correlation coefficiency, theoretical framework of this study. After that, 14 items were eliminated in comparing two or three items identified with the same meaning in each factor by this research team with factor loading and communality. This Hope Scale was finally constructed with 39 items. Psychometric evaluation was done on 492 adults(104 cancer patients, 338 adults who imagined who were cancer patients ranging from 18 to 76 years old. The results revealed high internal consistency Alpha coefficiency of .9351. Principal Component Factor Analysis with Varimax Rotation resulted in 8 factors with more than 1.0 of Eigenvalue. Referring to Eigenvalues percent of variances(>60%), reproduced correlation matrix, and our theoretical framework, we decided the eight factors were the best solution to represent hope dimension sufficiently. The eight factors were "confidence in possibility of cure", "sense of internal satisfaction", "being in communion", "meaning of life", "Korean hope perspectives", "belief in god", "self confidence", "self-worth". Among these factors, "confidence in possibility of cure", "sense of internal satisfaction", "Korean hope dimensions from those of Nowotny Hope Scale and Herth Hope Scale. There was significant negative correlation of r=-.4736 between this hope scale and Beck Hopelessness Scale(BHS), and significant positive correlation of r=.3685 between this hope scale and Life Orientation Test(LOT) which indicate convergent and discriminant validity. The range of hope scores was from 71 to 244, with a mean of 171.97(SD=28.16).

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Measurement Issues across Different Cultures
Ju Hee Lee, Duk Yoo Jung
Journal of Korean Academy of Nursing 2006;36(8):1295-1300.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.8.1295
AbstractAbstract PDF
Purpose

The purposes of this methodologic paper are to (1) describe theoretical background in conducting research across different cultures; (2) address measurement issues related to instrument administration; and (3) provide strategies to deal with measurement issues.

Methods

A thorough review of the literature was conducted. A theoretical background is provided, and examples of administering instrument in studies are described.

Results

When applying an instrument to different cultures, both equivalence and bias need to be established. Three levels of equivalence, i.e., construct equivalence, measurement unit equivalence, and full score comparability, need to be explained to maintain the same concept being measured. In this paper, sources of bias in construct, method, and item are discussed. Issues related to instrument administration in a cross-cultural study are described.

Conclusion

Researchers need to acknowledge various group differences in concept and/or language that include a specific set of symbols and norms. There is a need to question the philosophical and conceptual appropriateness of an assessment measure that has been conceptualized and operationalized in a different culture. Additionally, testing different response formats such as narrowing response range can be considered to reduce bias.

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Development of a Tool in Measuring Yangsaeng
Ae Jung Kim
Journal of Korean Academy of Nursing 2004;34(5):729-738.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.5.729
AbstractAbstract PDF
Purpose

‘Yangsaeng’ is a traditional healthcare regimen for the promotion of health and prevention of illnesses by means of specific principles and methods for the purpose of living a long and healthy life. The purpose of this paper was to develop a tool in measuring Yangsaeng and to verify its reliability and validity.

Method

Content validity was conducted three times by 8 experts. Factor analysis was conducted to test its construct validity.

Result

Thirty-one items were selected in 8 factors; Morality Yangsaeng, Mind Yangsaeng, Diet Yangsaeng, Activity & rest Yangsaeng, Exercise Yangsaeng, Seasonal Yangsaeng, Sleep Yangsaeng and Sex life Yangsaeng. The explanatory variance is 61.76%. Cronbach's alpha of the final tool is .89 and that of each factor is .68~.82. The analysis of the items shows that the item-total correlation is .40 or higher. Criterion-related validity was verified with the CMCHS V1.0 and the KoHSME V1.0.

Conclusion

Since the tool developed in this study was verified in terms of its reliability and validity, it could be utilized as a tool for evaluating the extent of Yangsaeng.

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A Comparison on the Degree of Pain according to Methods of Blood Sugar Test between DM Patients and Healthy Group
Ja Yun Choi
Journal of Korean Academy of Nursing 2003;33(7):928-935.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.928
AbstractAbstract PDF
Purpose

This study attempts to compare the degree of pain when different methods of blood sugar test are used between a DM patient group and a healthy group.

Method

A sample is composed of 56 DM patients and 57 their family who are admitted in a ward of C university hospital in Gwangju. Data were collected from July, 2001 to December, 2001. The blood sugar tests are administered four different ways. The degree of pain is measured twice with a visual analog scale in a week interval.

Result

The differences in the degree of pain according to methods of blood sugar test were not found between the DM patient group and the healthy group in both measures. The only use of a 27G needle method was shown to cause highest level of pain in comparison with the rest of methods in the first measure of the DM patient group and in both the measures of the healthy group.

Conclusion

The study results indicate that the method using lanceter is more recommendable than method of using a 27G needle. Furthermore, the ice therapy and EMLA cream is likely to be more effective on the pain relief in the healthy group than the DM patient group.

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Multiple Factors in the Second Trimester of Pregnancy on Preterm Labor Symptoms and Preterm Birth
Jeung-Im Kim, Mi-Ock Cho, Gyu-Yeon Choi
J Korean Acad Nurs 2017;47(3):357-366.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.357
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB).

Methods

This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB.

Results

Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m2) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05).

Conclusion

The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.

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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
AbstractAbstract 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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Development of the Program Evaluation Measurement of Continuing Nursing Education Programs
Mi Young Jho, Miyoung Kim
J Korean Acad Nurs 2013;43(2):236-246.   Published online April 30, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.2.236
AbstractAbstract PDF
Purpose

This study was done to develop a measurement tool for evaluation of continuing nursing education programs and to verify its validity for effective management and quality of education programs.

