Journal of Korean Academy of Nursing

Validity and Reliability of the Korean Version of the Occupational Coping Self-Efficacy Scale for Nurses: Youngrye Park, Sunah Park, Hee Ran Kang; J Korean Acad Nurs 2024;54(4):633-644. Published online November 30, 2024; DOI: https://doi.org/10.4040/jkan.24094

Abstract PDF ePub: Purpose
This study aimed to evaluate the validity and reliability of the Korean version of the occupational coping self-efficacy for nurses (K-OCSE-N) scale.
Methods
The English version of the OCSE-N scale was translated into Korean using a translation and back-translation process. Data were gathered from 213 nurses employed in a general hospital in South Korea. The content validity was assessed using the content validity index. The construct validity was verified through exploratory and confirmatory factor analyses. Criterion validity was assessed using Pearson’s correlation coefficients with the job stress coping and general self-efficacy scales. Reliability was examined using item-total score correlation and Cronbach’s α coefficient for internal consistency.
Results
The exploratory factor analysis identified two factors that explained 61.8% of the cumulative variance: occupational burden and relational difficulty. In confirmatory factor analysis, the model exhibited adequate fit (χ²/df = 2.07, GFI = .95, SRMR = .04, RMSEA = .07, CFI = .97, and TLI = .95), with both convergent and discriminant validity deemed acceptable. The criterion validity presented a positive correlation of the K-OCSE-N with both job stress coping (r = .72, p < .001) and general self-efficacy (r = .72, p < .001). The internal consistency of the scale using Cronbach’s α for the total items was .89.
Conclusion
The K-OCSE-N scale is a valid and reliable tool for measuring nurses’ occupational coping self-efficacy. This study suggests that various intervention studies can use the scale to assess and strengthen nurses’ occupational coping self-efficacy in nursing practice.

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

Abstract PDF ePub: Purpose
This study aimed to understand and describe the experiences of patients and their families who have received medical services from advanced practice nurses in tertiary general hospitals in Korea.
Methods
Data were collected through four focus group interviews with 20 patients and their families who had received medical services from advanced practice nurses for more than six months at four tertiary hospitals from November 29 to December 28, 2023. Verbatim transcripts were analyzed using qualitative content analysis.
Results
The four themes extracted from the experiences of patients and their families were as follows: unfamiliar medical personnel encountered during the treatment process, healthcare professionals who exhibited excellence, companions to light my way through the tunnel of illness, and an advanced practice nurse system that must be activated urgently.
Conclusion
The study’s findings indicate that patients and their families view the care provided by advanced practice nurses as excellent, reliable, and holistic. Research suggests that advanced practice nurses are valuable healthcare professionals in team-based care. The findings suggest that hospitals should utilize an advanced practice nurse system to improve patient outcomes and ensure the quality of care.

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Factors Influencing Clinical Nurses’ Perception of Structural and Content Career Plateau: Ji Hye Kim, Ji Yun Lee; J Korean Acad Nurs 2024;54(4):534-546. Published online October 23, 2024; DOI: https://doi.org/10.4040/jkan.24002

Abstract PDF ePub: Purpose
This study was intended to provide basic data for reducing the career plateaus of clinical nurses.
Methods
The participants were 288 clinical nurses who worked at five hospitals, general hospitals, and tertiary hospitals in Seoul, Gyeonggi, and Chungcheong provinces and had more than one year of clinical experience. The research data were collected from December 26, 2022, to April 7, 2023, using structured questionnaires and analyzed using SPSS software. The study conducted mean, standard deviation, percentage, t-test, ANOVA, Pearson‘s correlation coefficient, and hierarchical regression analysis.
Results
Perceived organizational support was identified as the factor influencing structural career plateaus. Factors influencing content career plateaus included growth needs, skill variety, organizational justice, and perceived organizational support.
Conclusion
The above research results suggest that to increase the motivation of clinical nurses and reduce career plateaus, it is necessary to improve awareness and systems of human resource management at the organizational level.

