Journal of Korean Academy of Nursing

Research Papers

Development of an end-of-life care competency scale for nurses in long-term care hospitals: a psychometric validation study: Sookyeon Son, Mi-Kyeong Jeon; J Korean Acad Nurs 2025;55(4):598-612. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25113

Abstract PDF ePub: Purpose
This study aimed to develop a scale to measure end-of-life care (EOLC) competency among nurses working in long-term care hospitals and to evaluate its validity and reliability.
Methods
Preliminary items were developed based on attributes and indicators identified through a conceptual analysis of EOLC competency. The initial version of the scale was refined through expert content validity assessment, item revision, and a pilot test. The main survey was conducted among 460 nurses in long-term care hospitals, and 409 valid responses were analyzed after excluding 51 incomplete or invalid cases. Data were analyzed using software-assisted item analysis, exploratory and confirmatory factor analyses, and assessments of convergent, discriminant, and criterion-related validity, as well as reliability testing.
Results
The initial 55 items were reduced to a final set of 30 items across seven dimensions. Model fit indices indicated good construct validity (χ²/degrees of freedom=1.91, standardized root mean square residual=.06, root mean square error of approximation=.07, Tucker-Lewis index=.90, comparative fit index=.91), with a total explained variance of 70.2%. The scale demonstrated strong criterion-related validity (r=.76, p<.001), high internal consistency (Cronbach’s α=.95; McDonald’s ω=.95), acceptable test–retest reliability (r=.56, p<.001), and an intraclass correlation coefficient of .72 (95% confidence interval, .51–.84; p<.001).
Conclusion
The developed scale is a valid and reliable instrument for assessing EOLC competency among nurses in long-term care hospitals. It can be effectively utilized for educational assessment, training evaluation, and the measurement of program effectiveness in end-of-life care.

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A qualitative exploration of acute stroke patients’ experiences with aphasia in Korea: Jiyeon Kang, Hyunyoung Heo; J Korean Acad Nurs 2025;55(4):621-633. Published online November 25, 2025; DOI: https://doi.org/10.4040/jkan.25132

Abstract PDF ePub: Purpose
This study aimed to explore the lived experiences of patients with acute stroke-related aphasia within the Korean healthcare context.
Methods
A qualitative research design using inductive content analysis was employed, following the Consolidated Criteria for Reporting Qualitative Research guidelines. Fourteen adults with acute stroke-related aphasia participated in one-on-one, in-depth interviews conducted between January and May 2025. Participants were recruited through purposive sampling until theoretical saturation was reached. Data were analyzed using an inductive qualitative content analysis approach.
Results
Five main categories emerged: “suddenly trapped in silence” described the abrupt loss of language, including the inability to articulate intended words and understand others; “emotional impact” captured psychological shock and feelings of loss; “communication crisis” encompassed expressive difficulties, exclusion from decision-making, and social withdrawal; “patient-centered interaction” highlighted supportive communication, empathic care, and active engagement by others; and “emerging hope” reflected signs of recovery, self-directed efforts, and anticipation of improvement. These categories converged into the overarching theme, “communication beyond language,” illustrating how patients sought meaningful interaction despite linguistic limitations.
Conclusion
Acute aphasia extends beyond a language disorder to encompass profound emotional and social experiences. Although communication barriers exist, meaningful interaction remains possible through empathetic, person-centered approaches. Healthcare professionals should recognize that patients with aphasia retain cognitive competence despite expressive limitations. These findings underscore the need to integrate emotional sensitivity into clinical care and to develop training programs that enhance person-centered communication skills in stroke rehabilitation settings.

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Development of a machine learning-based prediction model for early hospital readmission after kidney transplantation: a retrospective study: Hye Jin Chong, Ji-hyun Yeom; J Korean Acad Nurs 2025;55(4):528-542. Published online November 21, 2025; DOI: https://doi.org/10.4040/jkan.25030

Abstract PDF ePub: Purpose
This study aimed to develop and validate a machine learning-based prediction model for early hospital readmission (EHR) post-kidney transplantation.
Methods
The study was conducted at the organ transplantation center of a university hospital, utilizing data from 470 kidney transplant recipients. We built and trained four machine learning models and tested them to identify the strongest EHR predictors. Predictive performance was evaluated using confusion matrices and the area under the receiver operating characteristic curve (ROC AUC).
Results
Among the 470 kidney transplant recipients with a mean age of 46.1 ± 12.02 years, 322 (68.5%) were males, and 74 (15.7%) were readmitted within 30 days after kidney transplantation. In total, 241 (51.2%) recipients were found to have experienced EHR after applying the random over-sampling examples method. The random forest model achieved the best performance, with an ROC AUC of .87 (validation set) and .82 (test set). The 15 most important features were steroid pulse therapy (recipient), cerebrovascular accident (recipient), heart failure (recipient), male sex (donor), cardiovascular disease (recipient), weekend discharge (recipient), peritoneal dialysis (recipient) cerebrovascular accident as the cause of brain death (donor), current smoker (recipient), cardiac arrest (donor), previous kidney transplantation (recipient), age (donor), hypertension (donor), male sex (recipient), and dialysis duration (recipient).
Conclusion
Our framework demonstrated strong predictive interpretability. It can support appropriate and effective clinical decision-making by assisting transplant professionals in stratifying recipients based on their risk of EHR. prioritizing post-discharge care and follow-up for high-risk individuals, and allocating targeted interventions such as closer monitoring or education.

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Review Paper

A review of domestic and international contexts for establishing a communication platform for early-career nurse scientists: Jeung-Im Kim, Jin-Hee Park, Hye Young Kim, Mi Yu, Sun Joo Jang, Yeonsoo Jang, Sangeun Jun; J Korean Acad Nurs 2025;55(2):317-325. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.25041

Abstract PDF ePub: Purpose
As nursing continues to advance through digital health, clinical specialization, and interdisciplinary research, early-career nurse scientists are central to advancing innovation. However, Korea lacks a structured platform to support their research, collaboration, and career development. This review aimed to identify the needs of early-career nurse scientists and examine international best practices to guide the creation of an effective communication platform.
Methods
This study involved a secondary analysis of the final report from the project “Establishment of a communication platform for young nursing scientists,” carried out by the Korean Society of Nursing Science. The report comprises data from focus group interviews with domestic graduate students and early-career researchers, a literature review of international communication and support systems, and a global policy analysis related to young nursing scientists. Based on this report, the present review synthesizes key findings and draws implications for the development of a communication platform in Korea.
Results
International examples, such as grant writing programs, mentoring initiatives, and digital collaboration hubs, showed positive outcomes in strengthening research capacity and promoting the professional growth of nurse scientists. Based on these findings, key considerations for platform development include: (1) establishing clear leadership and a participatory governance model; (2) providing demand-driven content such as research guides, mentoring, and mental health resources; (3) implementing mechanisms to ensure sustainability, content quality, and user data protection; and (4) designing an integrated platform that fosters synergy across research, policy development, education, and global networking.
Conclusion
A digital platform for early-career nurse scientists should function not merely as an information portal, but also as dynamic infrastructure for collaboration, mentorship, and growth. It is recommended that the Korean Society of Nursing Science spearhead this initiative, with governmental support, to enhance the research capacity and expand the global engagement of Korean nursing scientists.

