Journal of Korean Academy of Nursing

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

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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Comprehensive Symptom Prediction in Inpatients With Acute Psychiatric Disorders Using Wearable-Based Deep Learning Models: Development and Validation Study
Minseok Hong, Ri-Ra Kang, Jeong Hun Yang, Sang Jin Rhee, Hyunju Lee, Yong-gyom Kim, KangYoon Lee, HongGi Kim, Yu Sang Lee, Tak Youn, Se Hyun Kim, Yong Min Ahn
Journal of Medical Internet Research.2024; 26: e65994. CrossRef
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Factors associated with readmissions in psychiatric inpatient care: a prospective cohort study based on hospital registers
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NEAT: Nurse Effort Assessment Tool—Human Factors Considerations in Designing for Appropriate Staffing
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Irene Ngune, Helen Myers, Amanda Cole, Peter Palamara, Robina Redknap, Michael Roche, Diane Twigg
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An Exploratory Study on Current Nursing Issues in the COVID-19 era through Newspaper Articles: The Application of Text Network Analysis
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Time to readmission in psychiatric inpatients with a therapeutic leave
Tiziana Ziltener, Julian Möller, Lukas Imfeld, Roselind Lieb, Undine E. Lang, Christian G. Huber
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Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea
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Original Articles

The Structural Analysis of Variables Related to Posttraumatic Growth among Psychiatric Nurses: Hyun Ju Yeo, Hyun Suk Park; J Korean Acad Nurs 2020;50(1):26-38. Published online January 31, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.1.26

Abstract PDF

Abstract Purpose:

The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.

Methods:

Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.

Results:

The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.

Conclusion

A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses’ hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.

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Jaehwa Bae, Eun Suk Choi
Research in Community and Public Health Nursing.2025; 36: 9. CrossRef
Mediating mechanism of posttraumatic growth as buffers of burnout and PTSD among nurses during the COVID-19 pandemic
Jae-Chang Sim, Sun-Kyung Cha, Sun-Young Im
Frontiers in Public Health.2024;[Epub] CrossRef
The effect of alexithymia on distress disclosure among nurses: the mediating role of resilience
Qianru Liu, Xuetai Jian, Fangyu Peng, Meng Wang, Jiaxin Li, Xinru Deng, Yinglu Wan, Li Geng
Current Psychology.2024; 43(25): 21931. CrossRef
Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross‐sectional study
Li Zeng, Guiling Liu, Fen Feng, Yinong Qiu, Shuping Wang, Meng Yu, Jialin Wang
International Journal of Nursing Practice.2024;[Epub] CrossRef
A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19
Soo Young An, Heejung Choi
Journal of Korean Academy of Nursing.2023; 53(3): 309. CrossRef
Relationship between rumination and post-traumatic growth in mobile cabin hospital nurses: The mediating role of psychological resilience
Jing Liu, Sha Wei, Guohong Qiu, Ni Li, Delin Wang, Xiaohou Wu, Xiangzhi Gan, Hongmei Yi
Preventive Medicine Reports.2023; 34: 102266. CrossRef
Promotion factors of emergency nurses’ post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study
Jinxia Jiang, Peng Han, Yue Liu, Qian Wu, Haiyan Shao, Xia Duan, Yan Shi
BMC Nursing.2023;[Epub] CrossRef
Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period—A qualitative study in Shanghai, China
Jinxia Jiang, Peng Han, Xiangdong Huang, Yue Liu, Haiyan Shao, Li Zeng, Xia Duan
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Ji Eun Oh, Ju Young Park
Journal of Korean Academy of Nursing Administration.2022; 28(5): 499. CrossRef
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Ju Young Yim, Jung A Kim
Journal of Nursing Management.2022; 30(6): 1940. CrossRef
Post-traumatic Growth and it’s associations with Deliberate Rumination, Self-disclosure, and Social Support among Intensive Care Unit Nurses
Sae Mi Min, Hee Jun Kim, Chun-Ja Kim, Jeong-Ah Ahn
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Predictors of posttraumatic growth of intensive care unit nurses in Korea
Ae Kyung Chang, Hyejin Yoon, Ji Hyun Jang
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Sun-Young Jung, Jin-Hwa Park
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Estimation of Psychiatric Nursing Costs by Using the Resource-Based Relative Value Scale(RBRVS): Eun Kyung Kim, Young Dae Kwon, Yoon Kim; Journal of Korean Academy of Nursing 2000;30(6):1580-1591. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.6.1580

