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Research Papers
Validity and Reliability of the Korean Version of the Occupational Coping Self-Efficacy Scale for Nurses
Youngrye Park, Sunah Park, Hee Ran Kang
J Korean Acad Nurs 2024;54(4):633-644.   Published online November 30, 2024
DOI: https://doi.org/10.4040/jkan.24094
AbstractAbstract PDFePub
Purpose

This study aimed to evaluate the validity and reliability of the Korean version of the occupational coping self-efficacy for nurses (K-OCSE-N) scale.

Methods

The English version of the OCSE-N scale was translated into Korean using a translation and back-translation process. Data were gathered from 213 nurses employed in a general hospital in South Korea. The content validity was assessed using the content validity index. The construct validity was verified through exploratory and confirmatory factor analyses. Criterion validity was assessed using Pearson’s correlation coefficients with the job stress coping and general self-efficacy scales. Reliability was examined using item-total score correlation and Cronbach’s α coefficient for internal consistency.

Results

The exploratory factor analysis identified two factors that explained 61.8% of the cumulative variance: occupational burden and relational difficulty. In confirmatory factor analysis, the model exhibited adequate fit (χ2/df = 2.07, GFI = .95, SRMR = .04, RMSEA = .07, CFI = .97, and TLI = .95), with both convergent and discriminant validity deemed acceptable. The criterion validity presented a positive correlation of the K-OCSE-N with both job stress coping (r = .72, p < .001) and general self-efficacy (r = .72, p < .001). The internal consistency of the scale using Cronbach’s α for the total items was .89.

Conclusion

The K-OCSE-N scale is a valid and reliable tool for measuring nurses’ occupational coping self-efficacy. This study suggests that various intervention studies can use the scale to assess and strengthen nurses’ occupational coping self-efficacy in nursing practice.

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Experiences of Unmarried Women Undergoing Planned Oocyte Cryopreservation
Miok Kim, Kim Mingyoung
J Korean Acad Nurs 2024;54(4):577-593.   Published online November 30, 2024
DOI: https://doi.org/10.4040/jkan.24064
AbstractAbstract PDFePub
Purpose

The present study investigated the experiences of unmarried women undergoing planned oocyte cryopreservation (OC).

Methods

Data were collected from August 2022 to February 2023 through individual in-depth interviews with thirteen unmarried women undergoing planned OC. Data were analyzed using Colazzi’s phenomenological method.

Results

The findings revealed four distinct clusters. The first cluster, “Safeguards against Future Uncertainty,” examined experiences associated with uncertainties in several aspects of reproductive health threats and decision-making regarding planned OC. The second cluster, “Indescribable Pain and Chaos,” explored the psychological and physical pain, complications, concerns about repeat procedures, and uncertainties about the use of frozen oocytes experienced during the planned OC process and afterward. The third cluster, “Motivation to Rebuild Resilience,” explored participants’ resilience in overcoming difficulties and shocks during the planned OC process and regaining their inner strength through the support of family and friends. The fourth cluster, “Finally Freeing the Mind,” focused on the sense of liberation from the pressure of marriage and childbirth, which enabled participants to engage in their present self and concentrate on self-stability and growth in preparation for the future.

Conclusion

The present study enhances our understanding of the emotional difficulties and distress experienced by women considering OC, thereby assisting in improving approaches for psychological support and clinical management. Furthermore, providing insights into these first-hand experiences to women considering planned OC, healthcare professionals, and policymakers could help establish systems to support the decision-making process.

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The Mediating Role of Psychological Resilience in Chinese Nursing Students’ Professional Identity and Learning Burnout
Liu Zhang, Qin Zhang, ShuWen Li, YuHong Li, GuoCui Wu, Ying Chen, YunNa Zhou
J Korean Acad Nurs 2024;54(4):509-518.   Published online November 25, 2024
DOI: https://doi.org/10.4040/jkan.24044
AbstractAbstract PDFePub
Purpose

This study investigated whether professional identity predicts learning burnout among Chinese nursing students, and whether resilience moderates this relationship.

Methods

This cross-sectional study recruited 635 students from a nursing college at a medical university in Hefei, China. Data were collected using the professional identity questionnaire, learning burnout scale for college students, and 10-item Connor-Davidson Resilience Scale. Pearson’s correlation analysis was used to investigate the relationships between variables. The mediation effect was evaluated using linear regression and the bootstrap method in SPSS.