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Research Papers

Core domains for pre-registered nurses based on program outcomes and licensing competencies: Soyoung Yu, Hye Young Kim, Jeung-Im Kim, JuHee Lee, Ju-Eun Song, Hyang Yuol Lee; J Korean Acad Nurs 2025;55(2):249-268. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.25017

Abstract PDF ePub: Purpose
This study aimed to identify core domains for pre-registered nurses by comparing licensing competencies with program outcomes (POs) in undergraduate nursing education. This was accomplished in preparation for the transition of the Korean Nurse Licensing Examination (KNLE) from a tradition seven-subject format to a newly integrated, competency-based single-subject format that reflects current trends in nursing assessment.
Methods
A literature review and survey were conducted. From 828 studies retrieved via PubMed, CINAHL, and Google Scholar using keywords such as “newly graduated registered nurses” and “competency OR competence,” 18 were selected according to pre-established inclusion and exclusion criteria. Documents from national and international nursing organizations were included to extract relevant licensing competencies. We also reviewed POs from all undergraduate nursing schools in South Korea to align educational outcomes with the identified core domains.
Results
The core domains identified were clinical performance and decision-making, professional attitudes and ethics, communication and interpersonal skills, leadership and teamwork, quality improvement and safety, health promotion and prevention, and information technology and digital health. These domains showed strong alignment with POs under the fourth-cycle accreditation standards.
Conclusion
It concludes the seven core domains will be appropriate for evaluating pre-registered nurses in the integrated KNLE. Based on the seven identified core domains, expert consensus should be sought in the next phase to support the development of integrated, competency-based test items grounded in these domains.

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Development of a communication self-efficacy scale for nurses: a psychometric validation study: Kuem Sun Han, Jihye Shin, Soo Yeon Lee; J Korean Acad Nurs 2025;55(2):269-284. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.24129

Abstract PDF ePub: Purpose
This methodological study was conducted to develop a scale to measure communication self-efficacy in nurses and examine its validity and reliability.
Methods
We selected 54 initial items from literature reviews and interviews with 10 clinical nurses. Thirty-two preliminary items were derived from consultations with 10 experts. To verify the scale’s factor structure, we conducted exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) among 469 nurses. Data were analyzed using item analysis, EFA, CFA, discriminant validity, convergent validity, and internal consistency using IBM SPSS Statistics ver. 29.0 (IBM Corp.) and IBM SPSS AMOS ver. 20.0 (IBM Corp.).
Results
The scale consisted of 18 items with three factors (ability to apply therapeutic communication skills, crisis management capabilities, and communication competence), which explained 46.1% of the total variance. Convergent validity and discriminant validity were confirmed for the factors. CFA supported the fit of the measurement model comprising three factors (standardized root mean square residual=.04, root mean square error of approximation=.03, goodness of fit index=.92, Tucker-Lewis index=.97, comparative fit index=.98, normed fit index=.89, critical N=216). Internal consistency was confirmed by a Cronbach’s α coefficient of .91.
Conclusion
The communication self-efficacy scale for nurses is expected to measure communication self-efficacy among nurses. It will be useful for improving nurses’ professional communication abilities.

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Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study: Haengsuk Kim, Wanju Park; J Korean Acad Nurs 2025;55(1):81-92. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24088

Abstract PDF ePub: Purpose
This study investigated the mediating effect of grit in the relationship between silence behavior and medication safety competence among nurses.
Methods
The study included 166 nurses from four university hospitals and general hospitals in Seoul and Gyeonggi-do, South Korea. Data were collected from March 1 to 10, 2024, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffé’s test, and Pearson’s correlation coefficients with IBM SPSS Statistics ver. 23.0 (IBM Corp.). A mediation analysis was performed using Hayes’s PROCESS macro model 4 and the bootstrapping method.
Results
Medication safety competence showed significant correlations with silence behavior (r=–.21, p=.008) and grit (r=.43, p<.001). Furthermore, grit partially mediated the relationship between silence behavior and medication safety competence.
Conclusion
This study indicates that grit is a significant mediator in the relationship between silence behavior and medication safety competence. Therefore, an integrated approach that reduces silence behavior and promotes grit is essential for strengthening nurses’ medication safety competence. Ultimately, these strategies will help ensure patient safety by improving medication safety competence.

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Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea: Eun Seo Park, Young Il Cho, Hyo Jin Kim, YeoJin Im, Dong Hee Kim; J Korean Acad Nurs 2025;55(1):107-118. Published online February 19, 2025; DOI: https://doi.org/10.4040/jkan.24095

Abstract PDF ePub: Purpose
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.

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Development and Effectiveness of Progressive Simulation Education Program on Medication Safety for Nursing Students: Se-Young Jung, Eun-Young Kim; J Korean Acad Nurs 2024;54(4):563-576. Published online October 14, 2024; DOI: https://doi.org/10.4040/jkan.24054

Abstract PDF ePub: Purpose
This study aimed to develop and verify a progressive simulation education program aimed at enhancing nursing students’ medication safety competency.
Methods
A non-equivalent control group pretest-posttest design was adopted. The participants were 40 third-year nursing students with no prior simulation education experience, comprising 20 each in the experimental and control groups. The experimental treatment utilized a hybrid simulation approach incorporating both full-body mannequins and standardized patients and was, conducted over three sessions with durations of 65, 80, and 95 minutes for the first, second, and third sessions, respectively, for a total of 240 minutes. The program was constructed based on Jeffries’ simulation model.
Results
The levels of medication safety competencies, communication self-efficacy, learning self-efficacy, and problem-solving abilities of the experimental group were significantly higher than that of the control group.
Conclusion
Our results confirm that the program effectively improves nursing students’ medication safety competence, communication self-efficacy, learning self-efficacy, and problem-solving ability. Therefore, this program can serve as a basis for developing educational strategies related to medication safety for nursing education institutions. Furthermore, the program is anticipated to have a positive impact on novice nurses’ education and practice in clinical settings.