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How Do We Approach Quality Care for Patients from Middle Eastern Countries? A Phenomenological Study of Korean Nurses’ Experiences: Jang, Dael , Choi, Seonhwa , Hwang, Gahui , Kim, Sanghee; J Korean Acad Nurs 2024;54(3):372-385. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24036

Abstract PDF: Purpose
Although more people from Middle Eastern countries are visiting South Korea for medical treatment, Korean nurses lack experience in treating them. Understanding and describing Korean nurses’ experiences can help them provide quality care to these patients by enhancing their competency in culturally appropriate care. This study described the experiences of nurses who provide care to Middle Eastern patients in clinical settings in South Korea.
Methods
We conducted a phenomenological study to describe nurses’ experience of caring for patients from Middle Eastern countries. Ten nurses with prior experience in caring for these patients were recruited from a university-affiliated tertiary hospital. Semi-structured face-to-face interviews were conducted between May 1 and June 4, 2020. The transcribed data were analyzed using Giorgi’s phenomenological method to identify the primary and minor categories representing nurses’ experiences.
Results
Four major categories (new experiences in caring for culturally diverse patients, challenges in caring for patients in a culturally appropriate manner, nursing journey of mutual agreement with culturally diverse patients, and being and becoming more culturally competent) and 11 subcategories were identified.
Conclusion
Nurses experience various challenges when caring for Middle Eastern patients with diverse language and cultural needs. However, nurses strive to provide high-quality care using various approaches and experience positive emotions through this process. To provide quality care to these patients, hospital environments and educational programs must be developed that center on field nurses and students and support them in delivering quality care while utilizing their cultural capabilities.

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Temporal Exploration of New Nurses’ Field Adaptation Using Text Network Analysis: Ahn, Shin Hye , Jeong, Hye Won , Yang, Seong Gyeong , Jung, Ue Seok , Choi, Myoung Lee , Kim, Heui Seon; J Korean Acad Nurs 2024;54(3):358-371. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24034

Abstract PDF: Purpose
This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion: These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.

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Concept Analysis of Social Intelligence of Nurses Using Hybrid Model: Lee, Kyung Ran , Lee, Na Kyoung , Oh, Hee , Park, Kyoung Ae; 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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The Influence of Diversity Management of Nursing Organization on Organizational Commitment: Double Mediating Effect of Diversity Sensitivity Orientation and Positive Nursing Organizational Culture: Jeon, Hwi Gon , Jang, Keum Seong , Kim, Eun A; J Korean Acad Nurs 2024;54(3):403-417. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.23120

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

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Factors Related to Emotional Leadership in Nurses Manager: Systematic Review and Meta-Analysis: Jang, Se Young , Park, Chan Mi , Yang, Eun Hee; J Korean Acad Nurs 2024;54(2):119-138. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.24026

Abstract PDF: Purpose
This study aimed to identify research trends related to emotional leadership among nurse managers by conducting a systematic literature review and meta-analysis. This study sought to derive insights that could contribute to improving emotional leadership in nursing practice.
Methods
A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Research Information Sharing Service, Koreanstudies Information Service System, Korean Medical Database, KoreaMed, ScienceON, and DBpia were searched to obtain papers published in English and Korean. Literature searches and screenings were conducted for the period December 1, 2023 to December 17, 2023. The effect size correlation (ESr) was calculated for each variable and the meta-analysis was performed using the statistical software SPSS 29.0, R 4.3.1.
Results
Twenty-five (four personal, six job, and fifteen organizational) relevant variables were identified through the systematic review. The results of the meta-analysis showed that the total overall effect size was ESr = .33. Job satisfaction (ESr = .40) and leader-member exchange (ESr = .75) had the largest effect size among the job and organizational-related factors.
Conclusion
Emotional leadership helps promote positive changes within organizations, improves organizational effectiveness, and increases member engagement and satisfaction. Therefore, it is considered an important strategic factor in improving organizational performance.

