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Research Papers
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
AbstractAbstract 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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National Petition Analysis Related to Nursing: Text Network Analysis and Topic Modeling
Ko, HyunJung , Jeong, Seok Hee , Lee, Eun Jee , Kim, Hee Sun
J Korean Acad Nurs 2023;53(6):635-651.   Published online December 31, 2023
DOI: https://doi.org/10.4040/jkan.23052
AbstractAbstract PDF
Purpose
This study aimed to identify the main keyword, network structure, and main topics of the national petition related to “nursing” in South Korea.
Methods
Data were gathered from petitions related to the national petition in Korea Blue House related to the topic “nursing” or “nurse” from August 17, 2017, to May 9, 2022. A total of 5,154 petitions were searched, and 995 were selected for the final analysis. Text network analysis and topic modeling were analyzed using the Netminer 4.5.0 program.
Results
Regarding network characteristics, a density of 0.03, an average degree of 144.483, and an average distance of 1.943 were found. Compared to results of degree centrality and betweenness centrality, keywords such as “work environment,” “nursing university,” “license,” and “education” appeared typically in the eigenvector centrality analysis. Topic modeling derived four topics: (1) “Improving the working environment and dealing with nursing professionals,” (2) “requesting investigation and punishment related to medical accidents,” (3) “requiring clear role regulation and legislation of medical and nonmedical professions,” and (4) “demanding improvement of healthcare-related systems and services.” Conclusion: This is the first study to analyze Korea's national petitions in the field of nursing. This study's results confirmed both the internal needs and external demands for nurses in South Korea. Policies and laws that reflect these results should be developed.
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Effects of Nursing Work Environment on Intention to Stay of Hospital Nurses: A Two-Mediator Serial Mediation Effect of Career Motivation and Job-Esteem
Lee, Yu Na , Kim, Eungyung
J Korean Acad Nurs 2023;53(6):622-634.   Published online December 31, 2023
DOI: https://doi.org/10.4040/jkan.23038
AbstractAbstract PDF
Purpose
This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses.
Methods
Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program.
Results
The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r = .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09~.59]) and job-esteem (B = 0.27 [.04~.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem.
Conclusion
In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses’ motivation for career development and recognition of the nursing profession through improvement of the nursing work environment.
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Effects of Clinical Nurses’ Job Crafting on Organizational Effectiveness Based on Job DemandsResource Model
Lee, Eun Young , Kim, Eungyung
J Korean Acad Nurs 2023;53(1):129-143.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22138
AbstractAbstract PDF
Purpose
This study aimed to examine the mediating effects of clinical nurses’ job crafting on organizational effectiveness based on the job demands-resources model proposed by Bakker and Demerouti (2017).
Methods
The participants consisted of 393 nurses working in nursing units of a tertiary general hospital located in Cheongju region. The data, collected using questionnaire from August 9 to August 20, 2021, were analyzed using SPSS 23.0 and AMOS 27.0.
Results
The goodness-of-fit (GoF) test results on the modified model (χ 2 = 2.7, GFI = .94, SRMR = .03, RMSEA = .06, NFI = .92, CFI = .94, TLI = .92, AGFI = .90), indicated that the GoF index satisfied the recommended level. Regarding the effects of each variable on organizational effectiveness, job crafting showed statistically significant direct (β = .48, p < .001), indirect (β = .23, p < .001), and total effects (β = .71, p < .001). Burnout showed statistically significant direct effect (β = - .17, p < .001). Work engagement showed statistically significant direct (β = .41, p < .001) and total effects (β = .41, p < .001). The factors explaining organizational effectiveness were job crafting, burnout, and work engagement, which had an explanatory power of 76.7%.
Conclusion
Nurses’ job crafting is an important mediating factor for enhancing the organizational effectiveness of nursing organizations. Hospitals should develop job-crafting success cases and related education and training programs as a strategy for enhancing the job crafting of nurses and, consequently organizational effectiveness.
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Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing
Ha, Ju-Young , Park, Hyo-Jin
J Korean Acad Nurs 2023;53(1):55-68.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22117