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Concept Analysis of Social Intelligence of Nurses Using Hybrid Model: Kyung Ran Lee, Na Kyoung Lee, Hee Oh, Kyoung Ae Park; J Korean Acad Nurs 2024;54(3):459-474. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.23121

Abstract PDF: Purpose
The purpose of this study was to conduct a concept analysis of social intelligence in nurses so that applying social intelligence to the nursing field.
Methods
In this study, we followed the hybrid model procedure, involving the following steps: First, in the theoretical stage, the attributes and definitions of the concept of social intelligence were determined through literature review. Second, the concepts’ reality was confirmed during fieldwork. In the final analysis stage, the results confirmed in the theoretical and fieldwork stages were compared and analyzed to confirm the properties and definition of the concept.
Results
Nurses’ social intelligence consists of three dimensions: social cognitive nursing competency, human-centered social evolution, and skills for solving complex nursing situations. Nurses’ social intelligence is a professional nursing competency that flexibly coordinates complex nursing situations, developed through accumulating experiences of continuous reflection and relationship expansion based on receptive listening and social sensitivity in clinical interpersonal relationships.
Conclusion
Nurses’ social intelligence is widely used in clinical practice and is shown to have a significant direct and indirect impact on clinical nursing. To effectively apply social intelligence in the clinical context, individual and organizational efforts are required to share and transfer knowledge and capacity-building methods through collective intelligence and education.

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Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients: Soomi Kim, Chul-Gyu Kim; J Korean Acad Nurs 2023;53(3):275-294. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22109

Abstract PDF

Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

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Research Advances in Evidence-Based Nursing for Clinical Practice Standards and Technological Optimization in Respiratory and Critical Care Medicine
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Associations between the Frequency and Quantity of Heated Tobacco Product Use and Smoking Characteristics among Korean Smoking Adolescents: Haein Lee, Bo Gyeong Lee; J Korean Acad Nurs 2023;53(2):155-166. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22125

Abstract PDF

Purpose
Although heated tobacco product (HTP) use among adolescents is an emerging public health problem, little is known about the frequency and quantity of HTP use. Thus, we investigated the associations between the frequency and quantity of HTP use and smoking characteristics (i.e., combustible cigarette [CC] and electronic cigarette [EC] use, and attempts to quit smoking) among CC-smoking adolescents.
Methods
We analyzed nationally representative data from 2,470 Korean adolescents who were current CC smokers. To investigate our aim, we conducted multinomial logistic and logistic regression analyses.
Results
We found that daily and heavier CC users had greater likelihoods of more frequent and heavier HTP use. In addition, dual users of CCs and ECs were more likely to use HTPs more frequently and heavily than CC users who did not use ECs. Moreover, daily EC users had the highest risk of frequent and heavy HTP use. The frequency and quantity of HTP use were not associated with attempts to quit smoking. Compared to CC-only use, dual use of CCs and HTPs was not associated with quitting attempts, and triple use of CCs, ECs, and HTPs was associated with a lower likelihood of quitting attempts.
Conclusion
HTP use was less likely to displace CC use and promote attempts to quit smoking. Thus, strict regulations are required to prevent the promotion of HTPs as a substitute for CCs or as a means of quitting smoking. Additionally, health professionals should consider preventive interventions for HTP, as well as CC and EC use among adolescents.

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The Health Effects of Heated Tobacco Product Use—A Narrative Review
Małgorzata Znyk, Dorota Kaleta
Healthcare.2025; 13(16): 2042. CrossRef
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Ian M Fearon, Sarah F Cordery, Martin Fitzpatrick, Sarah Weaver, Matthew Stevenson, Erika Grandolfo, Layla Malt, Keith Thompson, Thomas Nahde
Cureus.2024;[Epub] CrossRef

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36 Download
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Development and Evaluation of Motivational Interviewing Pulmonary Rehabilitation Program Based on Self-Determination Theory for Patients with Chronic Obstructive Pulmonary Disease: Jun Hee Jang, Hye Sook Min; J Korean Acad Nurs 2023;53(2):191-207. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22093

Abstract PDF

Purpose
This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey.
Methods
A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA.
Results
The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status.
Conclusion
The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

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Mediating Effect of Self-Efficacy on the Relationship between Symptom Experience and Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease
Enhee Jo, Ju-Young Park, Young Jun Jang
Journal of Korean Academy of Fundamentals of Nursing.2024; 31(3): 315. CrossRef

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1 Crossref

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

Abstract PDF

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

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Exploring Educational Stress and Competence of Intern Nurses' Following Two Years of Online Education: A Cross-Sectional Study
Fatma Dursun Ergezen, Ayşe Yacan Kök, Emine Kol
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Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students: Ye-Eun Kim, Hee-Young Kang; J Korean Acad Nurs 2023;53(1):87-100. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22130

Abstract PDF

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

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Validity and Reliability of Korean Version of Self-Care Chronic Obstructive Pulmonary Disease Inventory (SC-COPD) and Self-Care Self-Efficacy Scale (SCES-COPD): Ja Yun Choi, So Young Yun; J Korean Acad Nurs 2022;52(5):522-534. Published online October 31, 2022; DOI: https://doi.org/10.4040/jkan.22062

Abstract PDF

Purpose
This study examined the validity and reliability of the Korean version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) and the Chronic Obstructive Pulmonary Disease Self-Care Self-Efficacy Scale (SCES-COPD). The SC-COPDI consists of the Self-Care Maintenance Scale (SCMES), Self-Care Monitoring Scale (SCMOS), and Self-Care Management Scale (SCMAS).
Methods
The original tool was translated using a back-translation process. Participants were 241 patients with COPD at the Chonnam National University Hospital in Korea. The construct validity was verified through confirmatory factor analysis, and reliability was verified using Cronbach’s α.
Results
The SCMES consisted of 10 items of three factors―one of four factors was deleted from the original tool. In the SC-MOS, there were six items of two factors after two items were deleted from the original tool. The SCMAS consisted of the original 10 items of three factors. The SCES-COPD consisted of six items of two factors, with one item removed from the original tool. The model fit indices of all tools were good, and the construct validity was confirmed. Cronbach’s α of SCMES was .72, SCMOS was .90, SCMAS was .81, and SCES-COPD was .85.
Conclusion
The Korean version of SC-COPDI and SCES-COPD are valid and reliable instruments for measuring selfcare in people with COPD. These instruments can be used in self-care studies of COPD patients in Korea.