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Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study: Min, Ari , Seo, Jisu , Kang, Minkyung , Hong, Hye Chong; J Korean Acad Nurs 2024;54(2):139-150. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23164

Abstract PDF: Purpose
This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work.
Methods
This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis.
Results
Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning.
Conclusion
Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

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

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

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National Petition Analysis Related to Nursing: Text Network Analysis and Topic Modeling: Ko, HyunJung , Jeong, Seok Hee , Lee, Eun Jee , Kim, Hee Sun; J Korean Acad Nurs 2023;53(6):635-651. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23052

Abstract PDF: Purpose
This study aimed to identify the main keyword, network structure, and main topics of the national petition related to “nursing” in South Korea.
Methods
Data were gathered from petitions related to the national petition in Korea Blue House related to the topic “nursing” or “nurse” from August 17, 2017, to May 9, 2022. A total of 5,154 petitions were searched, and 995 were selected for the final analysis. Text network analysis and topic modeling were analyzed using the Netminer 4.5.0 program.
Results
Regarding network characteristics, a density of 0.03, an average degree of 144.483, and an average distance of 1.943 were found. Compared to results of degree centrality and betweenness centrality, keywords such as “work environment,” “nursing university,” “license,” and “education” appeared typically in the eigenvector centrality analysis. Topic modeling derived four topics: (1) “Improving the working environment and dealing with nursing professionals,” (2) “requesting investigation and punishment related to medical accidents,” (3) “requiring clear role regulation and legislation of medical and nonmedical professions,” and (4) “demanding improvement of healthcare-related systems and services.” Conclusion: This is the first study to analyze Korea's national petitions in the field of nursing. This study's results confirmed both the internal needs and external demands for nurses in South Korea. Policies and laws that reflect these results should be developed.

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1 Web of Science

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

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

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Effects of Nursing Work Environment on Intention to Stay of Hospital Nurses: A Two-Mediator Serial Mediation Effect of Career Motivation and Job-Esteem: Lee, Yu Na , Kim, Eungyung; J Korean Acad Nurs 2023;53(6):622-634. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23038

Abstract PDF: Purpose
This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses.
Methods
Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program.
Results
The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r = .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09~.59]) and job-esteem (B = 0.27 [.04~.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem.
Conclusion
In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses’ motivation for career development and recognition of the nursing profession through improvement of the nursing work environment.

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

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

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Effects of Emotional Intelligence on Job Satisfaction of Pediatric Nurses: The Mediating Effect of Communication Skills and Pediatric Nurse-Parent Partnership: Lee, Da Gyeon , Choi, Mi-Young; J Korean Acad Nurs 2023;53(5):514-524. Published online October 31, 2023; DOI: https://doi.org/10.4040/jkan.23044

Abstract PDF: Purpose
This study aimed to identify the mediating effects of communication skills and pediatric nurse-parent partnership on the relationship between emotional intelligence and job satisfaction among pediatric nurses.
Methods
A survey was administered to 205 pediatric nurses working in children’s, general, and tertiary hospitals situated in Chungcheong province and Seoul. Data were collected in August and September 2022. The collected data were analyzed using SPSS Statistics version 26.0 along with the PROCESS macro program.
Results
Emotional intelligence had a significant effect, and was a critical factor affecting the job satisfaction of pediatric nurses. Furthermore, communication skills and nurse-parent partnership had a serial double mediating effect.
Conclusion
These findings underscore the significance of conducting job satisfaction improvement programs, including strategies for augmenting emotional intelligence, bolstering communication skills, and fostering nurse-parent partnership.