AbstractAbstract PDF
Purpose
The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing.
Methods
After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were ’education,’ ‘medical robot,’ and ‘fourth industry.’ Five topics were derived from news articles related to artificial intelligence and nursing: ‘Artificial intelligence nursing research and development in the health and medical field,’ ‘Education using artificial intelligence for children and youth care,’ ‘Nursing robot for older adults care,’ ‘Community care policy and artificial intelligence,’ and ‘Smart care technology in an aging society.’ Conclusion: The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.
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The Moderating Effect of Organizational Justice on the Relationship between Self-Efficacy and Nursing Performance in Clinical Nurses
Kim, Ju-Ra , Ko, Yukyung , Lee, Youngjin , Kim, Chun-Ja
J Korean Acad Nurs 2022;52(5):511-521.   Published online October 31, 2022
DOI: https://doi.org/10.4040/jkan.22076
AbstractAbstract PDF
Purpose
This study aimed to examine the moderating effect of organizational justice on the relationship between self-efficacy and nursing performance among clinical nurses.
Methods
In January 2021, a cross-sectional survey was conducted with 224 clinical nurses recruited from a university-affiliated hospital in Suwon, South Korea. Participants completed online-based, self-report structured questionnaires. Collected data were analyzed using multiple regression and a simple model of PROCESS macro with a 95% bias-corrected bootstrap confidence interval.
Results
Self-efficacy and organizational justice were found to be significant predictors of nursing performance. These two predictors explained the additional 34.8% variance of nursing performance in the hierarchical regression model, after adjusting the other covariates. In addition, organizational justice moderated the relationship between self-efficacy and nursing performance among the clinical nurses. In particular, at low self-efficacy level, participants with high organizational justice had higher nursing performance compared to those with low organizational justice.
Conclusion
Enhancing organizational justice can be used as an organizational strategy for improving the organizational culture in terms of distribution, procedure, and interaction. Ultimately, these efforts will contribute to the improvement of nursing performance through a synergistic effect on organizational justice beyond nurses’ individual competency and self-efficacy.
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Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling
Park, Min Young , Jeong, Seok Hee , Kim, Hee Sun , Lee, Eun Jee
J Korean Acad Nurs 2022;52(3):291-307.   Published online June 30, 2022
DOI: https://doi.org/10.4040/jkan.22002
AbstractAbstract PDF
Purpose
The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports.
Methods
Data were media articles related to the topic “nurse” reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are “a nurse who committed suicide because she could not withstand the Taewoom at work” andf “a nurse as a perpetrator of a newborn abuse case,” while post-COVID-19 examples are “a nurse as a victim of COVID-19,” “a nurse working with the support of the people,” and “a nurse as a top contributor and a warrior to protect from COVID-19.” Conclusion: Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses’ image.
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Interorganizational Networks for Smoking Prevention and Cessation: A Blockmodeling Approach
Park, Eun-Jun , Kim, Hyeongsu , Lee, Kun Sei , Cho, Junghee , Kim, Jin Hyeong , Jeong, Ho Jin , Lee, Ji An
J Korean Acad Nurs 2022;52(2):202-213.   Published online April 30, 2022
DOI: https://doi.org/10.4040/jkan.21192
AbstractAbstract PDF
Purpose
This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea.
Methods
We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations’ characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling.
Results
Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration.
Conclusion
A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.
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Topic Modeling and Keyword Network Analysis of News Articles Related to Nurses before and after “the Thanks to You Challenge” during the COVID-19 Pandemic
Yun, Eun Kyoung , Kim, Jung Ok , Byun, Hye Min , Lee, Guk Geun
J Korean Acad Nurs 2021;51(4):442-453.   Published online August 31, 2021
DOI: https://doi.org/10.4040/jkan.20287
AbstractAbstract PDF
Purpose
This study was conducted to assess public awareness and policy challenges faced by practicing nurses.
Methods
After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles.
Results
Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic.
Conclusion
The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.