Abstract PDF

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

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Development of Psychiatric Inpatient Classification System based on Nursing Care Needs
In Ohg Oh, Kyoung A Nam
Journal of Korean Academy of psychiatric and Mental Health Nursing.2020; 29(3): 243. CrossRef
Analysis of Psychiatric Nursing Activity and Time for Development of Nursing Cost
Sook Bin Im, Whasoon Chang, Moon Hee Ko, Youngsuk Park, Eun-Kyung Kim
Journal of Korean Academy of Psychiatric and Mental Health Nursing.2012; 21(1): 41. CrossRef

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The Effects of a Community Psychiatric Nursing Program on the Rehabilitation of Home-based Long-term Psychiatric Patients: Sook Lee; Journal of Korean Academy of Nursing 1999;29(5):1103-1112. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.5.1103

Abstract PDF: In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabiliation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care actively and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used . Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contracted by phone, the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition, elimination, dressing, leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

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The Effects of Medication and Symptom Management Education Program Based on Self Efficacy Theory for the Psychiatric Patients: Kyung Hee Shon; Journal of Korean Academy of Nursing 2003;33(8):1145-1152. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.8.1145

Abstract PDF

Purpose

An effective rehabilitation program had been developed for psychiatric patients' self management of medication and symptoms in Korea. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur.

Methods

The developed program utilizes the self efficacy method reported by Bandura, it includes manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. This study investigated the effects of this program with respect to various predictable variables in psychiatric rehabilitation. Thirty eight patients were selected for this study, 18 in the experimental program and 20 as controls.

Results

The results showed that the subjects who attended this educational program reported significantly more improvement in attitude toward medication compliance (p=0.033), and significantly less relapse warning symptom scores (p=0.000) than the controls.

Conclusion

This program may be a useful psychoeducational resource for professionals in the field of clinical practice in psychiatry.

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Validation of the Korean Version of the Depression Coping Self-Efficacy Scale (DCSES-K)
Young Mi Lim, Suzanne Perraud
Archives of Psychiatric Nursing.2016; 30(4): 463. CrossRef

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A Correlation Study of Perceived Importance of Nursing Interventions with Performance Frequency in Psychiatric Nursing Units Using the 3th NIC: Ja Yun Choi, Hye Suk Kim, Mi Sun Park; Journal of Korean Academy of Nursing 2003;33(1):95-103. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.1.95

Abstract

Purpose

The purpose of this study was to identify the perceived importance of nursing intserventions of psychiatric nurses according to domains, classes and interventions using the 3th NIC.

Method

In this study, a 435 of 486 nursing interventions were selected from 75% consent reached by experts. Data were collected from 9 hospitals and 141 nurses(return rates : 94.0%) in Seoul, Kyonggi, Chungnam, Gwang-ju and Chonnam region from January, 2002 to February, 2002 using 4 point Likert scale.

Result

Total perceived importance score was 2.905+/−0.463 and total correlation score with performance frequency was r=0.295. The most important perceived domain and class was found to be ‘ safety’ (3.217+/−0.465) and ‘ community health promotion’ (3.285+/−0.866). The most correlated domain and class with performance frequency appeared to be ‘ behavioral’ (r=0.431, p=0.000) and ‘ communication enhancement’ (r=0.439, p=0.000). The most important perceived nursing intervention was found to be ‘ active listening’ (3.652+/−0.549).

Conclusion

In conclusion, nurses in clinical settings were found to perform less than perceive its importance. Therefore, further researches are needed to identify factors related to impede and develop strategies to improve the performance of nursing interventions.

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Korean Journal of Stress Research.2017; 25(3): 201. CrossRef
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Difficulties in Caring for Psychiatric Patient as Experienced by Non-Psychiatric Nurses: Jaewon Joung, Mi Young Jang, Jihyun Shim, Yoonhi Ko, Sung Hee Shin; J Korean Acad Nurs 2017;47(1):49-59. Published online February 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.1.49

Abstract PDF

Purpose

The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness.