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Analysis of Media Trends and Social Perceptions on Nursing Law Legislation: Lee, Seung-Hee , Joo, Min-Ho; J Korean Acad Nurs 2023;53(4):439-452. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.23030

Abstract PDF: Purpose
This study aimed to derive considerations for the enactment of nursing law by analyzing the trends and social perceptions of nursing law mentioned in major daily newspapers, cafes, and blogs.
Methods
Main texts and comments that included nursing law as a keyword were collected from major daily news and online postings from January 2021 to August 2022. The data collected through web crawling were analyzed using a TousFlux program used for big data analysis.
Results
During the period of study, the awareness level around nursing law enactment increased. In particular, public concern over nursing law enactment intensified due to the two political parties' policy pledges related to nursing law in January 2022 and the failure to introduce the nursing law to the national assembly judiciary committee in May 2022. Except in December 2021, public perception of nursing law enactment was generally favorable, with public opinion tilting more in favor of than against enactment.
Conclusion
Public opinion should be considered when drafting and implementing the nursing law to make it easier for the people to understand what the law constitutes. In addition, it is necessary to pay attention to and continuously promote the relationship between medical care and nursing in the nursing law system of developed nations. Lastly, nursing law enactment can enhance nurses' retention intention and provide a sense of efficacy to medical services.

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Effects of a Modified Six-Sigma-Methodology-Based Training Program on Core Competencies in Rehabilitation Nurse Specialists: Gu, Jiayi , Luo, Lan , Li,, Chengjuan , Ma, Sumin , Gong, Fanghua; J Korean Acad Nurs 2023;53(4):412-425. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.22122

Abstract PDF: Purpose
Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform—a modified Six-Sigma-based training program—against a conventional educational program on rehabilitation specialist nurses’ core competencies, post-training performance, and satisfaction.
Methods
A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base’s 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented.
Results
Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05).
Conclusion
The modified training program strengthens rehabilitation nurses’ base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.

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2 Web of Science

Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses: Ahn, Yun Sil , Oh, Pok Ja; J Korean Acad Nurs 2023;53(3):340-358. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.23039

Abstract PDF: Purpose
This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability.
Methods
A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha.
Results
The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, main-taining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90.
Conclusion
Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.

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Effects of Clinical Nurses’ Job Crafting on Organizational Effectiveness Based on Job DemandsResource Model: Lee, Eun Young , Kim, Eungyung; J Korean Acad Nurs 2023;53(1):129-143. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22138

Abstract PDF: Purpose
This study aimed to examine the mediating effects of clinical nurses’ job crafting on organizational effectiveness based on the job demands-resources model proposed by Bakker and Demerouti (2017).
Methods
The participants consisted of 393 nurses working in nursing units of a tertiary general hospital located in Cheongju region. The data, collected using questionnaire from August 9 to August 20, 2021, were analyzed using SPSS 23.0 and AMOS 27.0.
Results
The goodness-of-fit (GoF) test results on the modified model (χ 2 = 2.7, GFI = .94, SRMR = .03, RMSEA = .06, NFI = .92, CFI = .94, TLI = .92, AGFI = .90), indicated that the GoF index satisfied the recommended level. Regarding the effects of each variable on organizational effectiveness, job crafting showed statistically significant direct (β = .48, p < .001), indirect (β = .23, p < .001), and total effects (β = .71, p < .001). Burnout showed statistically significant direct effect (β = - .17, p < .001). Work engagement showed statistically significant direct (β = .41, p < .001) and total effects (β = .41, p < .001). The factors explaining organizational effectiveness were job crafting, burnout, and work engagement, which had an explanatory power of 76.7%.
Conclusion
Nurses’ job crafting is an important mediating factor for enhancing the organizational effectiveness of nursing organizations. Hospitals should develop job-crafting success cases and related education and training programs as a strategy for enhancing the job crafting of nurses and, consequently organizational effectiveness.