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Information Resource Network Analysis of Factors Influencing Breastfeeding Planning and Duration
Lee, Eunyoung , Cho, Insook , Cho, Seong Jin , Lee, Eunju
J Korean Acad Nurs 2021;51(2):232-244.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20280
AbstractAbstract PDF
Purpose
This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources.
Methods
A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration.
Results
The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital. The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group.
Conclusion
Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.
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Original Article
Secondary Data Analysis on the Quality of Sleep and Related Factors of Novice and Experienced Shift Work Nurses
Yu, Minjeong , Smi, Choi-Kwon
J Korean Acad Nurs 2020;50(5):646-657.   Published online October 31, 2020
DOI: https://doi.org/10.4040/jkan.19238
AbstractAbstract PDF
Purpose
The purpose of this study was to identify the quality of sleep in novice and experienced shift work nurses and compare the factors associated with their quality of sleep.
Methods
We analyzed the data of 192 and 256 novice and experienced nurses, respectively. The quality of sleep, sleep hygiene, job stress, and fatigue were measured using Insomnia Severity Index, Sleep Hygiene Practice Scale, the Korean Occupational Stress Scale, and Fatigue Severity Scale. Data were analyzed using SPSS 25.0 to calculate descriptive statistics and logistic regression.
Results
Sleep quality was lower in experienced nurses (12.55 ± 5.71) than in novice nurses (11.18 ± 5.78). Fatigue was more severe in experienced nurses (4.47 ± 1.13) than in novice nurses (4.23 ± 1.12). In the logistic regression, factors related to sleep quality in novice nurses were sleep hygiene (odds ratio; OR = 1.06, p < .001) and fatigue (OR = 2.49, p < .001). Factors related to sleep quality in the experienced nurses were also sleep hygiene (OR = 1.04, p = .001) and fatigue (OR = 1.53, p = .012).
Conclusion
Sleep quality of experienced nurses is lower than those of novice nurses. Factors associated with sleep quality in novice and experienced nurses are equally identified as sleep hygiene and fatigue. Therefore, personal efforts to improve sleep hygiene, such as providing comfortable sleep environment, are needed. Furthermore, organized efforts to decrease fatigue, such as constructing a working environment with a bright light at night and providing a fatigue-decreasing program that includes meditation, are required.
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Research Paper
Secondary Data Analysis on the Factors Influencing Premenstrual Symptoms of Shift Work Nurses: Focused on the Sleep and Occupational Stress
Baek, Jihyun , Choi-Kwon, Smi
J Korean Acad Nurs 2020;50(4):631-640.   Published online August 31, 2020
DOI: https://doi.org/10.4040/jkan.19230
AbstractAbstract PDF
Purpose
This study aimed to examine premenstrual symptoms (PMS) of shift nurses and identify the association between PMS, sleep, and occupational stress.
Methods
This study was conducted with a secondary data analysis that used data from the Shift Work Nurse’s Health and Turnover study. The participants were 258 nurses who were working in shifts including night shifts. PMS, sleep patterns (sleep time and sleep time variability), sleep quality, and the occupational stress of each participant were measured using the Moos Menstrual Distress Questionnaire, a sleep diary, an actigraph, the Insomnia Severity Index, and the Korean Occupational Stress Scale, respectively. Data were analyzed using SPSS 23 and STATA 15.1 to obtain descriptive statistics, Pearson’s correlation coefficients, multiple linear regression with generalized estimating equations (GEE) and Baron and Kenny’s mediating analysis.
Results
The average PMS score, average sleep time, average sleep time variability, average sleep quality score, and average occupational stress score of the participants was 53.95 ± 40.45, 7.52 ± 0.89 hours, 32.84 ± 8.43%, 12.34 ± 5.95, and 49.89 ± 8.98, respectively. A multiple linear regression analysis with GEE indicated that sleep time variability (B = 0.86, p = .001), and sleep quality (B = 2.36, p < .001) had negative effects on nurses’ PMS. We also found that sleep quality had a complete mediating effect in the relationship between occupational stress and PMS.
Conclusion
These findings indicate that both sleep time variability and sleep quality are important factors associated with PMS among shift work nurses. To improve shift nurses’ PMS status, strategies are urgently needed to decrease sleep time variability and increase sleep quality.
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Original Articles
Factors Relating to the Quality of Care for Nursing Home Residents in Korea: Using the Delphi Method
Juh Hyun Shin, Eun Mee Kim, Ji Yeon Lee
J Korean Acad Nurs 2019;49(6):783-794.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.783
AbstractAbstract PDF
Purpose