Methods

Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.

Results

General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were ‘nurse’ related factors, ‘patient’ related factors, ‘resource’ related factors. The nine categories were ‘unpreparedness’, ‘nursing barriers due to stigma’, ‘undervaluing and avoidance of psychiatric nursing’, ‘eroding into the trap of a vicious cycle’, ‘facing unapproachable patients’, ‘dealing with unhelpful family members’, ‘burdening already overburdened staff’, ‘obstructive environment’, and ‘isolation of staff with heavy responsibilities’.

Conclusion

The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

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Auditory hallucinations simulation in mental health nursing education: a scoping review
Mauro Parozzi, Mattia Bozzetti, Paolo Ferrara, Stefano Mancin, Anne Destrebecq, Marco Sguanci, Andrea Gazzelloni, Claudia Fantuzzi, Maura Lusignani, Stefano Terzoni
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Jina Shin, Hee Sook Kim
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Mphedziseni Esther Rangwaneni, Ndidzulafhi Selina Raliphaswa, Mary Maluleke, Thingahangwi Cecilia Masutha
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Suyoun Ahn, Soyoung Shin, Jaewon Joung
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Min-Ki Son, Suk-Sun Kim
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In Ok Sim, Kyoung Min Ahn, Eun Jeong Hwang
International Journal of Environmental Research and Public Health.2020; 17(14): 5159. CrossRef
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Hyun Mee Cho, Jeong Won Han, Eun Joung Choi, Hyo Eun Jeong, Bo Ram Hong, Eun Yong Kim
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A constructivist grounded theory of generalist health professionals and their mental health work
Scott Brunero, Lucie M. Ramjan, Yenna Salamonson, Daniel Nicholls
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Care Burden for Mental Illness Patients, Attitude toward Mental Illness and Psychiatric Nursing Competency in Non-psychiatric Nurses
Mi Young Jang, Sung Hee Shin
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The Korean Journal of Rehabilitation Nursing.2017; 20(1): 1. CrossRef

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Modification of Severe Violent and Aggressive Behavior among Psychiatric Inpatients through the Use of a Short-Term Token Economy: Jae Soon Park, Kyunghee Lee; J Korean Acad Nurs 2012;42(7):1062-1069. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.7.1062

Abstract PDF

Purpose

Meager research has been carried out to determine the effectiveness of the token economy among patients behaving violently in mental hospitals. The purpose of this study was to examine the effectiveness of the Short-Term Token Economy (STTE) on violent behavior among chronic psychiatric in-patients.

Methods

A nonequivalent control group design method was utilized. Participants in an experimental group (n=22) and control group (n=22) took part in this study from January to April, 2008. Observation on aggressive behavior among male in-patients in one hospital as a baseline was made during the week before the behavior modification program and measurement of aggressive behavior was done using the Overt Aggression Scale (OAS), which includes verbal attacks, property damage and physical attacks.

Results

The aggressive behavior scores of the experimental group decreased, those of the control group, scores showed an increase after the eight-week behavior modification program utilizing STTE.

Conclusion

The results of the study indicate that STTE is effective in reducing the incidence of aggressive behavior among male in-patients in psychiatric hospitals. The outcome of this study should be helpful in reducing the use of coercive measures or psychoactive medication in controlling the violent behavior among in-patients in hospitals.

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Fatemeh Ghojoghi, Elahe Hojati Abed, Mitra Khalaf Beigi, Esmaeil Mahboubi
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Effects of Weight Control Program on Body Weight and the Sense of Efficacy for Control of Dietary Behavior of Psychiatric Inpatients: Mi Na Hong, Geum Sun Baek, Yong Hee Han, Myung Soon Kwon; J Korean Acad Nurs 2008;38(4):533-540. Published online August 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.4.533

Abstract PDF

Purpose

This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients.

Methods

A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group).

Results

The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior.

Conclusion

Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.

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Eun-Suk Park, Eun-Hyun Lee
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