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Review Paper

Knowledge Structure of Chronic Obstructive Pulmonary Disease Health Information on HealthRelated Websites and Patients’ Needs in the Literature Using Text Network Analysis: Ja Yun Choi, Su Yeon Lim, So Young Yun; J Korean Acad Nurs 2021;51(6):720-731. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21086

Abstract PDF

Purpose
The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD).
Methods
Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis.
Results
The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management.
Conclusion
The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients’ needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.

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Research Papers

Job Analysis of Nurse Care Coordinators for Chronic Illness Management in Primary Care Settings: Using Developing a Curriculum Process: Ju-Hee Hwang, Yong-Jun Choi, Mi-Sook Kim, Seng-Eun Yi, Yong-Soon Park, Ji-Hyang Kim, Ju-Young Yoon, Dong-Soo Shin; J Korean Acad Nurs 2021;51(6):758-768. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21065

Abstract PDF

Purpose
This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job.
Methods
A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators’ jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task.
Results
From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, ‘assess the patient’s general health status’ was carried out most frequently. Nurse care coordinators perceived that ‘check vital signs’ and ‘strengthen patient competence to promote health behaviors’ were more important than all other tasks. The most difficult task was ‘develop professionalism as a nurse care coordinator’.
Conclusion
The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.

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

Abstract PDF

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

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Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale: Sook-Nam Kim, Hyun-Ju Lee, So-Young Kim, Nayoon Lee; J Korean Acad Nurs 2021;51(5):617-629. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21069

Abstract PDF

Purpose
The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K).
Methods
The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software.
Results
The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent.
Conclusion
This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

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Associations between Cigarette and Electronic Cigarette Use and Sleep Health in Korean Adolescents: An Analysis of the 14th (2018) Korea Youth Risk Behavior Surveys: Bo Gyeong Lee, Haein Lee; J Korean Acad Nurs 2021;51(3):380-389. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21034

Abstract PDF

Purpose
This study aimed to understand the relationship between cigarette and electronic cigarette (e-cigarette) use and sleep health among Korean adolescents.
Methods
Using the 14th Korea Youth Risk Behavior Survey, we included 52,928 adolescents who responded to sleep satisfaction and sleep duration. Participants were classified into four groups: non-users, cigarette-only users, e-cigarette-only users, and dual users of both products. To examine the associations between cigarette and e-cigarette use and sleep health, data were analyzed using complex samples cross tabulation and complex samples logistic regression.
Results
Of the four groups, dual users reported the lowest level of sleep satisfaction and sleep duration; 57.0% and 86.9% of dual users were not satisfied with their sleep and have insufficient sleep duration, respectively. The proportion of students who were not satisfied with their sleep was higher among cigarette-only users compared to e-cigarette-only users (52.7% vs. 45.8%), but the two groups reported similar rates of insufficient sleep duration (84.2% vs. 84.3%). Compared to non-users, cigarette-only users, e-cigarette-only users, and dual users were more likely to not be satisfied with sleep (odds ratios [ORs] were 1.49, 1.36, and 1.75, respectively) and had significantly higher odds of experiencing insufficient sleep duration (ORs were 1.85, 2.06, and 2.34, respectively).
Conclusion
E-cigarette-only use and dual use as well as cigarette-only use were associated with poor sleep health. Therefore, to improve adolescent sleep health, health professionals should provide sleep intervention strategies considering the association between smoking and sleep health.

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Review Article

Continuity of Care in Chronic Diseases: A Concept Analysis by Literature Review: Jingjing Hu, Yuexia Wang, Xiaoxi Li; J Korean Acad Nurs 2020;50(4):513-522. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.20079

Abstract PDF

Purpose
This study aimed to utilize concept analysis to obtain a better understanding of the concept of “continuity of care” in chronic diseases.
Methods
The concept of continuity of care was analyzed using the Walker and Avant method. Covering literature in English from 1930 to 2018, the data sources included CINAHL Complete, Academic Search Complete, MEDLINE, PsyARTICLES, Health Source: Nursing/ Academic Edition, Google Scholar, Science Direct, and the Cochrane Library.
Results
A comprehensive definition of concept of continuity of care was developed based on a systematic search and synthesis. The key defining attributes were identified as (a) care over time, (b) the relationship between an individual patient and a care team, (c) information transfer, (d) coordination, and (e) meeting changing needs. The antecedents of continuity of care were having a chronic disease, inexperienced with disease management, a poorly coordinated healthcare system, and medical care limitations. The consequences of continuity of care were decreasing hospital admissions, reducing costs, reducing emergency room visits, improving the quality of life, improving patient satisfaction, and delivering good healthcare.
Conclusion
The thorough concept analysis provides insight into the nature of “continuity of care” in chronic diseases and also helps ground the concept in healthcare.

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Original Articles

Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study: Ahra Jo, Heeyoung Oh; J Korean Acad Nurs 2019;49(6):713-723. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.713

Abstract PDF

Purpose

The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome.

Methods

This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24.

Results

During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42).

Conclusion

Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

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Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model: Sung Hae Kim, JuHee Lee, MiRa Jang; J Korean Acad Nurs 2019;49(4):437-448. Published online August 29, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.437

Abstract PDF

Purpose

This study was conducted to test a path model for the factors related to undergraduate nursing students' clinical practicum stress, based on Lazarus and Folkman's stress-coping model.

Methods

This study utilized a path analysis design. A total of 235 undergraduate nursing students participated in this study. The variables in the hypothetical path model consisted of clinical practicum, emotional intelligence, self-efficacy, Nun-chi, and nursing professionalism. We tested the fit of the hypothetical path model using SPSS/WIN 23.0 and AMOS 22.0.

Results

The final model fit demonstrated a satisfactory statistical acceptance level: goodness-of-fit-index=.98, adjusted goodness-of-fit-index=.91, comparative fit index=.98, normed fit index=.95, Tucker-Lewis index=.92, and root mean square error of approximation=.06. Self-efficacy (β=−.22, p=.003) and Nun-chi behavior (β=−.17, p=.024) were reported as significant factors affecting clinical practicum stress, explaining 10.2% of the variance. Nursing professionalism (β=.20, p=.006) and self-efficacy (β=.45, p<.001) had direct effects on emotional intelligence, explaining 45.9% of the variance. Self-efficacy had indirect effects on Nun-chi understanding (β=.20, p<.001) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. Nursing professionalism had indirect effects on Nun-chi understanding (β=.09, p=.005) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. The variables for self-efficacy and nursing professionalism explained 29.1% of the Nun-chi understanding and 18.2% of the Nun-chi behavior, respectively.

Conclusion

In undergraduate nursing education, it is important to identify and manage factors that affect clinical practicum stress. The findings of this study emphasize the importance of Nun-chi, self-efficacy, emotional intelligence, and nursing professionalism in the development of an educational strategy for undergraduate nursing students.