This study identified factors related to the quality of care in nursing homes, and elicited consensus opinions from experts on nursing homes.

Methods

A Delphi questionnaire was developed based on a review of the literature using the keywords “nursing homes,” “workforce,” and “quality of care.” A total of two Delphi surveys were conducted with 14 experts. The important and urgent factors related to the quality of care for nursing home residents emerged.

Results

A consensus was achieved on the important and urgent factors relating to the quality of care. The related factors were grouped into four sections: Organizational Characteristics, Staffing Characteristics, the Long-Term Care Market and Legal and Policy Issues, and Nursing Processes. In total, 23 items were important factors and 26 items were urgent factors relating to the quality of care. In addition, the unanimous advocacy by the experts for increased hours per resident day for registered nurses (RNs, 41 minutes 59 seconds) was much higher than the current hours per resident day of RNs in Korea.

Conclusion

To provide optimal care for residents in nursing homes in Korea, the mandatory and essential placement of RNs with professional knowledge and skills is paramount.

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A Topic Modeling Analysis for Online News Article Comments on Nurses' Workplace Bullying
Jiyeon Kang, Soogyeong Kim, Seungkook Roh
J Korean Acad Nurs 2019;49(6):736-747.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.736
AbstractAbstract PDF
Purpose

This study aimed to explore public opinion on workplace bullying in the nursing field, by analyzing the keywords and topics of online news comments.

Methods

This was a text-mining study that collected, processed, and analyzed text data. A total of 89,951 comments on 650 online news articles, reported between January 1, 2013 and July 31, 2018, were collected via web crawling. The collected unstructured text data were preprocessed and keyword analysis and topic modeling were performed using R programming.

Results

The 10 most important keywords were “work” (37121.7), “hospital” (25286.0), “patients” (24600.8), “woman” (24015.6), “physician” (20840.6), “trouble” (18539.4), “time” (17896.3), “money” (16379.9), “new nurses” (14056.8), and “salary” (13084.1). The 22,572 preprocessed key words were categorized into four topics: “poor working environment”, “culture among women”, “unfair oppression”, and “society-level solutions”.

Conclusion

Public interest in workplace bullying among nurses has continued to increase. The public agreed that negative work environment and nursing shortage could cause workplace bullying. They also considered nurse bullying as a problem that should be resolved at a societal level. It is necessary to conduct further research through gender discrimination perspectives on nurse workplace bullying and the social value of nursing work.

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Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach
Jin Kyu Choi, Byoungsook Lee
J Korean Acad Nurs 2019;49(5):562-574.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.5.562
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the response patterns of nursing unit managers regarding workplace bullying.

Methods

Q methodology was used to identify the response patterns. Thirty-six Q samples were selected from the Q population of 210 that included literature reviews and in-depth interviews with clinical nurses and nursing managers. Participants were 30 nursing unit managers who had experience managing workplace bullying and they classified the Q samples into a normal distribution frame measured on a nine-point scale. The data were analyzed using the PC-QUANL program.

Results

Five types of response patterns were identified: (1) sympathetic-understanding acceleration, (2) harmonious-team approach, (3) preventive-organizational management, (4) passive observation, and (5) leading-active intervention. The preventive-organizational management type was most frequently used by the nursing unit managers.

Conclusion

The results of this study indicated that nursing unit managers attempted to prevent and solve workplace bullying in various ways. Therefore, it is necessary to develop and conduct leadership training and intervention programs that appropriately address the response patterns of nursing unit managers, such as those identified in this study.

