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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A Predictive Model of Resilience in Mothers of Children with Developmental Disabilities: Cho, Youyoung , Kim, Hyeonok; J Korean Acad Nurs 2022;52(4):407-420. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.21235

Abstract PDF: Purpose
This structural model study was constructed and verified a hypothetical model to examine the effects of parenting stress, social resources, family resources, and positive coping on resilience among mothers of children with developmental disabilities.
Methods
Data were collected using self‐report structured questionnaires, from October 19 to October 30, 2018, with 214 mothers caring for chil-dren with developmental disabilities under the age of 20 years.
Results
In the fitness test results of the hypothesis model, with the fit index χ ² (p) = 69.27 (< .001), and the normed fit indices (χ ² = 1.87, GFI = .94, CFI = .97, NFI = .93, and TLI = .95, RMSEA = .06, SRMR = .06), this study satisfies the good fitness in standards. There are seven statistically significant paths among the 10 paths set in the hypotheti-cal model. The explanatory power of parenting stress and social resources, which affects the family resources was 41.4%, the explanato-ry power of parenting stress, social resources, and family resources affecting the positive coping was 58.9%, and the explanatory power of parenting stress, social resources, family resources, and positive coping affecting resilience was 55.5%.
Conclusion
Positive coping, family resources, and social resources of mothers of children with developmental disabilities directly affect their resilience, and parenting stress indirectly affects it. Therefore, to improve the resilience of mothers of children with developmental disabilities, it is necessary to develop a systematic nursing intervention that considers parenting stress, social resources, family resources, and positive coping.

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Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy: Shin, Jee Hye , Choi, Ja Yun; J Korean Acad Nurs 2021;51(3):334-346. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21019

Abstract PDF

Purpose
The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy.
Methods
The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes.
Conclusion
The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

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David W. Orme-Johnson, Vernon A. Barnes, Brian Rees, Jean Tobin, Kenneth G. Walton
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The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study
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Development and Evaluation of a Healthcare Empowerment Program for Patients with Temporary Ileostomy
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Original Articles

Relationship of Workplace Violence to Turnover Intention in Hospital Nurses: Resilience as a Mediator: Kang, Hyun-Jung , Shin, Jaeyong , Lee, Eun-Hyun; J Korean Acad Nurs 2020;50(5):728-736. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20147

Abstract PDF

Purpose
This study aimed to identify the relationship between workplace violence and turnover intention, and the mediation effect of resilience on the relationship in hospital nurses.
Methods
This was a cross-sectional study. A total of 237 registered nurses were recruited from three hospitals in South Korea from April to May 2019. Participants were invited to complete self-reported questionnaires that measure workplace violence, turnover intention, resilience, and demographic information. The data obtained were analyzed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval (5,000 bootstrap resampling).
Results
After controlling demographic covariates, workplace violence significantly accounted for the variance of turnover intention. It was also demonstrated that resilience partially mediated the relationship between workplace violence and turnover intention in hospital nurses. A 73.8% of nurses had experienced workplace violence (such as attack on personality, attack on professional status, isolation from work, or direct attack). Conclusion: Workplace violence directly influences turnover intention of nurses and indirectly influences it through resilience. Therefore, hospital administrators need to develop and provide a workplace violence preventive program and resilience enhancement program to decrease nurses’ turnover intention, and leaving.

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Özlem Gedik, Refika Ülke Şimdi, Şerife Kıbrıs, Derya Kara (Sivuk)
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Factors Affecting on Turnover Intentions of Emergency Department Nurses who have Experienced Verbal Abuse
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Effects of the Resilience of Nurses in Long-Term Care Hospitals during on Job Stress COVID-19 Pandemic: Mediating Effects of Nursing Professionalism
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Symptom Distress and Coping in Young Korean Breast Cancer Survivors: The Mediating Effects of Social Support and Resilience: Ji Hyun Lee, Hye Young Kim; J Korean Acad Nurs 2018;48(2):241-253. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.241

Abstract PDF

Abstract Purpose

The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors.

Methods

A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs.

Results

Symptom distress was found to have a significant indirect effect on coping (beta=-.32, p=.002), but not a significant direct effect (beta=.06, p=.577). Additionally, based on the values obtained for the squared multiple correlation, symptom distress, social support, and resilience were found to explain 46.4% of the total variance of coping.

Conclusion

Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors’ ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.

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Factors Influencing Post Traumatic Stress Disorder in Crime Scene Investigators: Seon Mi Nho, Eun A Kim; J Korean Acad Nurs 2017;47(1):39-48. Published online February 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.1.39

Abstract PDF

Purpose

The purpose of this study was to verify the relationships among social support, resilience and post traumatic stress disorder (PTSD), and especially to identify factors influencing PTSD in police crime scene investigators.

Methods

A cross-sectional design was used, with a convenience sample of 226 police crime scene investigators from 7 Metropolitan Police Agencies. Data were collected through self-report questionnaires during July and August, 2015. Data were analyzed using t-test, χ²-test, Fisher's exact test, and binary logistic regression analysis with SPSS/WIN 21.0 program.

