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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
Exploratory Study on Developing Model for Smoking Cessation Process
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1997;27(1):71-82.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.71
AbstractAbstract PDF

In this paper, the study model, which presents the patterns of how the changing mechanisms are adopted to the changing stages of smoking cessation, was developed modifying the integrative model of Prochaska et al.(1983) with including seven changing mechanisms which were identified by Oh and Kim(1996). Then the developed study model was exploratively tested with 155 University student between 20 and 29 years of age subjects. According to the study results, among the five mechanisms, which are significant in explaining the differences between stages, DUNCAN post-comparison showed that the least applied ones were Stimulus Control, Self Determinism, Cognitive Restructuring in the precompletion stage, and Reinforcement and Dramatic Relief, in the relapsed stage. In the contemplation stage, it was observed that Dramatic Relief is used most frequently and that the other two mechanisms, Information Management and Cognitive Restructuring, showed different results from those inferred in the study hypothesis. In the case of Information Management, it was excluded from the analysis it was not included in explaining significant difference among changing stages, but Cognitive Reconstruction turns out to be a more frequently used mechanism in the action stage rather than in the contemplation stage. Helping Relationship was also excluded in the post-comparison analysis since it was not included in explaining significant difference among changing stages and Reinforcement was a more frequently used mechanisms in the contemplation stage. Stimulus Control turns out to be the connecting mechanism which was most frequently used in both the contemplation and action stages. Self Determination was most frequently used in the action stage rather than in both the contemplation stage and action stage, differing from the presumption of the model. Lastly, subjects in the relapsed stage were utilizing Stimulus Control and Self Determination at the same level as subjects in the precontemplation stage, and the utilization of both Reinformcement and Dramatic Relief was lower than that of the precontemplation stage, that is at the lowest level. Only Cognitive Restructuring was used of the same level as the contemplation stage. The relapsed stage in this study did not represent the preparation for action stage as presumed in the model of Prochaska et. al.(1983) but did show a pattern similar to the initial stage of smoking cessation, However, since this interpretation about the relapser was based on only a small number of relapsers(n=5), this conclusion may not be reliable.

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Changing Mechanisms Corresponding to The Changing Stages of Smoking Cessation
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1996;26(4):820-832.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.4.820
AbstractAbstract PDF

The average smoking rate for Adults' in our country is 40.6%: It is 74.2% for men and 5.0% for women. Particularly, the smoking rate for men is reported higher than that of men in U. S. A. or Japan. Since the first report on the association between smoking and cancer appeared, 370 thousand smokers have succeeded in smoking cessation and over 90% of them have responded that they depended on a self-help smoking cessation approach. Despite this positive evidence about self-help approaches for smoking cessation, most studies on smoking cessation have focused on evaluation of formal treatment programs that are provided by clinics. Reports on the smoking cessation process used by smokers in our country could not be found. However, it is believed that the situation in our country would be quite similar to that in U.S.A. as far as approaches to successful smoking cessation are concerned. This study was conducted to classify the smoking stage to which they smoker belong and which changing mechanisms could be included at each changing stage (precontemplation stage, comtem-plation stage, action stage) with a sample of 155 college students between 20 and 29 years old. And it also identified which variables related both to smoking pattern and to health, which ones were significantly discriminating in the changing stages. From the results of the data analysis it was found that Self-Determination is the most influential variable as one of the changning mechanisms which can discriminate three changing stages. And as the next significant mechanisms were Reinforcement, Dramatic Relief, Cognitive Restructuring, Helping Relationship, and Information Management in that order. Among variables related to the smoking pattern, years of regular smoking, whether smoking is continued or not even when they are sick, the number of attempts to stop smoking, number of cigarettes smoked per day, and whether they have smoked over 100 cigarettes up to now, but not the time of the first cigarette after waking-up, were the significant factors to descriminate changing stages. It was confirmed that among variables related to health that, perceived control for health, confidence of health maintence ability, and self confidence in smoking cessation, were significant variables in determinating changing stages. The most influential variables among them was self-confidence in smoking cessation. Conclusively, it was shown that smoking cessation is the process of attempting to change smoking habits through the various changing processes. Also it can be shown that a few factors smoking habit, self-confidence of smoking cessation, and belief in self control of his/her health, were influential in discriminating the changing stages of the smoking habit.