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Structural Equation Model for Sleep Quality of Female Shift Work Nurses
Ji Yeong Jeong, Mee Ock Gu
J Korean Acad Nurs 2018;48(5):622-635.   Published online October 31, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.622
AbstractAbstract PDF
Purpose

This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses.

Methods

This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data.

Results

The final model showed good fit to the empirical data: χ2/df=2.19, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (β=.32), perceived shift work status (β=−.16), stress response (β=.16), shift work experience (β=.15), perceived health status (β=−.14), and circadian rhythm (β=−.13) explaining 36.0% of the variance.

Conclusion

The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.

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Effect of Breathing Exercise Using Panflutes on the Postoperative Compliance, Pulmonary Infections and Life Satisfaction in Elderly Patients Undergoing Spinal Surgery
Hyun Mi Jo, Hyunsook Shin
J Korean Acad Nurs 2018;48(3):279-288.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.3.279
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the effects of breathing exercises performed using panflutes in elderly patients undergoing spinal surgery.

Methods

The study design was a nonequivalent control group non-synchronized pre-post test. The study included 24 patients in both the experimental group and the control group. The experimental group completed a daily breathing exercise regimen using panflutes for 30minutes after meals, whereas the control group was provided standard preoperative education, including breathing exercises using incentive spirometers. After the exercise regimen, breathing exercise compliance, pulmonary infections, and life satisfaction were measured in both groups, and the data were analyzed using the SPSS/WIN program.

Results

The compliance rate of breathing exercises was significantly higher in the experimental group. The experimental group presented no pulmonary infections in the later period, whereas the control group presented higher pulmonary infection rates in the same period. In addition, the life satisfaction score in the experimental group significantly increased.

Conclusion

The breathing exercise program using panflutes for elderly patients undergoing spinal surgery enhanced their breathing exercise compliance and their daily life satisfaction in addition to reducing their pulmonary infection rates.

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Effect of the Education on AIDS for Korean Healthe Care Workers
Soon Bok Chang, C W Lee
Journal of Nurses Academic Society 1997;27(1):201-211.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.201
AbstractAbstract PDF

This study was an evaluation study of AIDS education program. The purpose of this study was to clarify the education effects on AIDS for health care workers to develop abetter next education program. This study was done by self reporting with a 67 items of structured questionnaire by 431 health care workers included doctors, nurses, laboratory technicians, and health educators. Data were collected at the time of completion of each AIDS education with the help of education program manager. Both the AIDS related knowledge score and the acceptance attitudes score were significantly higher in the male group, in the medical institution employer group, in the group who have met the HIV infected person, who has known the HIV positive person, and the group of laboratory technician, but the AIDS prevention intention score was statistically higher in the group of female and laboratory technician group. The post education scores of AIDS related knowledge, acceptance attitudes, and preventive intention were statistically higher than those of the preeducation. The most increased item among AIDS prevention intention list was 'I will provide the meeting between the HIV infected persons and the public(+21.9%)'. But even the decreased item among AIDS prevention intention list was 'I will advice to female not to have extra marital sexual contact to avoid AIDS(-3.1%)'. It could be concluded that the health care workers were ignorant of vertical transmission of AIDS, they were afraid of disclosing the infection status, and have less AIDS prevention intention. Therefore is needed to take an assessment process before each new education strategy to increase AIDS related the effect of the education on AIDS.

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Factors Discriminating Nurses' Depression among Personal and Environmental Characteristics
Hae Jung Lee, Yong Sook Eo, Nam Hee Park, Gil Za Lee
Journal of Korean Academy of Nursing 2002;32(6):867-877.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.867
AbstractAbstract PDF

PURPOSE: The purpose of this study was to examine the levels of depression experienced by Korean hospital nurses (N=198) and to identify discriminating factors of their depression experience among personal and environmental characteristics. METHOD: A cross-sectional survey design was used to answer the research questions. A sample consisted of 198 hospital nurses in Korea. The data were collected from May 1999 to March 2000. Descriptive and discriminant analyses were utilized. RESULT: Korean nurses experienced low levels of depression. Twenty nine percent of nurses in the study experienced depression based on the cut-point suggested by Radloff. Role ambiguity, working in the tertiary hospital, work satisfaction in autonomy, professional status and interaction within nurses were significant discriminating factors for nurses' depression. These factors correctly discriminated 71% of the sample (Hit ratio= .71). CONCLUSION: Based on the findings of this study, developing managemental intervention programs and examining the effects of the program for nurses to reduce their depression experience are suggested.

