Journal of Korean Academy of Nursing

Research Papers

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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Factors Affecting the Intention to Use Smartmonitor-Based Mobile Health in Middle-Aged in Patients Applying the Technology Acceptance Model II: Ol Eum Joo, Yi Kyung Ha; J Korean Acad Nurs 2024;54(4):620-632. Published online November 13, 2024; DOI: https://doi.org/10.4040/jkan.24091

Abstract PDF ePub: Purpose
This study aimed to identify factors that influence the intention to use smart monitor-based mobile health (SBM) technology among middle-aged inpatients, based on the technology acceptance model II (TAM II).
Methods
A total of 222 participants were surveyed. Data were analyzed using SPSS Statistics 23.0 and IBM SPSS Amos 23. Seven exogenous variables–social influence (SI), personal self-efficacy, (PSE), environmental self-efficacy (ESE), health literacy, health concerns, resistance to innovative technology (RIT), accessibility (AC)– and three endogenous variables–perceived ease of use (PEOU), perceived usability (PU), and intention to use (ITU)–were investigated.
Results
The hypothesized path model demonstrated a good fit for the data. SI (β = .13, p = .042), PU (β = .46, p < .001), and PEOU (β = .16, p = .008) had significant direct effects on the ITU, which explained 39.5% of the variance. Additionally, SI (β = .27, p < .001), ESE (β = .16, p = .010), RIT (β = - .12, p = .026), AC (β = .28, p < .001), and PEOU (β = .20, p = .001) indirectly affected ITU through PU, which explained 50.7% of the variance. Furthermore, PSE (β = .38, p < .001) indirectly influenced ITU via PEOU, which explained 38.4% of the variance.
Conclusion
This study demonstrates that the TAM II can be used to effectively predict ITU in SBMs among middle-aged inpatients. To expand the intention to use SBMs, it is necessary to develop SBMs that include content and programs that promote PU, SI, and PEOU.

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The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty: Kyung-Hye Park, Hee-Young Kang; J Korean Acad Nurs 2024;54(4):547-562. Published online October 22, 2024; DOI: https://doi.org/10.4040/jkan.24027

Abstract PDF Supplementary Material ePub: Purpose
This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.
Methods
This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.
Results
Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.
Conclusion
These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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An Exploratory Study on Non-Contact Nursing Experiences of Clinical Nurses during the COVID-19 Pandemic: Byun, Hye Min , Yun, Eun Kyoung; J Korean Acad Nurs 2024;54(3):446-458. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24045

Abstract PDF: Purpose
This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic.
Methods
A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences.
Results
During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows: (1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism.
Conclusion
This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

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Structural Topic Modeling Analysis of Patient Safety Interest among Health Consumers in Social Media: Kim, Nari , Lee, Nam-Ju; J Korean Acad Nurs 2024;54(2):266-278. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23156

Abstract PDF: Purpose
This study aimed to investigate healthcare consumers’ interest in patient safety on social media using structural topic modeling (STM) and to identify changes in interest over time.
Methods
Analyzing 105,727 posts from Naver news comments, blogs, internet cafés, and Twitter between 2010 and 2022, this study deployed a Python script for data collection and preprocessing. STM analysis was conducted using R, with the documents’ publication years serving as metadata to trace the evolution of discussions on patient safety.
Results
The analysis identified a total of 13 distinct topics, organized into three primary communities: (1) “Demand for systemic improvement of medical accidents,” underscoring the need for legal and regulatory reform to enhance accountability; (2) “Efforts of the government and organizations for safety management,” highlighting proactive risk mitigation strategies; and (3) “Medical accidents exposed in the media,” reflecting widespread concerns over medical negligence and its repercussions. These findings indicate pervasive concerns regarding medical accountability and transparency among healthcare consumers.
Conclusion
The findings emphasize the importance of transparent healthcare policies and practices that openly address patient safety incidents. There is clear advocacy for policy reforms aimed at increasing the accountability and transparency of healthcare providers. Moreover, this study highlights the significance of educational and engagement initiatives involving healthcare consumers in fostering a culture of patient safety. Integrating consumer perspectives into patient safety strategies is crucial for developing a robust safety culture in healthcare.

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Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals: Choi, Jeeeun , Lee, Sujin , Park, Eunjin , Ku, Sangha , Kim, Sunhwa , Yu, Wonhye , Jeong, Eunmi , Park, Sukhee , Park, Yusun , Kim, Hye Young , Kim, Sung Reul; J Korean Acad Nurs 2024;54(2):151-161. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23127

Abstract PDF: Purpose
Patients’ perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients.
Methods
For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald’s omega coefficient was used to examine the internal consistency of reliability.
Results
In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald’s omega coefficient was .90.
Conclusion
The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.