Results

The mean score for PTSD in police crime scene investigators was 13.69. 11 points. Of the crime scene investigators 181 (80.1%) were in the low-risk group and 45 (19.9%) in high-risk group. Social support (t=5.68, p<.001) and resilience (t=5.47, p<.001) were higher in the low-risk group compared to the high-risk group. Logistic regression analysis showed that resilience (OR=4.74, 95% CI: 1.57~14.35), and social support (OR=2.13, 95% CI: 1.23~3.69) are effect factors for PTSD low group.

Conclusion

For effective improvement of PTSD in police crime scene investigators, intervention programs including social support and strategies to increase should be established.

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Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia: Jinhee Kim, Hyunjoo Na; J Korean Acad Nurs 2017;47(5):638-650. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.5.638

Abstract PDF

Abstract Purpose

Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia.

Methods

The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis.

Results

Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant.

Conclusion

The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia.

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The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses’ Resilience, Violence Coping, Nursing Competency and Burnout: Seung Min Lee, Kyung Mi Sung; J Korean Acad Nurs 2017;47(3):332-344. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.3.332

Abstract PDF

Abstract Purpose

The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms.

Methods

A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks.

Results

Levels of resilience, F=59.41, p<.001, active coping behavior, c²=33.09, p<.001, and nursing competency, F=59.41 p<.001, increased significantly and levels of passive coping behavior, c²=22.92, p<.001, and burnout, F=52.74, p<.001, decreased significantly in the experimental group.

Conclusion

The results suggest that the VCP could be an effective strategy for reducing burnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms.

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The Structural Equation Model on Resilience of Breast Cancer Patients Receiving Chemotherapy: Jeong Ha Yang, Ok Soo Kim; J Korean Acad Nurs 2016;46(3):327-337. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.327

Abstract PDF

Purpose

The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy.

Methods

Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0.

Results

Lower depression (γ=-.33, p=.020) and symptom experience (γ=-.31, p=.012) and higher self-efficacy (γ=.32, p=.005) and hope (γ=.48, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (β=-.18, p=.016), higher self-efficacy (β=.49, p=.023), and higher hope (β=.46, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (β=.54, p=.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (β=-.10 p=.013), self-efficacy (β=.27, p=.006) and hope (β=.25, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors.

Conclusion

The findings of the study suggest that breast cancer patientsw ith greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.

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Development and Application of an Overcoming Compassion Fatigue Program for Emergency Nurses: Yeong Ah Kim, Jeong Sook Park; J Korean Acad Nurs 2016;46(2):260-270. Published online April 29, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.2.260

Abstract PDF

Purpose

This study was conducted to develop a program to help emergency nurses overcome compassion fatigue, and to analyze the effects of the program.

Methods

A nonequivalent control group pretest-posttest design was used. There were 14 participants in the experimental group and 18 subjects in the control group. The program was comprised of five, weekly 80-minute sessions including understanding and assessment of compassion fatigue, enhancing positive affect, balancing work-life, planning self care, training in relaxation techniques and cognitive restructuring, and getting social support. Research variables were ego-resiliency, compassion satisfaction and compassion fatigue of the ProQOL 5, and salivary cortisol. Data were analyzed using Chi-square test, independent t-test, and paired t-test.

Results

The first hypothesis, "There will be a difference in scores for ego resiliency between the experimental group and the control group". was not supported. The second hypothesis, "There will be a difference in scores for compassion satisfaction between the experimental group and the control group" was supported (t=2.15, p=.046). The third hypothesis, "There will be a difference in scores for compassion fatigue between the experimental group and the control group" was not supported.

Conclusion

The first program for emergency nurses to overcome compassion fatigue in Korea was effective in increasing emergency nurses' compassion satisfaction and decreasing salivary cortisol level in the experimental group. Therefore, this program for overcoming compassion fatigue is useful to increase emergency nurses' compassion satisfaction. However replication studies of short-term intensive program reflecting emergency nurses' opinion are needed.

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Effectiveness of Forgiveness Therapy on Resilience, Self-esteem, and Spirituality of Wives of Alcoholics: Hee Kyung Kim, Mihyoung Lee; J Korean Acad Nurs 2014;44(3):237-247. Published online June 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.3.237

Abstract PDF

Purpose

In this study the effects of forgiveness therapy on the resilience, self-esteem, and spirituality of wives of men suffering from alcohol abuse was examined.

Methods

The study design was a quasi-experimental design. Forgiveness therapy was conducted once a week for 12 weeks. Data were obtained from March 2012 to December 2013. Participants were chosen from women in two Alcohol Counseling Centers. Of the 29 participants, 16 were assigned to the experimental group and 13 to the control group. Data were analyzed using descriptive statistics, t-test, χ²-test, and repeated measure ANOVA.

Results

There were statistically significantly differences for resilience, self-esteem, and spirituality between the experimental and control groups. Forgiveness therapy improved the resilience, self-esteem, and spirituality in the experimental group compared to the control group (p<.05). In follow-up tests, the experimental group had a statistically significantly increase only in self-esteem.

Conclusion

This study results show that forgiveness therapy is effective in improving resilience, self-esteem, and spirituality in wives of men suffering from alcohol abuse. Therefore, forgiveness therapy can be considered a useful nursing intervention to promote improvements in emotional stability and provide pain relief for these wives.

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