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Workload Measurement of Home Health Care Nurses' Services using Relative Value Units
Tae Wha Lee, Jung Sook Park, In Sook Kim
Journal of Korean Academy of Nursing 2000;30(6):1543-1555.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1543
AbstractAbstract PDF

Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.

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Concept Analysis about Workers Health
Chung Min Cho, Boon Han Kim
Journal of Korean Academy of Nursing 2000;30(2):272-281.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.272
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The purpose of this study is to clarify the phenomenon worker's health as a basis for the future study. Concepts help us to identify how experiences are similar or equivqlent by categorizing all the things that are similar. The concept of health in workers was investigated using the Chinn and Krammer's method. The process of analysis involves choosing the concept, clarifying the purpose, using evidence of data, exploration of context, and value and category formalization. Dimensions of health in workers were identified as follows: (1) clinical dimension (2) role execution (3) coping with dimensia (4) mental well being (5) possibility (6) concrete activity (7) symbolization (8) hardiness Characteristics of anality of health in workers are activity, dimension of symbolization and of hardiness. Through this study it is identified that health in workers is with the beyond physical well-being, focused functional ability, and harmony environment.

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Confirmatory Analysis of Perception and Preference Scales for Work Characteristics among Korean Nurses
Yeon Ok Suh, Rha Yun Song, Daily Barbara
Journal of Korean Academy of Nursing 1999;29(2):215-224.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.215
AbstractAbstract PDF

The study was conducted to confirm the construct of individual perception and preference for work characteristics as personal factors influencing Korean nurses' job satisfaction. The subjects of the study were 231 nurses who are currently working in intensive care units and have been for a minimum of 6 months. The study used the Staff Perception and Preference Scale(Song et al., 1997) to measure the individual's perception and preference on the technical, practice, and management components of the ideal work environment. The Korean version of the Staff Perception and Preference Scale consists of 16 items on perception and 13 on preference with each item related on a scale from 1 (not at all) to 4 (a great deal). Psychometric testing revealed that the preference and perception scale is internally consistent with Chronbach's alphas of .83 for perception scale and .80 for preference scale. The subscales of the perception and preference scale also showed acceptable reliability for the early stage of the development of the instruments with Chronbach alphas of .62-.76 and .69-.83 respectively. Criterion0related validity of the scale was tested by examining correlations with individual growth need that is conceptually close to individual preference, but not to individual perception. Individual growth need was significantly related to individual preference(r=.63, p<.05), but the correlation with the perception scale was not significant. A separate factor analysis for the each of perception and preference scales was performed with a three-factor loading solution based on a previous study. The results on the staff perception scale confirmed with varimax rotation that the items were cleanly and strongly loaded on technique, practice and management components, which together explained 50.7% of the variance. The factor analysis on the staff preference scale also yielded a three factor solution that explained 56.7% of the variance, but items on technique and management components were loaded together. This phenomena may due to the current nursing delivery system in Korea where nurses never experience either shared governance nor case management, and as a results they may not be able to consider management roles as their potential extended roles. Therefore, more efforts should be given to enhance nurses' autonomy and decision making in the technique, practice and management components of their work environment. Meanwhile, there is a need for continuously confirming and developing tools for individual perception and preferences to effectively enhance job satisfaction among Korea nurses through innovative work environments.