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Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design: Kim, Hyun-Joo , Lee, Sun-Hee , Lee, Jai-Jung , Seong, Sun-Suk , Yang, Hee , Lee, Hyang-Yuol; J Korean Acad Nurs 2024;54(2):237-249. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.22142

Abstract PDF: Purpose
This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload.
Methods
The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively.
Results
The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload.
Conclusion
These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

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Development of Nursing Clinical Judgment Scale: Kwon, Shi Nae , Park, Hyojung; J Korean Acad Nurs 2023;53(6):652-665. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23042

Abstract PDF

Purpose
This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses.
Methods
A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale.
Results
The final scale comprised 23 items scored on a 5-point Likert scale. Six factors – integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues – accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach’s α for all the items was .92.
Conclusion
The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

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How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Mi Hwa Seo, Eun A. Kim, Hae Ran Kim, Mohammad Jamil Rababa
PLOS ONE.2025; 20(1): e0316654. CrossRef
Effects of Critical Thinking Disposition, Clinical Judgement, and Nurse–Physician Collaboration on Triage Competency Among Triage Nurses
Ji-Won Song, Hyung-Ran Park
Healthcare.2025; 13(4): 405. CrossRef

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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: Kim, Ye-Eun , Kang, Hee-Young; 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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Clinical Judgment Model‐Based Critical Reflection Program for Newly Graduated Nurses: A Nonrandomized Controlled Trial
Ae Ran Kim, Jeong Hee Hong, Kyeongsug Kim, Yuna Kim, Jung Min Lee, Heejin Lee, Ji Hyun Yoon, Mi Soon Kim
Research in Nursing & Health.2025;[Epub] CrossRef
The impact of unfolding case studies combined with think-aloud strategies on the clinical reasoning and self-directed learning abilities of postgraduate students: A mixed methods study
Yuehai Yu, Yuanjing Qiao, Yaoyao Zhu, Hao Pei, Yuting Wang, Qingyang Zhu, Shuo Liu
Nurse Education in Practice.2024; 80: 104132. CrossRef
Effect of Infection Control Simulation Based on a Negative Pressure Isolation Room Using Mixed Reality
Kyeng-Jin Kim, Joonyoung Lee, Moon-Ji Choi
CIN: Computers, Informatics, Nursing.2024; 42(8): 608. CrossRef
Expectations and concerns about transitioning to face-to-face learning among Korean nursing students: A mixed methods study
Hyeongsuk Lee, Hye Jin Yoo, Chao Gu
PLOS ONE.2024; 19(1): e0296914. CrossRef

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Review Paper

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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The influencing factors of pediatric nurses’ perception of patient safety culture and partnership with patients’ parents on patient safety nursing activities in South Korea: a descriptive study
Seo Jin Lee, Young Ran Han
Child Health Nursing Research.2024; 30(4): 255. CrossRef
Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities
JaHyun Kim, Seok Hee Jeong, Hee Sun Kim, Sunmi Kim
Journal of Korean Academy of Nursing Administration.2024; 30(4): 343. CrossRef
Mediating Effects of Job Satisfaction between Nurses’ Perceptions of Patient Safety Culture and Their Safety Nursing Activities
I Jung Han, Young Ran Han
Journal of Korean Academy of Fundamentals of Nursing.2023; 30(1): 46. CrossRef
The Effects of Professional Autonomy, Job Satisfaction, and Perceived Patient-Safety Culture on Nurses' Patient-Safety Management Activities: A Cross-Sectional Study
Bokja Koak, Junglim Seo, Eunji Song, Haneul Shin, Jaehee Jeon
Korean Journal of Adult Nursing.2023; 35(2): 117. CrossRef

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Research Papers

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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Effect of Counting Error Prevention Training on Operating Room Nurses’ Counting Error Prevention Awareness and Perceptions of Patient Safety
Myung Jin JANG, Mi Kyung HONG, Mi Jeong LEE, Kyung A LEE, Yang Ok KIM, Jin A JEON, Hana KO
Korean Journal of Health Promotion.2024; 24(1): 20. CrossRef

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The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients: Kim, Jin Sook , Ko, Il-Sun , Koh, Su Jin; J Korean Acad Nurs 2022;52(1):52-65. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21120

Abstract PDF

Purpose
This study was conducted to develop a scale to measure spiritual distress in cancer patients.
Methods
A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient.
Results
The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83.
Conclusion
The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

