Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required.
The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables.
The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care.
These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.
This second study on the effectiveness of nursing organization was designed to test the relationships between effectiveness of nursing organizations and structural variables that had been significant variables in the first study, the group design variable and the personal characteristic variables that had not been analysed in the first study based on personal resource productivity model. The data were collected through self-reported questionnaires completed by 605 nurses working in hospitals in seoul and 782 patients being hospitalized in 5 tertiary hospitals in Seoul. The results showed that according to the canonical correlation analysis, the managing job design, nursing delivery system. nurse's age career, and formalization were revealed as predicting variables of a nurses' job satisfaction and patients satisfaction among the five hospitals. Hospitals in which the team nursing method was used showed a higher score in nurses' job satisfaction and patient satisfaction than in hospitals which used the functional nursing model.
Today's healthcare environment is changing driven by demographic, environmental, social, political and technological forces. These rapidly changing healthcare environment and increasingly professional nursing practice indicate that identifying leadership characteristic of nursing leaders and executives is a vital importance in today's time and also mandate innovative leadership for nursing service. Therefore, the purpose of this study is to examined the transformational, transactional leadership styles of the Nurse Administrators. Also described are the relationships between these leadership style and the job satisfaction, the organizational commitment of their subordinates. The sample consisted of sixteen mid-level nurse administrators, fifty head nurses and one hundred and fifty-three staff nurses of 4 public and private University Hospitals and 1 General Hospital. Data for this study was collected from Sep. 20 to Oct. 5by Questionnaire(Bass' MLQ, Job Satisfaction scale developed by Poter et al(1978). Organizational Commitment scale by Poter at al(1070). The data was analyzed by frequency, percentage, one-way ANOVA, Pearson's Correlation Coefficient with SPSS PC+ program. Major findings are as follows : Appropriate one-way ANOVA tests revealed that the difference for transformation and transactional leadership styles of nurse executives, mid-level nurse administrators, head nurses as perceived by their immediate subordinates were statistically significant(P<.05). The scores of transformational and contingent reward behaviors were declined of the mid-level nurse administrators, nurse executives. The transactional scores of nurse administrators were lower than transformational ones, which is desirable findings. The result of the highest transformational leader by their subordinates, and second was the mid-level nurse administrators. The nurse executives received the lowest transformational leadership scores from their subordinates. These results were opposit to the previous studies. And significant positive correlations were founded between transformational leadership including charisma, intellectual stimulation, individual consideration and contingent reward of nurse administrators and the job satisfaction, the organizational commitment of their subordinates. From the data, it can be concluded that transformational leadership style of nurse administrators promotes the job stratification, the organizational commitment of their staff nurses. Therefore leader looks for potential motives in subordinates, seeks to satisfy higher need, and engages the full person of the subordinate resulting in a relationship of mutual stimulation and elevation.
This study was designed to test relationship between effectiveness of nursing organizations and structural and managerial variables of nursing organizations that are described in the Robbins Organizational theory model. The data were collected through self reported questionnaires from 605 nurses working in, and 782 patients hospitalized in, five tertiary hospitals in seoul. Results showed that according to MANOVA there was a significant difference in nurses job satisfaction and patient satisfaction among the five hospitals. According to cluster analysis of the structural and managerial variables of nursing organizations, the five hospitals were divided into two clusters and there was no significant difference in nurses job satisfaction or patient satisfaction between the two clusters. According to canonical correlation analysis the formalization and centralization of structural variables were shown to be predicting variables for nurses job satisfaction, and the managing job design and managing change of managerial variables were shown to be predicting variables for nurses job satisfaction.
PURPOSE: The Purpose of this study was to identify the relationship among leadership style of nurse managers, job satisfaction, organizational commitment, and turnover intention. METHOD: The subjects were 468 nurses and 19 head nurses who were working at the 3 general hospitals in seoul. The data were collected from July 6 to September 14, 2001 by the structured questionnaires. For data analysis, descriptive statistics, ANOVA, Pearson correlation coefficient, and stepwise multiple regression with SAS package were used. RESULT: 1) The score of the nurse managers' transformational leadership perceived by surbodinates' were higher than that of the nurse managers' transactional leadership. Among 5 subdimensions of the leadership styles perceived by surbodinates', the scores of 'charisma' and 'intellectual stimulation' were highest and 'management by exception' were lowest. 2) 'Charisma', 'intellectual stimulation', 'individual consideration' and 'contingent reward' were positively related to all of variables except 'turnover intention'. 'Management by exception' was negatively related to all of variables and was positively related to 'turnover intention'. 3) 'Job satisfaction' was positively related to 'organizational commitment' and 'Job satisfaction', 'organizational commitment' were negatively related to 'turnover intention'. 4) As a result of stepwise multiple regression analysis, the key determinants of 'turnover intention' were 'organizational commitment' and this explained 44.4% of the total variance of it.
With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.