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Effect of Rapid Rotating Shift Work on the Urinary Na+, K+, and Cl-
Soon Min, Dae Soo Moon, Wook Bin Im
Journal of Korean Academy of Nursing 1998;28(4):869-880.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.869
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In order to investigate of the effects of rapid rotating shift work on physiological stress, the activities of urinary Na+, K+, Cl- were measured in 14 rotational shift nurses, during day shifts(8AM-4PM, n=4), evening shifts(4PM-12MN, n=5), and night shifts(12MN-8AM, n=5) in hospital twenty students attending nursing college a used as control group. Urine specimens were collected in 30 minutes before and after work on the second day of shift work. In day shift nurses, Na+ activity was 137mM at 8AM and increased to 206mM at 4PM, whereas K+ activity was 42mM at 8AM and no significant change at 4PM. Cl- activity was changed from 234mM to 344mM at 4PM at 8AM. In the evening shift, Na+ activity was 117mM at 4PM and 140mM at 12MN, K+ activity was 22mM and 32mM, respectively. Cl- activity was 169mM and changed to 270mM. During the night shift, Na+ activity was 128mM at 12MN and changed to 161mM at 8AM, K+ activity was 42mM at 12MN and 8AM, and Cl- activity was from 303mM and changed to 355mM. In general, the urinary ion activities seemed to increase after work, however there were no significant changes in ion activities except the Na+ increase in day shift. The mean of the activities of K+ and Cl- before and after work during the day and night shift were significantly higher than those in control group(P<0.05). K+ activities were also higher than that of evening shift(P<0.05). However, there was no difference in Na+ activity among the control group and three shifts. There was a significant relationship among urinary Na+, Cl- and K+ in the control group and rotating shift nurses except between Na+ and K+ in shift. The relationship between Na+ and Cl- was low in shift work and there was no significant relationship between Na+ and K+ in shift, suggesting that the active regulation K+ and/or Na+ in response to stress upon the shift work disrupted the ratio of urinary Na+ to K+ and also lowered the relationship between K+ and Cl-. These results suggest that nurses working the day shift were overloaded and under stress, and the night shift interfered with the physiological rhythm of the nurses.

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Job Satisfaction among ICU nurses according to the Preference and Perception of Work Characteristics
Rha Yun Song, Yeon Ok Suh
Journal of Korean Academy of Nursing 1998;28(2):431-440.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.431
AbstractAbstract

The purposes of this study were to determine the factors that influence job satisfaction for ICU nurses and to analyze group differences in job satisfaction based on the nurses' preference and perception of the work environment with an enhanced professional role. A total of 231 nurses who had been working in Intensive Care Units at least for 6 months at selected university hospitals participated in the study while head nurses or those with administrative positions were excluded. The study participants had an average of 33 months of clinical experience with an age range of 23 to 40 years. The data were analyzed by utilizing SPSSWIN and the results are as follows. 1) Hierarchical multiple regression analysis showed that work characteristics defined by Job characteristics theory and nurses' preference/ perception of ideal work environment together explained 33% of variance in job satisfaction. Skill variety, task identity and autonomy as well as individual perception of work environment were significant variables for explaining job satisfaction. Job satisfaction was not significantly related to age, marital status, education, and clinical experience. 2) The groups classified by nurses' preference and perception of work environment were significantly different in their job satisfaction. Nurses with high preference and high perception showed significantly higher general and specific job satisfaction than other nurses. The nurses who showed high preference but perceived their work environment as not reflecting ideal job characteristics reported the lowest job satisfaction among the groups. In conclusion, the role of individual preference and perception of the work environment in explaining the relationship between the redesign of work environment and job satisfaction was supported by the study. The preferences of nurses to the innovative work characteristics should be considered in the process of enhancing job characteristics to lead job satisfaction and low turn over and ultimately to improve quality of care.

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Work Analysis for the Role of the Emergency Department Nurses
Eun Jung Kim
Journal of Korean Academy of Nursing 1998;28(1):93-103.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.1.93
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Nursing works in emergency department were analyzed and the importance of nursing works that the emergency department nurses perceived at university hospitals in Seoul. 12 nursing domains including 76 nursing activities were identified. The most frequently performed nursing domain was records and the most frequently performed activity in the emergency department was checking the vital sign of patients. The most important nursing activity that emergency department nurses perceived was physical crisis intervention.

