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6 "Nurse-patient relations"
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Research Paper
A Concept Analysis of Quality Nursing Care
Juanamasta, I Gede , Aungsuroch, Yupin , Gunawan, Joko
J Korean Acad Nurs 2021;51(4):430-441.   Published online August 31, 2021
DOI: https://doi.org/10.4040/jkan.21075
AbstractAbstract PDF
Purpose
This study aimed to perform a concept analysis of quality nursing care.
Methods
Walker and Avant’s concept analysis method was used to carry out this study.
Results
The defining attributes identified were as follows: caring, the nurse-patient relationship, and patient needs. Antecedents included patient characteristics, individual factors (age, education, knowledge, competence, and experience), job position, and environmental factors. The consequences of quality nursing care have significant influence on both patients and nurses.
Conclusion
The findings can aid researchers in obtaining a better understanding of quality nursing care, and stakeholders can consider the factors related to quality nursing care and its consequences to improve the nursing process.
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Original Articles
Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study
Myoung Sun Jang, Sungjae Kim
J Korean Acad Nurs 2019;49(4):423-436.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.423
AbstractAbstract PDF
Abstract Purpose

The aim of the study was to explore nurses’ experience of person-centered relational care in the context of critical care.

Methods

Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data.

Results

Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory.

Conclusion

The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

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A Study about the Human Communication between Clinical Nurse and Patient
Myung Hee Jun
Journal of Korean Academy of Nursing 1999;29(4):841-854.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.4.841
AbstractAbstract PDF

This study tried to the answer to the question : "How does the human communication happen between clinical nurse and patient?" To answer that, a micro-ethnographic research method was used and I performed field work at the orthopedic ward in one Korean metropolitan city. After analysis of interview data, observational data and field notes, I could understand that clinical nurse-patient communication performed for clinical decision making, providing patient education and emotional support. Prepared nurse communicate with patient more effectively, eventually can establish more trust relationship with patient. Conclusively I discussed about the way of nurse's skill acquisition, need of collaborative conference with doctor and nurse, and curriculum development to promote nurses's understanding of human.

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

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

Methods

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

Results

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

Conclusion

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

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Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns
Myungsun Yi
J Korean Acad Nurs 2009;39(2):166-176.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.166
AbstractAbstract PDF
Purpose

The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility.

Methods

Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005.

Results

Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding.

Conclusion

It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in health-care institutions for elders.

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Emergency Nurse-Patient Interaction Behavior
Eun Jeong Kim
Journal of Korean Academy of Nursing 2005;35(6):1004-1013.   Published online October 31, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.6.1004
AbstractAbstract PDF
Purpose

The main purpose of this study was to explore nurse-patient interaction behaviors and patient satisfaction with the interaction in the emergency department.

Method

This study used video technology to record complete conversations between the nurse and patient, thus obtaining the interactions naturally occurring in a clinical setting. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data was collected from November, 2002 to April, 2003. The video recordings were observed for 4 hours for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS), which yields frequencies of thirty-six types of interaction behaviors.

Result

The information exchange related to therapeutic items including medications, simple orientation, and situational positive talk were characterized in the nurses' interaction behaviors. Giving information about one's own condition, questions about therapeutic regimen, and showing worry were characterized in patient interaction behaviors. The patients' satisfaction with the interaction was 37.75.9 (range 9-45).

Conclusion

The emergency nurse-patient interaction behavior was task-related. The results suggest that identification of effective interaction behavior in the Emergency department and an interaction skill training program could increase patient satisfaction.

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