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Development of the Patient Caring Communication Scale: Myoung Lyun Heo, Sook Bin Im; J Korean Acad Nurs 2019;49(1):80-91. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.80

Abstract PDF

Purpose

This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity.

Methods

The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha.

Results

This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability.

Conclusion

The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

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Structural Equation Modeling on Clinical Decision Making Ability of Nurses: Min Kyoung Park, Soukyoung Kim; J Korean Acad Nurs 2019;49(5):601-612. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.601

Abstract PDF

Abstract Purpose

The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory.

Methods

The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed.

Results

The goodness-of-fit of the final model was at a good level (χ ²/df=2.46, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability.

Conclusion

The nurses’ clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.

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Development and Evaluation of Electronic Health Record Data-Driven Predictive Models for Pressure Ulcers: Seul Ki Park, Hyeoun-Ae Park, Hee Hwang; J Korean Acad Nurs 2019;49(5):575-585. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.575

Abstract PDF

Abstract Purpose

The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital.

Methods

A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale.

Results

The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model.

Conclusion

Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

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Reliability and Validity of Korean Version of Nursing Students’ Anxiety and Self-Confidence with Clinical Decision Making Scale: Mi Yu, Young Eun, KA White, KyungJa Kang; J Korean Acad Nurs 2019;49(4):411-422. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.411

Abstract PDF

Abstract Purpose

The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM^©) for Korean nursing students.

Methods

Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM^© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity.

Results

The Korean version of the NASC-CDM^© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety.

Conclusion

The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students’ clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM^© version.

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Review Article

Effect of Autogenic Training for Stress Response: A Systematic Review and Meta-Analysis: Eunju Seo, Soukyoung Kim; J Korean Acad Nurs 2019;49(4):361-374. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.361

Abstract PDF

Abstract Purpose

This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis.

Methods

A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program.

Results

A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07), in the studies on long term intervention targeting the patient group.

Conclusion

Autogenic training is effective for adults’ stress management, and nurses will be able to effectively perform autogenic training programs for workers’ stress relief at the workplace.

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Original Articles

Development and Validation of the Communication Behavior Scale for Nurses Caring for People with Dementia: Jihye Lee, Moonhee Gang; J Korean Acad Nurs 2019;49(1):1-13. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.1

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and validate the Communication Behavior Scale for nurses caring for people with Dementia (CBS-D).

Methods

Based on communication accommodation theory, the initial items were generated through a literature review and interviews with 20 experts. Content and face validity of the initial items were assessed. Data from 486 nurses caring for people with dementia were analyzed using item analysis, exploratory and confirmatory factor analysis, criterion-related validity, and internal consistency.

Results

The final scale consisted of 18 items and four factors (discourse response management, interpersonal control, emotional expression, and interpretability) that explained 57.6% of the variance. Confirmatory factor analysis indicated that the theoretical model with 18 items satisfied all goodness-of-fit parameters. Criterion-related validity was shown by the Global Interpersonal Communication Competence Scale (r=.506, p<.001). Cronbach's alpha for the total scale was .88.

Conclusion

The CBS-D can be used to measure the communication behavior of nurses caring for people with dementia.

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A Structural Model on the Nursing Competencies of Nursing Simulation Learners: Soo Jin Park, Eun Sun Ji; J Korean Acad Nurs 2018;48(5):588-600. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.588

Abstract PDF

Purpose

The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory.

Methods

Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs.

Results

The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability.

Conclusion

In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.

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Prediction Modeling on Family Life Satisfaction of Old Adults Living at Home: Young Mi Huh, Sohyune Sok; J Korean Acad Nurs 2018;48(5):534-544. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.534

Abstract PDF

Purpose

This study was conducted to construct and test a structural model on family life satisfaction of aged individuals living at home. The conceptual model was based on Bandura's self-efficacy and social cognitive theories (1977; 1986) and Bowen's (1976) family systems theory.

Methods

From January 25 to March 5, 2016, 227 older adults living at home completed a structured questionnaire. Data were analyzed to calculate the direct and indirect effects of factors affecting family life satisfaction. SPSS WIN 20.0 and AMOS 20.0 were used.

Results

The hypothetical model was a good fit for the data. The model fit indices were χ²=78.05, χ²/df=1.35, RMSR=.02, GFI=.98, AGFI=.96, NFI=.94, CFI=.98, and RMSEA=. 05. Family life satisfaction was positively affected by perceived collective family efficacy, status of physical health, family communication, and family support. Depression resulted in a significant negative effect. Family differentiation had a significant indirect effect on family life satisfaction. The model explained 76% of variance in family life satisfaction.

Conclusion

Perceived collective family efficacy, status of physical health, depression, family differentiation, family communication, and family support were significant factors explaining family life satisfaction among older adults staying at home. Further research should be conducted to seek intervention strategies to improve family life satisfaction among older adults living at home by focusing on the respective contributing factors.

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The relationship between family support and life satisfaction in hypertensive patients: the multiple mediating roles of self-esteem and self-care
Han Wu, Haijun Zhang, Congzhi Wang, Tian Pan, Yue Zhao, Xiang Chen, Lin Zhang
Geriatric Nursing.2026; 69: 103799. CrossRef
The Effect of Pain Catastrophizing on Depression among Older Korean Adults with Chronic Pain: The Mediating Role of Chronic Pain Interference and Sleep Quality
Kyoung-eun Lee, Hyunju Ryu, Sun Ju Chang
International Journal of Environmental Research and Public Health.2020; 17(23): 8716. CrossRef

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Testing a Middle-Range Theory of Self-Care of Chronic Illness: A Validation for Korean Adult Patients with Severe Hypertension: Eunha Gil, Heeyoung Oh; J Korean Acad Nurs 2018;48(5):521-533. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.521

Abstract PDF

Purpose

The aims of this study are to provide a theoretical framework for improving the self-care of adults with severe hypertension and to examine the practical suitability of a middle-range theory of self-care for chronic illness by validating the structural model.

Methods

Data were collected at a university hospital in D metropolitan city from July 1 to August 14, 2015. A total of 224 Korean adult patients with severe hypertension were recruited. Data were analyzed using SPSS 22.0 and AMOS 22.0.

Results

The results show that the fit index of the hypothetical model meets the recommended level; 7 out of 8 hypothetical model paths were statistically significant. Motivation, self-efficacy, support from others, and accessibility to care showed statistical significance and explained 67.3% of the self-care process. The self-care process explained 45.3%, 63.6%, and 26.5% of quality of life, health, and illness stability, respectively.