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Factor Analysis on Behavior Change Mechanisms in Self-help Smoking Cessation
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1996;26(3):678-687.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.678
AbstractAbstract PDF

Smoking is considered to be one of the important risk factors associated with various health problems. Thirty seven million people in America quit smoking in the past decade, with 90% quitting on their own(Americal Heart Association, 1986). According to McAlister(1975), 70% of smokers reported that they adopted a self-help smoking cessation approach rather than a formal treatment program. In our country, although, auccessful exsmokers have used, are not available, concerns about smoking cessation have increased, recently, due to changes in social and political attitudes to health promotion. This study was conducted to help smokers who had made a decision to adopt a self-helf smoking cessation approach instead of depending on a formal treatment program. It provided a structurd way for sucessful smoking cessation by identifying change mechanism factors which have been commonly used by smokers. The subjects selected for this study were 155 university students between 20 and 29. Years of age the results from the analysis of the collected data showed that seven factors in the self-help change processes significant, and they are named, Stimulus Control, Self-Determination, Information Management, Reinforcement Management, Helpful Relationships, Dramatic Relief and Cognitive Restructuring. All of the factors except Self-Determination represent the same change mechanisms which are proposed by Prochaska et al. (1988). Self-Determination uniformly includes items belonging to various change processes. Therefore, it might be an transitional factor including strategies related to both cognitive and behavioral dimensions. In spite of this, noted that one item which gives meaning of Self-Determination shows the highest factor loading, it is named Self-Determination.

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A Grounded Theory Approach to the Adjustment Process of the Institutionalized Elderly: The Control of Reluctance
Ga Eon Lee
Journal of Korean Academy of Nursing 2002;32(5):624-632.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.5.624
AbstractAbstract PDF

PURPOSE: The number of residents in elderly institution has been increasing due to the change of the family support system. This study was focused on understanding the process of adjustment of the institutionalized elderly using the Grounded Theory approach. METHOD: There were seven participants, 4 men and 3 women living in 3 different elderly facilities. The data was collected through in-depth interviews and participant observation from June 20, 1999 to January 10, 2000 and analyzed by the Strauss and Corbin's analysis method. RESULT: 125 concepts were found and grouped into 30 sub-categories and then grouped into 13 categories. These categories are <humiliation>, <fear>, <reluctance>, <difficulty of economic status>, <health problem>, <process of entrance>, <loss of family support>, <facility support>, <personality disposition>, <positive self mind-control>, <negative self mind-control>, <adjustment> and <maladjustment>, which were synthesized into the process of adjustment. <The Control of Reluctance (to live in facility)> being the core category. The adjustment process of the facility elderly consisted of: 1. expressive phase of 'reluctance' 2. control phase of 'reluctance' 3. latent phase of 'reluctance' CONCLUSION: This study offers better understandings on the adjustment process of the institutionalized elderly and provides more appropriate nursing care to the New Comers of these facilities.

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The Classification of Standard Nursing Activities in Korea
Jung Ho Park, Young Hee Sung, Mi Sook Song, Jung Sook Cho, Won Hee Sim
Journal of Korean Academy of Nursing 2000;30(6):1411-1426.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1411
AbstractAbstract PDF

A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.

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A Prediction Model for Stage of Change of Exercise In the Korean Elderly: Based on the Transtheoretical Model
Soon Yong Kim, So In Kim, Young Ja Chun, Pyoung Sook Lee, Sook Ja Lee, Eun Sook Park, Sung Ok Chang
Journal of Korean Academy of Nursing 2000;30(2):366-379.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.366
AbstractAbstract PDF

The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.

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Process of Change Corresponding to the Stage of Change of Exercise in Elderly
Young Ja Chun, So In Kim, Pyoung Sook Lee, Soon Yong Kim, Sook Ja Lee, Eun Sook Park, Sung Ok Chang
Journal of Korean Academy of Nursing 2000;30(2):354-365.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.354
AbstractAbstract PDF

Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly.
Methods
Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program.
Results
1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition.
Conclusion
The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.