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Intention to Delegate Clinical Practice of Medical Specialists in Accordance with the Enactment of the Scope of Practice for Advanced Practice Nurses: Kim, Min Young , Choi, Su Jung , Kim, Jeong Hye , Leem, Cho Sun , Kang, Young-ah; J Korean Acad Nurs 2023;53(1):39-54. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22098

Abstract PDF: Purpose
This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs).
Methods
Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN.
Results
The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks.
Conclusion
To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

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Conceptual Analysis of Career Anchors of Nurses: Oh, Jae Woo , Kim, Mi Ran; J Korean Acad Nurs 2023;53(1):28-38. Published online February 28, 2023; DOI: https://doi.org/10.4040/jkan.22091

Abstract PDF: Purpose
This study aimed to provide a theoretical basis for career anchors of nurses by defining and organizing its concept.
Methods
Using the Walker and Avant concept analysis, a total of 29 articles were analyzed through a literature search in this study.
Results
The career anchors of nurses are individual career choice motives, a self-concept where in competency and values are harmonized, which act as a desire for growth and development in nursing, and are actions that maintain careers. Additionally, they indicate the direction for achieving individual career goals and act as a core value expected of nurses by nursing organizations, indicating continuous and integrated professional growth and development of the nursing profession.
Conclusion
The career anchors of nurses identified in the results contribute to securing patient safety, providing quality care through policies, institutionalizing bases for career development, preventing nurse turnover, and retaining skilled nurses.

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The Moderating Effect of Organizational Justice on the Relationship between Self-Efficacy and Nursing Performance in Clinical Nurses: Kim, Ju-Ra , Ko, Yukyung , Lee, Youngjin , Kim, Chun-Ja; J Korean Acad Nurs 2022;52(5):511-521. Published online October 31, 2022; DOI: https://doi.org/10.4040/jkan.22076

Abstract PDF: Purpose
This study aimed to examine the moderating effect of organizational justice on the relationship between self-efficacy and nursing performance among clinical nurses.
Methods
In January 2021, a cross-sectional survey was conducted with 224 clinical nurses recruited from a university-affiliated hospital in Suwon, South Korea. Participants completed online-based, self-report structured questionnaires. Collected data were analyzed using multiple regression and a simple model of PROCESS macro with a 95% bias-corrected bootstrap confidence interval.
Results
Self-efficacy and organizational justice were found to be significant predictors of nursing performance. These two predictors explained the additional 34.8% variance of nursing performance in the hierarchical regression model, after adjusting the other covariates. In addition, organizational justice moderated the relationship between self-efficacy and nursing performance among the clinical nurses. In particular, at low self-efficacy level, participants with high organizational justice had higher nursing performance compared to those with low organizational justice.
Conclusion
Enhancing organizational justice can be used as an organizational strategy for improving the organizational culture in terms of distribution, procedure, and interaction. Ultimately, these efforts will contribute to the improvement of nursing performance through a synergistic effect on organizational justice beyond nurses’ individual competency and self-efficacy.

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Effects of Leadership Styles of Nursing Managers on Turnover Intention of Hospital Nurses: A Systematic Review and Meta-Analysis: Cho, Yunjeong , Jeong, Seok Hee , Kim, Hee Sun , Kim, Young Man; J Korean Acad Nurs 2022;52(5):479-498. Published online October 31, 2022; DOI: https://doi.org/10.4040/jkan.22039

Abstract PDF: Purpose
This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses.
Methods
A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers’ leadership styles; the outcome assessed was nurses’ turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used.
Results
The total effect size r (ESr) was - 0.25 (95% confidence interval: - 0.29 to - 0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = - 0.34), transformational leadership (ESr = - 0.28), authentic leadership (ESr = - 0.23), transactional leadership (ESr = - 0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses.
Conclusion
Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings.