This study investigated the relationship between the nurse's followership, job satisfaction and organizational commitment. The sample consisted of 173 nurses of 2 private university hospitals. The instruments used in this study were the followership scale (Kelly, 1994), the job satisfaction scale (Slavitts et al., 1978), the organizational commitment questionnaire (Mowday et al., 1979) and the demographic questionnaire. SPSS/WIN program was used for descriptive statistics, ANOVA, and Pearson correlation analysis of data. The results were as follows: 1) The styles of followership were classified as pragmatist followers (73.4%), exemplary followers (19.7%), passive followers (4.6%), and alienated followers (2.3%). 2) The mean of independent/ critical thinking was 3.32 (M=3.0), and active involvement was 3.04 (M=3.0). As a whole, the mean of followership was 3.18 (M=3.0), job satisfaction was 2.82 (M=2.5), and organizational commitment was 3.97 (M=3.5). 3) Significant differences were found in the degree of clinical nurses' perception of followership according to the demographic characteristics such as age, education, position, and career. 4) Significant differences were found in the degree of clinical nurses' perception of followership according to followership styles. 5) The followership was significantly related to job satisfaction and organizational commitment. In conclusion, the nurse's followership is considered as an important concept and this suggested that the concept could be used as a major variable in measuring effectiveness of nursing organization.
The purpose of this study was to investigate the influence of job characteristics on the nurses' the moderating effect of locus of control on the job satisfaction and organizational commitment and relationship between job characteristics and attitude. The sample for this study consisted of 594 nurses from 8 university hospitals. Factor analysis, Cronbach's alpha analysis, multiple regression analysis and hierarchical multiple regression analysis were used for the statistical methods. The results of this study were found that (1) autonomy among 5 core job characteristics showed positive influence on job satisfaction, (2) task significance and autonomy among 5 core job characteristics had positive influence on organizational commitment, (3) the internals of locus of control moderated the effect of job characteristics on nurses' job satisfaction, and (4) internals and externals of locus of control moderated the effect of job characteristics on nurses' organizational commitment.
This study was performed to analyze effects of the power and empowerment on job satisfaction and organizational commitment. This study was based on the Kanter's theory of organizational empowerment.
A predictive, non-experimental design was used to test the model in a sample of 688 nurses working in 7 university hospitals that have over 500 beds in Seoul, Kyunggi and Kangwon provinces. The data were collected from December, 2003 to January, 2004. It was analyzed with descriptive statistics and Pearson correlation of SPSS and with path analysis of LISREL.
The formal and informal power had direct effects on empowerment. Formal power also had direct effects on informal power. Empowerment had direct effects on job satisfaction and organizational commitment. Organizational commitment had direct effects on job satisfaction. There was positive effects in all of the variables.
The positive changes show on personal behaviors and attitudes when the nurses who have formal and informal power are empowered. These findings would be important resource to nurse administrators for clinical implication.
The purpose of this study is to investigate the role of social support in the experience of job stress among hospital nurses.
This study was carefully designed to overcome methodological shortcomings found in past research, and examined two organizational effectiveness variables(job satisfaction and organizational commitment) as outcome variables. The sample used in this study consisted of 602 nurses from 5 general hospitals. Data were collected with self-administered questionnaires and analyzed using hierarchical regression and LISREL technique.
It was found that: (a) three job stress variables(workload, role conflict and conflict with other medical staff) have negative effects on job satisfaction and organizational commitment; (b) social support have positive main effects on the two output variables; (c) the negative effects of job stress variables on job satisfaction and organizational commitment are not buffered by social support, and (d) social support mediates the effects of job stress on job satisfaction and organizational commitment, and the size of the mediating effects is small.
Further research needs to be done to further refine this study.
The purpose of this study was to analyze the paths of influence that a hospital's ethical climate exerts on nurses' organizational commitment and organizational citizenship behavior, with supervisor trust as the mediating factor, and verify compatibility of the models in hospital nurses.
The sample consisted of 374 nurses recruited from four hospitals in 3 cities in Korea. The measurements included the Ethical Climate Questionnaire, Supervisor Trust Questionnaire, Organizational Commitment Questionnaire and Organizational Citizenship Behavior Questionnaire. Ethical Climate Questionnaire consisted of 6 factors; benevolence, personal morality, company rules and procedures, laws and professional codes, self-interest and efficiency. Data were analysed using SPSS version 18.0 and AMOS version 18.0.
Supervisor trust was explained by benevolence and self-interest (29.8%). Organizational commitment was explained by benevolence, supervisor trust, personal morality, and rules and procedures (40.4%). Organizational citizenship behavior was explained by supervisor trust, laws and codes, and benevolence (21.8%).
Findings indicate that managers need to develop a positive hospital ethical climate in order to improve nurses' trust in supervisors, organizational commitment and organizational citizenship behavior.
The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM).
A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses.
The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ2=586.03, χ2/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life.
The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.
The purpose of this study was to validate the Korean version of the Ethical Leadership at Work questionnaire (K-ELW) that measures RNs' perceived ethical leadership of their nurse managers.