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Educational Issues and Strategies to Improve APN Education
Kasil Oh, Kang Mi Ja Kim, Keum Soon Kim, Jee Won Park, Myung Sook Sung, Eui Geum Oh, Myung Ha Lee, Chae Weon Chung, Dong Sook Cho, Young Ran Tak, Jee In Yoo
Journal of Korean Academy of Nursing 2007;37(5):801-809.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.801
AbstractAbstract PDF
Purpose

This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education.

Methods

A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews.

Results

The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic.

Conclusion

The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.

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A Meta-Analysis of Effects of Job Stress Management Interventions(SMIs)
Jeong Hee Kim
Journal of Korean Academy of Nursing 2007;37(4):529-539.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.529
AbstractAbstract PDF
Purpose

This quantitative meta analysis sought to determine the effectiveness of SMIs.

Method

Forty-six experimental studies with a randomized or nonequivalent control group pre-post test design were included in the analysis. The selected studies were classified according to the sample characteristics, the types and methods of the interventions, and the types of outcome variables. Six intervention types were distinguished: cognitive-behavioral intervention(CBT), relaxation techniques(RT), exercise(EX), multimodal programs 1 and 2(MT1, 2), and organizationfocused interventions(OTs). Effect sizes were calculated for the 4 outcome categories across intervention types: psycho-social outcome, behavioral-personal resources, physiologic, and organizational outcome.

Results

Individual worker-focused interventions(ITs) were more effective than OTs. A small but significant overall effect was found. A moderate effect was found for RT, and small effects were found for other ITs. The effect size for OTs was the smallest. The interventions involving CBT and RT appeared to be the preferred means of reducing worker's psycho-social and organizational outcomes. With regard to physiologic outcomes, RT appeared to be most effective. CBT appeared to be most effective in reducing psycho-social outcomes. The effects of OT were non-significant, except for the psycho-social outcomes.

Conclusions

SMIs are effective. Interventions involving RT and CBT are more effective than other types.

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Comparison of Cardiovascular Risk Profile Clusters Among Industrial Workers
Seon Young Hwang, Ji Hyun Lee
Journal of Korean Academy of Nursing 2005;35(8):1500-1507.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.8.1500
AbstractAbstract PDF
Purpose

The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups.

Sample and Methods

Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis.

Results

Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p<.05). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria.

Conclusion

Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

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Estimating the Cost of Visiting Nursing Service by Visiting Nursing Model for Urban Public Health Center in Korea
Ho Sihn Ryu
Journal of Korean Academy of Nursing 2004;34(6):983-993.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.983
AbstractAbstract PDF
Purpose

This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center.

Method

The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done.

Result

The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year.

Conclusion

This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.

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A Study on Influencing Factors in Health Promoting Behaviors of Women Workers at Small-scale Industries
Soo Min Bae, Ihn Sook Jeong, Jeong Soon Kim, Seong Sook Jeon
Journal of Korean Academy of Nursing 2004;34(6):964-973.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.964
AbstractAbstract PDF
Purpose

This study was aimed to identify the major factors affecting performance in health promoting behaviors in women workers at small-scale industries.

Method

This study was based on the Pender's Health Promotion Model. The subjects for this study were 251 women workers at 23 small-scale industries in Busan city. The data for this study was collected from July 15th to August 15th 2003 by structured questionaries, and were analyzed with ANOVA, t-test, Pearson' correlation coefficient, and multiple Regression in the SPSS/WIN 10.0.

Result

The mean performance of the health promoting behavior was 2.56. The factors related to the performance of the health promoting behaviors were social support, marital status, status of owning a house, perceived barriers to action, working time, and self-efficacy, and they explained 58.4% of the variance of the health promoting behaviors.

Conclusion

The mean performance of the health promoting behavior seemed to be low, and the most important variable related to health promoting behaviorsof women working at a small-scale industry was social support. Therefore, intervention programs to increase the social support for women worker need to be developed.

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