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A study on the Experience of Nurses' socialization Process in the Hospital Setting
Bok Soon Kim, Eun Jung Ryu, Kyung Hee Kim, Hae Kyung Chung, Mi Seung Song, Kyung Sook Choi
Journal of Korean Academy of Nursing 1999;29(2):393-404.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.393
AbstractAbstract PDF

Socialization is the process of moving from one social role to another by gaining knowledge, skills and behaviors to participate in a group. Nurses who graduate from nursing school, enter the work force, and develop a career undergo socialization as they become insiders in the hospital. This study was designed to identify experiences of the nurses' socialization process in the hospital setting. The subjects were 6 nurses. Data were collected by recording and transcribing interviews and analyzed in the framework of grounded theory as mapped out by Strauss and Corbin(1990). The core category in the analysis of the experiences of nurses' socialization process was "being beyond". In the process of data analysis, 22 categories were identified. These categories were again grouped into 13. Based upon these results, it is recommended that development of resocialization models to establish nursing identity are necessary.

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Analysis of the Nursing Practice in a Medical ICU Based on an Electronic Nursing Record
Kyung Ja Song
Journal of Korean Academy of Nursing 2007;37(6):883-890.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.883
AbstractAbstract PDF

PURPOSE: The purpose of this study was to identify the entity of critical care nursing practices through analyzing nursing statements described by electronic nursing records in a MICU. METHODS: 176,459 nursing statements of 188 patients during a 6 month-stay were analyzed statement by statement according to the nursing process(nursing phenomena, nursing diagnosis, & nursing activity) and 21 nursing components of Saba's Clinical Care Classification. RESULTS: Among 176,459 single statements, the statements of nursing activity ranked first in number. The contents of the statements were analyzed and categorized by main themes. Among 489 categorized themes, the number of themes of nursing phenomena statements was the highest. When analyzed by Saba's clinical Care Classification, the nursing statements mainly included a physiological component. Among 21 components, the respiratory component ranked in the first position in nursing phenomena, nursing diagnosis and nursing activity. The extra statements not included in the 21 components were 9,294(15.1%) in nursing phenomena and 21,949(22.7%) in nursing activity. Most are statements related to tests and the doctor. CONCLUSION: The entity of MICU nursing practice expressed by electronic nursing records was mainly focused on physiological components and more precisely on respiratory components.

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The Role Adaptation Process of Head Nurses in the General Hospitals
Sung Rye Kang
Journal of Korean Academy of Nursing 2004;34(8):1416-1426.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1416
AbstractAbstract PDF
Purpose

The purpose of this study is to identify the role adaptation process experienced by head nurses.

Methods

Data were collected from 10 head nurses with in-depth interviews about their actual experiences. All the interviews were recorded and transcribed. The collected data were analyzed by the grounded theory methodology of Strauss and Corbin.

Results

The core category was identified as “weighing and balancing,” and the role adaptation process was divided into six stages by time sequence: inquiring, approaching to others, bringing people into their fold, working with conviction, avoiding conflicts, and settling.

Conclusion

The results of this study yield useful information for top mangers of nursing to identify, by stages, the demands of the head nurses in their role adaptation process. The findings of this study contributes to developing programs that facilitates the head nurses' role adaptation.

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Conquering Process of the Group-bullies among Teenagers
Soon Gu Kim, Young Hae Kim, Myung Hee Kim
Journal of Korean Academy of Nursing 2004;34(3):458-466.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.3.458
AbstractAbstract PDF
Purpose

This study was to develop a substantive theory on the conquering experience of group-bullies among teenagers, and thereafter suggest a model for solving the problems.

Method

Data collection and analysis was proceeded by a method of Grounded Theory. Data was collected by interviewing the participants. Five teenagers participated in this study who had already overcome the situation.

Result

In the analysis 31 concepts, 6 categories, and 14 subcategories are extracted from the raw data, and all are constituted on the paradigm model. The causal condition is a painstaking of participants. The context is affirmative reconsidering and the phenomenon is conquering difficulties. The intervening condition is a positive intervention of a supporting system and the strategy for action/interaction is building a relationship. The consequences of this analysis is harmonizing.

Conclusion

The results of this study suggest adequate ways of conquering group-bullies. These are positive attitudes towards solving problems and the full use of support systems surrounding them.