The strong validation process suggested by Benson (1998), including translation and cultural adaptation stage, structural stage, and external stage, was used. Participants were 241 RNs who reported their perceived ethical leadership using both the pre-version of K-ELW and a previously known Ethical Leadership Scale, and interactional justice of their managers, as well as their own demographics, organizational commitment and organizational citizenship behavior. Data analyses included descriptive statistics, Pearson correlation coefficients, reliability coefficients, exploratory factor analysis, and confirmatory factor analysis. SPSS 19.0 and Amos 18.0 versions were used.
A modified K-ELW was developed from construct validity evidence and included 31 items in 7 domains: People orientation, task responsibility fairness, relationship fairness, power sharing, concern for sustainability, ethical guidance, and integrity. Convergent validity, discriminant validity, and concurrent validity were supported according to the correlation coefficients of the 7 domains with other measures.
The results of this study provide preliminary evidence that the modified K-ELW can be adopted in Korean nursing organizations, and reliable and valid ethical leadership scores can be expected.
The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity.
A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program.
Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity.
This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.
The purpose of this study was to examine the impact of strategies to promote reporting of errors on nurses' attitude to reporting errors, organizational culture related to patient safety, intention to report and reporting rate in hospital nurses.
A nonequivalent control group non-synchronized design was used for this study. The program was developed and then administered to the experimental group for 12 weeks. Data were analyzed using descriptive analysis, χ2-test, t-test, and ANCOVA with the SPSS 12.0 program.
After the intervention, the experimental group showed significantly higher scores for nurses' attitude to reporting errors (experimental: 20.73 vs control: 20.52, F=5.483,
The study findings indicate that strategies that promote reporting of errors play an important role in producing positive attitudes to reporting errors and improving behavior of reporting. Further advanced strategies for reporting errors that can lead to improved patient safety should be developed and applied in a broad range of hospitals.
The purpose of this study was to identify the moderating and mediating effects of self-leadership in the relationship between organizational culture and nurses' informatics competency.
Participants in this study were 297 nurses from the cities of Busan and Ulsan. The scales of organizational culture, self-leadership and informatics competency for nurses were used in this study. Descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were used for data analysis.
Nursing informatics competency of the participants was relatively low with a mean score 3.02. There were significant positive correlations between subcategories of perceived organizational culture, self-leadership and nursing informatics competency. Self-leadership was a moderator and a mediator between organizational culture and informatics competency.
Based on the results of this study, self-leadership promotion strategies to improve nursing informatics competency are needed.
This study was conducted to identify the factors that influence nurses' organizational citizenship behavior.
A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational·transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis.
The factors influencing nurses' organizational citizenship behavior were identified as self-leadership (β=.247), empowerment (β=.233), job satisfaction (β=.209), organizational commitment (β=.158), and transactional leadership (β=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior.
The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.
This study was a secondary analysis to verify the mediating role of organizational citizenship behavior (OCB) between organizational justice (OJ) and organizational effectiveness (OE) in nursing organizations.
The RN-BSNs and their colleagues in Seoul and Busan were subjects. The data was collected for 20 days between September 13 and October 2, 2004. Two hundred eighty three data sets were used for the final analysis. The fitness of models were tested using AMOS 5.
The fitness of hypothetical model was moderate. Procedural Justice (PJ), Interaction Justice (IJ) and Distributive Justice (DJ) had direct effects on Job Satisfaction (JS), Organizational Commitment (OC) and Turnover Intention (TI) in OE, and indirect effects on JS, OC and TI mediated by OCB. The modified model improved with ideal fitness showed the causal relations among OE. In modified model, PJ, IJ and DJ had direct positive effects on OCB and JS and OC in OE, and indirect effects on JS and OC mediated by OCB. JS and OC in OE had a direct negative effect on TI.
OCB mediated the relationship between OJ and OE, so the nursing managers should enhance OCB of the nurses in order to improve OE.
The purpose of this study was to identify factors related to nurses' organizational citizenship behavior using multilevel analysis which included both nurse characteristics at individual levels and nursing unit characteristics at group levels.
The sample was composed of 1,996 nurses who were selected from 182 nursing units in 28 hospitals in six metropolitan cities and seven provinces using cluster sampling. Data were collected using self-reported questionnaires from February to March 2006.
The results of the study indicated that individual level variables related to organizational citizenship behavior were religion, job position, clinical career, self efficacy, positive affectivity, and supervisor support. The group level variables related to organizational citizenship behavior were collective efficacy, number of nurses in a nursing unit, and the average salary level of a nursing unit. 30.9% of individual level variances of organizational citizenship behavior were explained by the nurses' individual level variables. The explanatory power of group level variables, which is related to group level variances of organizational citizenship behavior, was 75.5%.
This research showed that it was necessary to develop appropriate strategies related to not only individual factors, but also higher-level organizational factors such as collective efficacy, to improve individual performances in the hospital.