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Validity and reliability of the integrated palliative care outcome scale (IPOS) in Korea: a multicenter study of terminally ill cancer patients
So-Jung Park, Yujin Park, Mira Han, Sun-Hyun Kim, In Cheol Hwang, Go-un Woo, Yoo Jeong Lee, Young Sung Kim, Hyun Jung Jho, Yoon Jung Chang
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Nurses’ Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation: Noh, Eun-Young , Chai, Young Jun , Kim, Hyun Jeong , Kim, Eunjin , Park, Yeon-Hwan; J Korean Acad Nurs 2021;51(5):585-596. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21148

Abstract PDF

Purpose
The purpose of this study was to explore nurses’ experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic.
Methods
This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis.
Results
Two main themes emerged from the analysis: ‘Struggling in an isolated space’ and ’Limitations of nursing infrastructure and system’. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system.
Conclusion
The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

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An Exploratory Study on Non-Contact Nursing Experiences of Clinical Nurses during the COVID-19 Pandemic
Hye Min Byun, Eun Kyoung Yun
Journal of Korean Academy of Nursing.2024; 54(3): 446. CrossRef
Nurses’ intention to care of COVID-19 patients in hospitals dedicated to infectious disease in South Korea: application of the theory of planned behavior and verification of the moderating effect of ethical nursing competence
Mira Mo, Seongmi Moon, Eun Kyeung Song
BMC Nursing.2024;[Epub] CrossRef
Nurses' perceptions of medical service robots in negative‐pressure isolated wards and in general wards: A cross‐sectional survey
Jung Hwan Lee, In Ho Han, Jong Hwan Park, Kye‐Hyung Kim, Jaehyun Hwang, Dong Hwan Kim, Jae Il Lee, Kyoung Hyup Nam
Nursing Open.2024;[Epub] CrossRef
Korean Hospital Nurses’ Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings
Suk-Jung Han, Hee-Jung Hong, Bok-Soon Shin
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Hyeran An, Kyungmi Kim, Jongeun Lee, Sunhwa Won
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Eun-Young Noh, Yeon-Hwan Park, Young Jun Chai, Hyun Jeong Kim, Eunjin Kim
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Journal of Nursing Management.2022; 30(7): 2514. CrossRef
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Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units: Woo, Dahae , Yu, Hanui , Kim, Hyo Jin , Choi, Minyoung , Kim, Dong Hee; J Korean Acad Nurs 2021;51(5):573-584. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21143

Abstract PDF

Purpose
This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19.
Methods
This study adopted the double diamond process of service design comprising the discovery, defining, and development stages.
Results
We developed an untact visit service based on an application that considered the child’s status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder.
Conclusion
Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child’s information in real-time, and provide one-stop service without increasing healthcare providers’ work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

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Experiences of Family Members With Visitation Prohibition for Critically Ill Patients
Sunjung Kim, Sunghee H. Tak
Western Journal of Nursing Research.2024; 46(11): 854. CrossRef
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Eun Kyoung Kim, In Young Cho, Ji Yeong Yun, Bobae Park
Journal of Pediatric Nursing.2023; 68: e27. CrossRef
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HyunJung Ko, Seok Hee Jeong, Eun Jee Lee, Hee Sun Kim
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Effects of Second Victim Experiences after Patient Safety Incidents on Nursing Practice Changes in Korean Clinical Nurses: The Mediating Effects of Coping Behaviors: Jeong, Seohee , Jeong, Seok Hee; J Korean Acad Nurs 2021;51(4):489-504. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21089

Abstract PDF

Purpose
This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes.
Methods
A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval.
Results
The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice.
Conclusion
Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses’ constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

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Factors influencing negative outcomes for nurses who experience patient safety incidents: An integrative review
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International Nursing Review.2025;[Epub] CrossRef
How does just culture reduce negative work outcomes through second victim distress and demand for support in clinical nurses? A path analysis
Seohee Jeong, Sunmi Kim, Hyoung Eun Chang, Seok Hee Jeong
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“Learn from Errors”: Post-traumatic growth among second victims
Huanhuan Huang, Tong Liu, Ying Peng, Xingyao Du, Qi Huang, Qinghua Zhao, Mingzhao Xiao, Yetao Luo, Shuangjiang Zheng
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Eun Ha Kim, Yeojin Yi
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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