Conclusion

This model can be used as a theoretical framework for improving self-care among adult Korean patients with severe hypertension. Moreover, the practical suitability and validity of the middle-range theory of self-care for chronic illness is secured.

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Miok Kim
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Tatik Pujiastuti, Musheer A. Aljaberi, Tukimin Sansuwito, Bibi Florina Abdullah, Ruma Poddar
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Chronically Ill Patients' Perception of Hospital Nurses: Byoung-Sook Lee, Mi-Aie Lee, Yong-Sook Eo; J Korean Acad Nurs 2018;48(3):311-322. Published online June 30, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.311

Abstract PDF

Purpose

The purpose of this qualitative research was to investigate chronically ill patients' perception of hospital nurses.

Methods

Individual in-depth interviews and qualitative content analysis were used for data collection and analysis respectively. Participants were 13 chronically ill hospitalized patients or outpatients in three universities hospitals. All interviews were recorded and transcribed verbatim. Data were analyzed using the qualitative content analysis suggested by Graneheim and Lundman (2004).

Results

Three themes emerged from the 10 sub-themes, which were categorized from the 21 condensed meaning units by interpreting the underlying meanings. The three themes were “person giving comfort and support by caring”, “person facilitating the process of healing”, and “person taking the initiative in power relations”. Two themes involved positive experiences of patients and the other included negative ones.

Conclusion

The results showed that the participants perceived the hospital nurses as devoted to caring for patients and facilitating treatments, but authoritative in performing their duty. Based on these results, it is recommended that hospital nurses improve their nursing knowledge, skills and humanistic attitude.

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Claudia Andrea Ramírez-Perdomo, Claudia Patricia Cantillo-Medina, Alix Yaneth Perdomo-Romero , María Elena Rodríguez-Vélez, Lili Andrea Buitrago Malaver, Ana Ligia Escobar Tobón
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Person-Centered Care Experience of Nursing Home Workers: A Qualitative Meta-Synthesis Study
Eun Young Kim, Sung Ok Chang
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Jin-Yeong Ahn, Young Eun
Korean Journal of Adult Nursing.2021; 33(2): 134. CrossRef
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Juhhyun Shin, Sunok Jung, Hyeonyoung Park, Yaena Lee, Yukyeong Son
International Journal of Environmental Research and Public Health.2021; 18(14): 7398. CrossRef

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Effects of Communication Empowerment Program Based on Situated Learning Theory for Nursing Students: Soo Jin Kim, Boyoung Kim; J Korean Acad Nurs 2018;48(6):708-719. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.6.708

Abstract PDF

Abstract Purpose

This study was conducted to examine the effects of a communication empowerment program based on situated learning theory for nursing students.

Methods

A non-equivalent control group pretest-posttest design was used. The study participants were 61 nursing students (31 in the experimental group and 30 in the control group) from G city. Data were collected from November 3, 2015 to December 10, 2015. The experimental group received eight sessions of the program, which were scheduled twice a week, with each session lasting two hours. The data were analyzed using chi-square test, Fisher's exact test, and an independent t-test using SPSS/WIN 20.0.

Results

There were significant increases in self-efficacy for communication (t=2.62, p=.011), emotional intelligence (t=2.66, p=.010), and interpersonal communication competence (t=2.87, p=.006) in the experimental group compared to the control group.

Conclusion

Based on the findings, our study suggests a need to include content from communication curricula or clinical communication training programs for improving undergraduate nursing students’ communication skills in practice settings.

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María Carmen Martínez-Monteagudo, Beatriz Delgado, José Manuel García-Fernández, Cecilia Ruíz-Esteban
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Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP): Eunmi Kwak, Heeyoung Oh; J Korean Acad Nurs 2018;48(4):419-431. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.419

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors.

Methods

The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability.

Results

The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967.

Conclusion

This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

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Se-Hoon Jung
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Lianfeng Wang, Junlin Chen, Othman Talib
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Development of a Triage Competency Scale for Emergency Nurses: Sun Hee Moon, Yeon Hwan Park; J Korean Acad Nurs 2018;48(3):362-374. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.362

Abstract PDF

Abstract Purpose

This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability.

Methods

Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios.

Results

The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91.

Conclusion

Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

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Self-Management Experiences of the Adolescents with Chronic Kidney Disease: Sug Young Lee, Heesun Shin; J Korean Acad Nurs 2018;48(3):266-278. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.266

Abstract PDF

Abstract Purpose

The aim of this study was to develop a substantive theory on self-management conducted by the adolescents with chronic kidney disease from their lived experience.

Methods

Data was collected through in-depth interviews from May to December in 2015 with thirteen adolescents with chronic kidney disease. The data collected were analyzed on the basis of Strauss and Corbin's grounded theory.

Results

The core of the category found in this study was “overcoming the unstable sense of self- control and integrating disease experience into their life”. The causal conditions triggering the central phenomenon were “restriction in daily life” and “manifestation and aggravation of symptom”. The central phenomenon in the experience of self-management within the adolescents with chronic kidney disease was “unstable sense of self control”. The intervening condition for unstable self control were “micro system support” and “motivational resources”. This study found that the adolescents with chronic kidney disease followed a series of strategies when they faced the central phenomenon, including; passive coping, reappraisal of illness, active coping, compliance with treatment, controlling physical activity, and adjusting school life. With these strategic approaches, the adolescents with chronic kidney disease could maintain their active lifestyles and achieve their health behaviors. The process of self-management by these adolescents passed through four phases; limited experience caused by diseases, effort for normalization, reorganizing their daily lives, and integration with daily lives and self-management.

Conclusion

This Study explored the process and experience of self-management of adolescents with chronic kidney disease. These findings can be used for basis for developing substantive theory and nursing intervention strategy for adolescents with chronic kidney diseases.