Methods

The draft of the evaluation measurement was developed from consultation with professionals, focus group interviews targeting groups of nurses, and individual interviews with education program planners. After 6 professionals examined content validity, 46 items were retained. A pilot-survey was conducted to confirm the time required to complete the questionnaire and the level of understanding of general content and each item in the questionnaire. Construct validity was verified through exploratory factor analysis of data from a survey with 44 items completed by 452 nurses and 59 education program planners.

Results

The final evaluation measurement for continuing nursing education programs consisted of 6 evaluation factors and 36 evaluation items. The 6 evaluation factors included identifying program goals and target groups, program planning, performance, operation and management, program outcomes, and program effectiveness.

Conclusion

The evaluation measurement for continuing nursing education programs developed in this study is considered suitable to utilize as an evaluation measurement of the quality of continuing education programs for nurses.

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Measurement Properties of Self-report Questionnaires Published in Korean Nursing Journals
Eun-Hyun Lee, Chun-Ja Kim, Eun Jung Kim, Hyun-Ju Chae, Soo-Yeon Cho
J Korean Acad Nurs 2013;43(1):50-58.   Published online February 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.1.50
AbstractAbstract PDFSupplementary Material
Purpose

The purpose of this study was to evaluate measurement properties of self-report questionnaires for studies published in Korean nursing journals.

Methods

Of 424 Korean nursing articles initially identified, 168 articles met the inclusion criteria. The methodological quality of the measurements used in the studies and interpretability were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. It consists of items on internal consistency, reliability, measurement error, content validity, construct validity including structural validity, hypothesis testing, cross-cultural validity, and criterion validity, and responsiveness. For each item of the COSMIN checklist, measurement properties are rated on a four-point scale: excellent, good, fair, and poor. Each measurement property is scored with worst score counts.

Results

All articles used the classical test theory for measurement properties. Internal consistency (72.6%), construct validity (56.5%), and content validity (38.2%) were most frequently reported properties being rated as 'excellent' by COSMIN checklist, whereas other measurement properties were rarely reported.

Conclusion

A systematic review of measurement properties including interpretability of most instruments warrants further research and nursing-focused checklists assessing measurement properties should be developed to facilitate intervention outcomes across Korean studies.

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Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients
Eun-Mi Kwak, Heeyoung Oh
J Korean Acad Nurs 2012;42(1):76-84.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.76
AbstractAbstract PDF
Purpose

The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients.

Methods

A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated.

Results

The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t=-14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001).

Conclusion

Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

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Computerized Measurement for Asthma-Specific Quality of Life: Comparison with a Conventional Paper-and-Pencil Questionnaire
Eun-Hyun Lee
J Korean Acad Nurs 2009;39(6):781-787.   Published online December 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.6.781
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate a computerized touch-screen version of the asthma-specific quality-of-life (cA-QOL) questionnaire against the conventional paper-and-pencil version (pA-QOL) for equivalence, time for completion, user preference, and ease of use.

Methods

A total of 261 patients were recruited. A randomized cross-over design was used. Patients in group A completed the cA-QOL first while waiting to see a physician, and completed the pA-QOL version after seeing the physician. Patients allocated in group B completed these questionnaires in the reverse order. The patients were asked questions about user preference and ease of use of the cA-QOL. The time taken to complete both versions of the questionnaire was measured.

Results

Weighted kappa coefficients of all items showed almost perfect agreement. The time required to complete the pA-QOL is faster than the time for cA-QOL. The patients who preferred the cA-QOL were 37.5%, while those who preferred the pA-QOL were 29.9%. Most patients reported that the cA-QOL was "easy" or "very easy" to complete.

Conclusion

The cA-QOL is the computerized equivalent of the pA-QOL. The findings herein demonstrate that the cA-QOL can be helpful to nurses in busy practices for assessing, collecting, and evaluating their patients' health related quality of life.

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Development of a Stress Scale for Korean Nursing Students
Ji-Soo Yoo, Soo Jung Chang, Eun Kyoung Choi, Jee Won Park
J Korean Acad Nurs 2008;38(3):410-419.   Published online June 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.3.410
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a stress measurement scale for Korean nursing students.

Methods

Sixty preliminary items were selected by classifying 229 basic items extracted via literature review and Q-sorting method. In order to verify the reliability and validity of the preliminary instrument, data were collected from 617 nursing students in 2 colleges of nursing in Korea.

Results

As a result of the item analysis, 58 items were selected. They consisted of 2 types of stress which were college-based stress (38 items) and clinical-based stress (20 items). Ten factors in college-based stress and four factors in clinical-based stress were extracted by factor analysis, and each had a total variance of 63.01%, and 64.93%. Cronbach's Alpha of those 58 items were .937 in college-based stress and .922 in clinical-based stress, which was high.

Conclusion

This paper is meaningful in a way that it has developed a tool capable of measuring stress for nursing students, which reflects the characteristics of our country. It is recommended for further study to re-verify the relevance and stability of this measurement.

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Development of a Performance Measurement Scale for Hospital Nurses
Yu Kyung Ko, Tae Wha Lee, Ji Young Lim
Journal of Korean Academy of Nursing 2007;37(3):286-294.   Published online April 30, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.3.286
AbstractAbstract PDF
Purpose

The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale.

Methods

This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients.

Results

The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was .92.

Conclusion

The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a steping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.

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