Abstract 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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Yu Cheng, Yuan-Xing Chen
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Prevalence of burnout and its determinants among Indonesian nurses: a multicentre study
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Ni Made Nopita Wati, I Gede Juanamasta, Jutharat Thongsalab, Jintana Yunibhand
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Validity and Reliability of the Korean Version of Person-Centered Practice Inventory–Staff for Nurses: Kim, Sohyun , Tak, Sunghee H; J Korean Acad Nurs 2021;51(3):363-379. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21027

Abstract PDF

Purpose
The purpose of this study was to evaluate the validity and reliability of the Korean version of Person-Centered Practice Inventory– Staff (PCPI-S) for nurses.
Methods
The English PCPI-S was translated into Korean with forward and backward translation. Data were collected from 338 nurses at one general hospital in Korea. Construct validity was evaluated with confirmatory factor analysis, convergent validity, and discriminant validity. Known-group validity was also evaluated. Cronbach’s α was used to assess the reliability.
Results
The PCPI-S Korean version consisted of 51 items in three areas: prerequisites, the care environment, and person-centered process. The comparative fit index (CFI) and values of person-centered care process were improved after engagement and having sympathetic presence items were combined as one component. The construct validity of PCPI-S Korean version was verified using four-factor structures (.05 < RMSEA < .10, AGFI > .70, CFI > .70, and AIC). The convergent validity and discriminant validity of the entire PCPI-S question were verified using a two-factor structures (AVE > .50, construct reliability > .70). There was an acceptable known-group validity with a significant correlation between the PCPI-S level and the degree of person-centered care awareness and education. Internal consistency was reliable with Cronbach’s α .95.
Conclusion
The Korean version of PCPI-S is valid and reliable. It can be used as a standardized Korean version of person-centered care measurement tool. Abbreviation: RMSEA = root mean square error of approximation; AGFI = adjusted goodness of fit index; AIC = Akaike information criterion; AVE = average variance extracted.

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Yeo Ju Kim, Gunjeong Lee, Sunyeob Choi
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Cut-Off Values of the Post-Intensive Care Syndrome Questionnaire for the Screening of Unplanned Hospital Readmission within One Year: Kang, Jiyeon , Jeong, Yeon Jin , Hong, Jiwon; J Korean Acad Nurs 2020;50(6):787-798. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20233

Abstract PDF

Purpose
This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors.
Methods
Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios.
Results
Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores.
Conclusion
The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

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Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention
Xiaofang He, Yuwei Song, Yuchun Cao, Liying Miao, Bin Zhu
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Motives for Empathy among Clinical Nurses in China: A Qualitative Study: Zhu, Yu , He, Ming-Mei , Zhu, Ji-Min , Huang, Li , Li, Bai-Kun; J Korean Acad Nurs 2020;50(6):778-786. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20123

Abstract PDF

Purpose
This study aimed to explore the motives of clinical nurses for experiencing empathy with patients and their families based on a self-determination theory framework.
Methods
Semi-structured face-to-face interviews with twenty-one nurses at four tertiary hospitals in Anhui, China, were conducted, recorded and transcribed. A content analysis with a directed approach was performed.
Results
An analysis of the interview transcripts revealed three categories of empathy motivation: autonomous motivation, controlled motivation and a lack of empathy motivation. Autonomous motivation included personal interests, enjoyment and a sense of value, pure altruism, assimilation, and recognition of the importance of empathy. Controlled motivation highlighted pressures from oneself and others, the possibility of tangible or intangible rewards, and avoidance of adverse effects. Finally, a lack of empathy motivation referred to a lack of intention for empathy and denial of the value of empathy.
Conclusion
This study provides a deep understanding of the motives underlying empathy in nurses. The results reveal the reasons for empathy and may support the development of effective strategies to foster and promote empathy in nurses.

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Original Article

Analysis of Subgroups with Lower Level of Patient Safety Perceptions Using Decision-Tree Analysis: Shin, Sun Hwa; J Korean Acad Nurs 2020;50(5):686-698. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20044

Abstract PDF

Purpose
This study was aimed to investigate experiences, perceptions, and educational needs related to patient safety and the factors affecting these perceptions.
Methods
Study design was a descriptive survey conducted in November 2019. A sample of 1,187 Koreans aged 20-80 years participated in the online survey. Based on previous research, the questionnaire used patient safety-related and educational requirement items, and the Patient Safety Perception Scale. Descriptive statistics and a decision tree analysis were performed using SPSS 25.0.
Results
The average patient safety perception was 71.71 (± 9.21). Approximately 95.9% of the participants reported a need for patient safety education, and 88.0% answered that they would participate in such education. The most influential factors in the group with low patient safety perceptions were the recognition of patient safety activities, age, preference of accredited hospitals, experience of patient safety problems, and willingness to participate in patient safety education.
Conclusion
It was confirmed that the vulnerable group for patient safety perception is not aware of patient safety activities and did not prefer an accredited hospital. To prevent patient safety accidents and establish a culture of patient safety, appropriate educational strategies must be provided to the general public.