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Hye Seung Hong, YeoJin Im
Journal of Child Health Care.2025; 29(3): 658. CrossRef
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Sug Young Lee
Journal of Korean Academy of Fundamentals of Nursing.2025; 32(1): 105. CrossRef
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Ao Zhang, Anita van Zwieten, Anastasia Hughes, Siah Kim, Kelly Lambert, Luca G. Torrisi, Allison Jaure, Chandana Guha
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Ji Eun Kim, Ilaria Campesi
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The Effect of Pain Relieving Intervention During Infiltration among Gamma Knife Surgery Patients for Stereotactic Frame Fixation: Young Jun Jang, Hyeon Ok Kim; J Korean Acad Nurs 2018;48(2):221-231. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.221

Abstract PDF: Abstract Purpose
This study aimed to compare the effects of three interventions on pain, blood pressure, and pulse rate during infiltration anesthesia in patients about to undergo gamma knife surgeries.
Methods
The three interventions employed in a university-affiliated Hospital in J City, South Korea were as follows: EMLA cream plus Vapocoolant spray (Vapocoolant, n=30), EMLA cream plus 10.0% Lidocaine spray (Lidocaine, n=30), and EMLA cream only (EMLA, n=30). The equivalent control-group pre test - post test study design was used. Pain was assessed subjectively using the numeric rating scale (NRS) and objectively using a Galvanic Skin Response (GSR) tester. NRS scores were assessed after infiltration anesthesia and the GSR was assessed during infiltration anesthesia. Blood pressure and pulse rate were assessed twice: before and after infiltration anesthesia. Data were collected between August 3, 2016 and March 24, 2017.
Results
NRS scores after infiltration anesthesia and the GSR during infiltration anesthesia were significantly lower in the Vapocoolant group than in the Lidocaine and EMLA groups (F=13.56, p<.001 and F=14.43, p<.001, respectively). The increase in systolic blood pressure (F=4.77, p=.011) and in pulse rates (F=4.78, p=.011) before and after infiltration anesthesia were significantly smaller in the Vapocoolant group than in the Lidocaine and EMLA groups; however, no significant differences were observed in diastolic blood pressures (F=1.51, p=.227).
Conclusion
EMLA cream plus Vapocoolant spray was the most effective intervention to relieve pain and to lower increase in systolic blood pressure and pulse rate caused by infiltration anesthesia for stereotactic frame fixation. Thus, application of Vapocoolant spray in addition to EMLA cream is highly recommended as a nursing intervention for patients undergoing gamma knife surgeries.

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Structural Equation Modeling on Successful Aging in Elders with Chronic Obstructive Pulmonary Disease Based on Selection-Optimization-Compensation Strategy: Young Mi Jang, Rhayun Song; J Korean Acad Nurs 2017;47(4):488-498. Published online August 31, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.4.488

Abstract PDF

Purpose

The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies.

Methods

Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0.

Results

The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging.

Conclusion

The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

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A study on the Experience of the Life of Caregivers with Mentally Ill Children: Kyoung Soon Lee; Journal of Nurses Academic Society 1997;27(4):953-960. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.4.953

Abstract: The purpose of this study was to explore and describe the experience of caregivers with mentally ill children. The sample consists of 4 participants who care for their children with mentally ill. They were asked open-ended questions in order for them to talk about their experiences. With permission of the subjects, the interviews were recorded and transcribed. The methodology utilized was the Colaizzi's phonomenological approach. The interview data was organized by themes into 5 categories : anguish, positive emotion, maturation, acceptance of the disease, and seeking information. These 5 themes were further categorized into 4 main groups : emotional impact, spiritual maturation, adapting to the illness, and seeking support needs. The results of this study have clinical and theoretical implications not only for psychiatric nursing in Korea but also for all clinicians working with the families of the mentally ill.

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A Study on Clinical Nurses Level of Perception of Importance, Performance and Satisfaction in the control of Nosocomial Infection: Sun Ock Kim, Soo Hyun Cho; Journal of Nurses Academic Society 1997;27(4):765-776. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.4.765

Abstract PDF: Hospitals accomodate patients who have a high risk of infection due to reduced immunity as well as people who require surgical, medical or other treatments. Consequently, the role of clinical nurses, who come into close contact with these patients is very important in the control of nosocomial infection. This study was done to investigate and compare the level of perception of the importance of the control of nosocomial infections as well as the level of actual performance, and the level of satisfaction with the control of nosocomial by the clinical nurses. Thus, the purpose of this study is to contribute basic data for improving policies and educational programs to control nosocmial infection. A summary of the survey results is as follows. 1) The means of scores on all categories of the inquiry were 4.51 for awareness 4.42 for actual performance, and 3.20 for satisfaction, of a possible high score of 5.00. 2) Correlations of the level of perception of importance between characteristics of nurses and hospital control of nosocomial infection differed significantly according to the type of hospital establishment type(p=.005), age(p=.000), career(p=.000), position(p=.002), and regular conferences on infection control in working departments(p=.003). Correlation of the level of actual performance between characteristics of nurses and hospital control of nosocomial infection differed significantly according to type of hospital(p=.000), hospital size(p=.009), working department(p=.000), age(p=.000), career(p=.000), school career(p=.040), position(p=.000), education experience on nosocomial infection(p=.020), and regular conferences on infection control in working department (p=.000). Correlation of degree of satisfaction between characteristics of nurses and hospital control of nosocomial infection also differed significantly according the type of hospital establishment(p=.003), working department(p=.000), age(p=.000), and regular conferences on infection control in working department(p=.000). 3) Correlation between clinical nurses, level of perception of importance and actual level of performance for the control of nosocomial infection was relatively positive(r=.57, p=.000). Correlation between clinical nurses degree of satisfaction and level of actual performance for control of nosocomial infection was relatively positive(r=.47, p=.000). Correlation between clinical nurses, level of perception of importance and degree of satisfaction degree with the control of nosocomial infection was also relatively positive (r=.27, p=.000).

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Biological Monitoring on the Absorption of Antineoplastic Drugs in Nursing Personnel: Bong Im Kim; Journal of Nurses Academic Society 1997;27(3):520-530. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.520

Abstract PDF: Antineoplastic agents may exhibit effects not only in patients therapeutically exposed, but also in health workers who prepare and administer these drugs. This study was done to clarify whether nurses who handle anticancer drugs show signs of drug absorption. The experimental group was 14 nurses handling anticancer drugs at three medical wards of a hospital in J city ; the control group was 12 psychiatric nurses at the same hospital. The test materials were the nurses' 24hr urine specimens, which were concentrated by XAD-2column chromatograpy. Tester strains were TA98(+/-S9mix), TA100(+/-S9mix), TA135(+/-S9mix)and TA1537(+/-S9mix) ; the salmonella mammalian microsomal test(Ames test) was used for the urinary mutagenicity assay. The results are summarized as follow : 1. In qualitative analysis of the results, both experimental group and control group showed 15.4% urine toxicity. 2. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, the two groups showed no difference in the non-activation method test, but the activation method revealed a difference. 3. In urinary mutagenicity of the experimental group by ward career, there was a significant difference between the group with more than 20 months experience and the group with less than 20 months on the tester strains TA98, TA100, and two groups by the tester strain TA1537. No Significant difference was found between two groups by the tester strain TA1535.