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

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

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Patient Safety Management Activities of Korean Nurses: A Meta-Analytic Path Analysis: Jeong, Seohee , Jeong, Seok Hee; J Korean Acad Nurs 2022;52(4):363-377. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22022

Abstract PDF: Purpose
This study aimed to test a hypothetical model of Korean nurses’ patient safety management activities using meta-analytic path analysis.
Methods
A systematic review, meta-analysis, and meta-analytic path analysis were conducted following the PRISMA and MOOSE guidelines. Seventy-four studies for the meta-analysis and 92 for the meta-analytic path analysis were included. The R software program (Version 3.6.3) was used for data analysis.
Results
Four variables out of 49 relevant variables were selected in the meta-analysis. These four variables showed large effect sizes (ESr = .54) or median effect sizes (ESr = .33∼.40) with the highest k (number of studies) in the individual, job, and organizational categories. The hypothetical model for the meta-analytic path analysis was established using these variables and patient safety management activities. Twelve hypothetical paths were set and tested. Finally, the perception of the importance of patient safety management and patient safety competency directly affected patient safety management activities. In addition, self-efficacy, the perception of the importance of patient safety management, patient safety competency, and patient safety culture, indirectly affected patient safety management activities.
Conclusion
Self-efficacy, the perception of the importance of patient safety management, patient safety competency, and the organization’s patient safety culture should be enhanced to improve nurses’ patient safety management activities.

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Effect of Patient Safety Training Program of Nurses in Operating Room: Zhang, Peijia , Liao, Xin , Luo, Jie; J Korean Acad Nurs 2022;52(4):378-390. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22017

Abstract PDF: Purpose
This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR).
Methods
A pretest–posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge–attitude–practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest).
Results
A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses’ adverse event reporting were above the moderate level.
Conclusion
The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture.

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

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

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Validity and Reliability of the Korean Version of the Climate, Health, and Nursing Tool: Jeong, Da Woon , Kim, Gwang Suk , Park, Min Kyung; J Korean Acad Nurs 2022;52(2):173-186. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21211

Abstract PDF: Purpose
Climate change has various negative effects on human health, which has resulted in increased burden on the health care system. Nurses contribute significantly to assessing climate-related health risks and creating a healthy environment. This study aimed to evaluate the reliability and validity of the Korean version of the Climate, Health, and Nursing Tool (K-CHANT) to measure nurses’ awareness, motivation, concern, and behaviors at work and at home regarding climate change and health.
Methods
The 22 items of English CHANT were translated into Korean with forward-backward translation techniques. Internal consistency reliability, test-retest reliability, and construct validity using confirmatory factor analysis were performed using SPSS WIN (25.0) and AMOS (26.0). Survey data were collected from 220 master’s, doctoral, and post-doctoral nursing students.
Results
The K-CHANT consists of 20 items across 5 domains.Two items of the original CHANT were excluded because of low content validity index and standardized regression weights. The internal consistency reliability of the K-CHANT, assessed by Cronbach’s αá was .81, with an intraclass correlation coefficient of .66~.90. The five subscales model was validated by confirmatory factor analysis (SRMR < .08, RMSEA < .08, AGFI > .70, CFI > .70).
Conclusion
The K-CHANT has satisfactory construct validity and reliability to measure nurses’ awareness, motivation, concern, and behaviors at work and at home regarding climate change and health. Future research should examine nurses’ perceptions and behaviors related to the health effects of climate change and develop an action plan to improve it.

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Relationships among Knowledge and Skills about Suicide Prevention, Attitudes toward Suicide, and Burnout of Suicide Prevention Work of Nurses at Mental Health Welfare Centers: A Mixed Methods Study: Dong, Hee-Ra , Seo, Ji Min; J Korean Acad Nurs 2022;52(1):92-104. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21189

Abstract PDF: Purpose
This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers.
Methods
An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method.
Results
Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18,p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were ‘feeling a lack of confidence in one’s suicide counselling skills’, ‘feeling of the limits of one’s ability to cope with a suicide crisis’, ‘feeling regret for not being able to help the clients’, ‘being over-empathetic to the clients’, ‘Not being able to understand the clients because the subjects (nurses) opposes committing suicide’, and ‘thinking that the suicidal thoughts of suicide attempters do not improve’.
Conclusion
To reduce burnout of nurses’ suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

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

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

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