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Nari Kim, Nam-Ju Lee
Journal of Korean Academy of Nursing.2024; 54(2): 266. CrossRef
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Jieun Shin, Ji-Hoon Lee, Nam-Yi Kim
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Review Article

Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data: Park, Suin , Park, Sohee , Lee, Young Joo , Park, Choon-Seon , Jung, Young-Chul , Kim, Sunah; J Korean Acad Nurs 2020;50(3):333-348. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19203

Abstract PDF

Purpose
The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Koreaby assessing National Health Insurance claims data.
Methods
The dataset included 70,136 patients aged 19 years who were inpatientsin psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia,schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registerednurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomesincluded length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint,and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and systemcharacteristics using multilevel modeling.
Results
Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatientsper registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission.More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnoticsuse but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injectedpsycholeptics for chemical restraint.
Conclusion
Lower nurse staffing levels are associated with negative health outcomes of psychiatricinpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatricinpatients in Korea.

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Original Articles

Effects of Oral Gargling with Aroma Solution in Psychiatric Inpatients: A Non-Randomized Controlled Trial: Jung, Yun Ah , Kim, Hee Sook; J Korean Acad Nurs 2020;50(2):200-209. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.200

Abstract PDF

Purpose
The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients.
Methods
A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an c2-test, Fisher’s exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0.
Results
After the intervention, significant differences were revealed in xerostomia (F=15.30, p <.001), objective oral status (F=38.44, p <.001), and oral health-related quality of life (F=62.70, p <.001) with an interaction effect between group and time.
Conclusion
These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.

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Ae Kyung Chang, Bo kyoung Kim, Ah Young Kim
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Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital: Bom Mi Park, Ho Sihn Ryu, Kyeung Eun Kwon, Chun Young Lee; J Korean Acad Nurs 2019;49(2):203-214. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.203

Abstract PDF

Purpose

The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects.

Methods

This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ²-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software.

Results

For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368).

Conclusion

These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

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Frontiers in Public Health.2023;[Epub] CrossRef
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Maria Aline Moreira Ximenes, Maria Girlane Sousa Albuquerque Brandão, Thiago Moura de Araújo, Nelson Miguel Galindo Neto, Lívia Moreira Barros, Joselany Áfio Caetano
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Jian Zhou, Bo Liu, Ming-Zhao Qin, Jin-Ping Liu
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A Predictive Model on Patient-Centered Care of Hospital Nurses in Korea: Hyun Jeong, Myonghwa Park; J Korean Acad Nurs 2019;49(2):191-202. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.191

Abstract PDF

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease: Kyung Ae Kim, Seon Young Hwang; J Korean Acad Nurs 2019;49(2):113-125. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.113

Abstract PDF

Purpose

The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease.

Methods

This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program.

Results

There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio.

Conclusion

Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

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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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Development of the Patient-Centered Nursing Culture Scale for Hospitals: Esther Shin, Sook-Hee Yoon; J Korean Acad Nurs 2019;49(5):613-630. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.613

Abstract PDF

Abstract Purpose

This study aimed to develop a scale measuring the Patient-Centered Nursing Culture (PCNC) and provide a basic tool to improve PCNC in Korea.

Methods

A conceptual framework and construct factors were extracted through extensive literature review and in-depth interviews with nursing professionals. In total, 59 items were derived based on the pilot survey. Data were collected from 357 nurses working at general hospitals and analyzed for verifying the reliability and validity of the scale.

Results

Nine factors containing 54 items were extracted from the exploratory factor analysis to verify the construct validity. The nine factors were top management leadership, policy and procedure, education and training, middle management leadership, supportive teamwork, nursing workplace environment, professional competence, patient-centered nursing activity, and nurses’ values. These items were verified by convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α=.96).

Conclusion

The developed PCNC scale is expected to be used as the tool for the development of theory and improvement of PCNC, the empirical testing for cause and effect of PCNC, the development of interventions, education and training programs for improving PCNC, and indicators for evaluation or accreditation of hospital service quality.

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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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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

Abstract 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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Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory: Kyengjin Kim, Wanju Park; J Korean Acad Nurs 2019;49(3):274-285. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.274

Abstract PDF

Abstract Purpose

This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients.

Methods

To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale.

Results

Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102).

Conclusion

These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

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