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An Exploration of the Life Experiences of Patients with Chronic Pain: Women with Rheumatoid Arthritis: Hea Kyung Hur; Journal of Nurses Academic Society 1997;27(1):13-25. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.1.13

Abstract PDF: Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had if for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their own terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emerged from the analysis were 'Emotional Disturbances', 'Trying to Adapt to the Progress of Treatment', ' Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

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Urinary Mutagenicity, Physical Symptoms and Stress of Nurses Handling Anticancer Drugs: Bong Im Kim; Journal of Nurses Academic Society 1996;26(4):963-975. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.4.963

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The purpose of this study was to call attention to the mental, physical and occupational hazards of the anticancer-drug-handling nurses by examining the possible urinary mutagenicity and measuring physical symptoms and stress level of the nurses exposed to anticancer drugs. The experimental group of the urinary mutagenicity assay was 14 nurses handling anticancer drugs at the medical wards of a hospital located in J city; the control group was 12 psychiatric nurses of the same hospital. The test material was the nurses' 24hrs urine, which was concentrated by XAD-2 column chromatography. Tester strains were TA98( +/- S9 mix), TA100( +/- S9 mix), TA1535( +/- S9 mix) and TA1537( +/- S9 mix); Salmonella mammalian-microsomal test (Ames test) was employed for the urinary mutagenicity assay. The physical symptoms of which the nurses experienced were investigated through self-reports on open-questionnaires. The stress levels of the experimental group were measured by a stress measuring instrument developed by this author. Reliability of this instrument was found to be adequate (Cronbach's Alpha=0.9079). To ascertain the urinary mutagenicity of the experimental group, the mean and the standard deviation of the colonies of Tester strains appearing on the minimal plates were taken and compared differences between two groups. T-test was employed for the significance test of two groups. The physical symptoms were compared between the two groups through the analysis of the nurse' self-reports. The mean and standard deviation of the stress levels of the experimental group were also calculated and were examined through t-test. The results were summarized as follows: 1. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and the non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, two groups showed no difference in the non-activation method test, but the activation method revealed difference. 2. The physical symptoms were also much more frequently reported in the experimental group. 79. 3% of the experimental group reported more than 1 kind of physical symptoms. On the other hand, 33.2% of the control group complained of 1 kind of physical symptom. The items with high symptom frequency were 'headache', 'itching sensation', 'corneal congestion', 'skin allergy'. 3. The mean score of stress in the experimental group was 2.41(range 1-4). The experimental group showed the stress level above 2.0 in the 14 of 15 items in all. The highest stress level were recorded in the following items in the order quoted, 'I fear that anticancer drug may touch any part of body while handling it.', 'I feel concerned there is no protective countermeasure against anticancer drug handling.', 'I am afraid the anticancer drug handling may produce a fetal loss in the future'.

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Knowledge and safe handling practices affecting the occupational exposure of nurses and midwives to hazardous drugs: A mixed methods systematic review
Pheona van Huizen, Philip L. Russo, Elizabeth Manias, Lisa Kuhn, Clifford J. Connell
International Journal of Nursing Studies.2024; 160: 104907. CrossRef
Effects of safe handling education on cognition, compliance and stress handling of antineoplastic drugs in clinical nurses
Eun‐Mi Jun, Se‐Won Kang
Nursing Open.2023; 10(6): 4144. CrossRef
Nurses’ Compliance with Safety Guidelines for the Use of Antineoplastic Agents, Observable Symptoms, and Stress from Occupational Exposure
Seon-Ja Park, Hyun-Ju Kim
Journal of Korean Academy of Fundamentals of Nursing.2018; 25(4): 293. CrossRef

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A Preliminary Study on Development and Evaluation of Home Health Care Nurse Clinical Practice Program: Focused on Postoperative Orthopedic Patients: Young Sook Suh; Journal of Nurses Academic Society 1996;26(1):15-32. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.15

Abstract PDF: The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed included confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient/family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who had had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

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Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education: Won Hee Lee, So Sun Kim, Shin Hi Han, So Yon Lee, Gi Yon Kim; Journal of Nurses Academic Society 1995;25(3):581-596. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1995.25.3.581

Abstract PDF

Clinical practice in nursing education provides an opportunity for students, through the process of applying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide advice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the precep-torship, the three-tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et al was also used to measure student competencies. The results of this study are as follows: 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t= -5.13, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that: 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse (student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their burden. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to upgrade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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The Students’ Evaluation of Practice Sites and Preceptors in Pharmacy Experiential Education
Jeong-Hyun Yoon, Hae Sun Suh, Nam Kyung Je
Korean Journal of Clinical Pharmacy.2017; 27(2): 69. CrossRef

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Factors Influencing on Quality of Life in Aged Women with Chronic Pain: Jung Tae Son, Sun Rim Suh; Journal of Korean Academy of Nursing 2002;32(5):735-742. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.735

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PURPOSE: This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. METHOD: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. RESULT: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second . CONCLUSION: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.

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Journal of the Korean Society of Cosmetology.2022; 28(2): 233. CrossRef
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An Analysis of Research on Clinical Nursing Education: In Soo Kwon; Journal of Korean Academy of Nursing 2002;32(5):706-715. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.706

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PURPOSE: This literature review was designed to identify a trend of study in clinical nursing education, to propose the idea for further study on an improvement of teaching students in the clinical setting. METHOD: The researches reviewed were 36 (seven in Korea and twenty nine out of Korea) on clinical nursing education in baccalaurate program from 1996 to 2000 from Journal of Korean Academy of Nursing, Journal of Korean Education of Nursing, Journal of Nursing Education, and Nurse Educator. RESULT: The prevailing research design was the nonexperimental(N=21). Subjects were predominantly nursing students(N=24). Structured questionnaire(N=22) was used most often for data collection. Among clinical setting studied, specific area was none in Korea. Research variables in nonexperimental studies were 4 types of student, teacher and teaching method. Independent variables in experimental studies were 7 types of clinical teaching methods, and dependent variables were six types of competence and knowledge of student. Research theme of qualitative research was most in clinical experience of student. CONCLUSION: In Korean, there were the lack of researches in specific clinical area, clinical teacher and teaching method. Accordingly, future studies need to be focused on various clinical areas, clinical teacher, and teaching method to improve the clinical nursing education in Korea.

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Factors Influencing Functional Status in People with Chronic Lung Disease: Eui Geum Oh, Cho Ja Kim, Won Hee Lee, So Sun Kim, Bo Eun Kwon, Yeon Soo Chang, Ji Yeon Lee, Young Jin Kim; Journal of Korean Academy of Nursing 2002;32(5):643-653. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.643

Abstract PDF: PURPOSE: The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. METHOD: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. RESULT: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. CONCLUSION: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

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