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Decisional Balances and the Process of Change in Smoking Cessation in Patients with Coronary Artery Diseases
Haeng Mi Son
Journal of Korean Academy of Nursing 2003;33(8):1171-1177.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.8.1171
AbstractAbstract PDF
Purpose

Despite many smoking cessation programs, many patients with CAD continue to smoke or re-smoke. The processes of change and self-change for smoking cessation is emphasized. The purpose of present study was to investigate decisional balances and processes of change according to stages of change for smoking cessation in the patients with CAD.

Methods

This descriptive study was performed using the self-reported questionnaires from 157 male patients with CAD who have smoking experiences. The questionnaires consisted of decisional balances toward smoking (pros/cons) and processes of change including 7 factors.

Results

45.2% of the subjects had myocardial infarction and 54.8% for angina pectoris. Major stages of change were maintenance, contemplation, and precontemplation in 62%, 14%, and 18% respectively. The mean score of pros smoking was 31.07 and cons smoking was 32.52. The mean scores of processes of change were high in all 7 factors, especially in self determination. The pros smoking in precontemplation stage was significantly higher than those in other stages. Between contemplation and precontemplation stages, processes of change showed significant differences in stimulus control, self determination, information management, and dramatic relief.

Conclusion

This study suggests that decisional balances and processes of change are stage-specific. As this study, smoking cessation program in the patients with CAD must put priority on the patients group in precontemplation and contemplation stages, and stress self determination and dramatic relief.

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Comparison on Nursing Importance and Performance of Nursing Interventions linked to Nursing Diagnoses-focused on 5 NANDA Nursing Diagnoses
Eun Joo Lee, In Hee Choi
Journal of Korean Academy of Nursing 2003;33(2):210-219.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.2.210
AbstractAbstract PDF
Purpose

The purpose of this study was to identify nursing importance and the performance of nursing interventions linked to five nursing diagnoses and find out core nursing interventions to each of the five nursing diagnosis. The five nursing diagnoses were Pain, Diarrhea, Constipation, Hyperthermia, and Infection: Risk for.

Method

Data was collected from nurses working in four different hospitals. Data were analyzed using mean, SD, and paired t-test to compare difference between importance and performance of each intervention.

Result

In general interventions related to medication, such as Medication Administration: IV, Medication Administration: IM, Medication Administration: Oral, Medication Management were all considered highly important and performed very often regardless of nursing diagnoses. And the level of importance was higher than the performance in most of all the interventions linked to five nursing diagnoses. Only two interventions, Medication Administration and Intravenous (IV) insertion had higher level of performance than importance in the diagnoses of Pain and Diarrhea respectively.

Conclusion

Using the above findings, we now know which intervention should be performed more frequently to solve nursing problems and which interventions are more critically important to nursing diagnosis. This information can be very helpful for developing nursing information system.

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The Role Adaptation Process of The Executive Director of Nursing Department
Sung-Ye Kang, Kwang-Ok Park, Jong-Kyung Kim
J Korean Acad Nurs 2010;40(6):785-798.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.785
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the role adaptation process experienced by executive directors of nursing department of general hospitals.

Methods

Data were collected from 9 executive nursing directors though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of role adaptation as an executive nursing director?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology.

Results

The core category of experience of the process of role adaptation as an executive nursing director was identified as "entering the center with pushing and pulling". The participants used five interactional strategies; 'maintaining modest attitudes', 'inquiring about trends of popular feeling', 'making each person a faithful follower', 'collecting & displaying power', 'leading with initiative'. The consequences of role adaptation in executive nursing directors were 'coexisting with others', 'immersing in one's new role with dedication', and 'having capacity for high tolerance'. The types of role adaptations of executive directors in nursing department were friendly type, propulsive type, accommodating type.

Conclusion

The results of this study produced useful information for executive nursing directors on designing a self-managerial program to enhance role adaptation based on interactional strategies.

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Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients: NANDA, NOC, and NIC Linkages
Hye Suk Kim
Journal of Korean Academy of Nursing 2005;35(6):979-990.   Published online October 31, 2005
DOI: https://doi.org/10.4040/jkan.2005.35.6.979
AbstractAbstract PDF
Purpose

The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions.

Method

The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004.

Results

Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the ‘Acute pain’ nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention.

Conclusion

It is expected that this program will help nurses perform their nursing processes more efficiently.

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