Results

Nursing students exhibited intermediate learning burnout levels (score: 54.95 ± 10.42). Professional identity was positively correlated with psychological resilience (r = .42, p < . 001), whereas learning burnout was negatively correlated with professional identity (r = - .54, p < . 001) and psychological resilience (r = - .57, p < . 001). Psychological resilience mediated the relationship between professional identity and learning burntout to the tune of 32.8%.

Conclusion

Psychological resilience mediates the relationship between professional identity and learning burnout. Thus, nursing educators can mitigate student burnout by developing their students' professional identities and psychological resilience.

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Review Paper
Exploring Symptom Cluster Patterns in Adult Cancer Patients Undergoing Chemotherapy: A Systematic Review
Pan Yang, Hui-juan Mei, Hao-yu Zhao, Rong-rong Wu, Yong-qin Ge, Yin Lu
J Korean Acad Nurs 2024;54(4):478-494.   Published online November 25, 2024
DOI: https://doi.org/10.4040/jkan.24041
AbstractAbstract PDFSupplementary MaterialePub
Purpose

This systematic review aimed to scrutinize the progression of symptom cluster research in adult cancer patients who received primary or adjuvant chemotherapy between 2001 and 2023, providing a comprehensive understanding of clinical practice and future research.

Methods

PubMed, Ovid MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Web of Science databases were searched for theme words and free words related to symptom clusters, cancer, and chemotherapy. Eligible studies were published between January 1, 2001, and May 30, 2023; adults who were diagnosed with cancer and received primary or adjuvant chemotherapy were evaluated.

Results

Twenty-eight studies were included in this review. The Memorial Symptom Assessment Scale emerged as the predominant instrument and exploratory factor analysis was the most frequently employed statistical method to identify symptom clusters. Psychological, gastrointestinal, and physical image symptom clusters were the most commonly delineated. Furthermore, the temporal stability of the symptom clusters showed varying dynamics, with psychological symptom clusters displaying relative consistency over time.

Conclusion

Interventions are needed for the most common and stable symptoms in patients with cancer undergoing chemotherapy. Future endeavors may necessitate more longitudinal studies to delve deeper into the temporal stability and dynamic variations of symptom clusters. Such investigations hold promise for advancing symptom cluster research, elucidating the underlying mechanisms, and fostering the development of targeted interventions, thereby enriching the symptom management paradigm in oncological care.

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Research Papers
Effect of the Spinning Babies Program on Birth Outcomes and Satisfaction during Labor: A Non-Randomized Controlled Trial
Mi-Yeon Jeong, Hyang Mi Jung
J Korean Acad Nurs 2024;54(4):607-619.   Published online November 20, 2024
DOI: https://doi.org/10.4040/jkan.24097
AbstractAbstract PDFePub
Purpose

This study evaluated the effects of the Spinning Babies program applied during labor on birth outcomes and satisfaction among pregnant women.

Methods

This non-equivalent control group, non-synchronized post-test only design study included 42 participants (22 in the experimental group and 20 in the control group). The Spinning Babies program was conducted four times in the experimental group during the first and second stages of delivery for 50 min per session. The program comprised performing pelvic circles on a birth ball, followed by wide squatting and adopting of open knee-chest and side-lying positions.

Results

Compared with those in the control group, pregnant women in the experimental group had a significantly shorter labor time (t = - 6.64, p < .001), a higher success rate for normal vaginal delivery (χ2 = 4.86, p = .043), improved Apgar scores of newborns (z2 = - 2.18, p = .029), differences in neonatal oxygen therapy use (χ2 = 4.86, p = .043), and improved birth satisfaction (t = 11.99, p < .001).

Conclusion

The Spinning Babies program improves the birth environment by increasing the normal vaginal delivery success rate, as well as pregnant women’s birth satisfaction, and promotes neonatal health.

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

This study aimed to identify factors that influence the intention to use smart monitor-based mobile health (SBM) technology among middle-aged inpatients, based on the technology acceptance model II (TAM II).

Methods

A total of 222 participants were surveyed. Data were analyzed using SPSS Statistics 23.0 and IBM SPSS Amos 23. Seven exogenous variables–social influence (SI), personal self-efficacy, (PSE), environmental self-efficacy (ESE), health literacy, health concerns, resistance to innovative technology (RIT), accessibility (AC)– and three endogenous variables–perceived ease of use (PEOU), perceived usability (PU), and intention to use (ITU)–were investigated.

Results

The hypothesized path model demonstrated a good fit for the data. SI (β = .13, p = .042), PU (β = .46, p < .001), and PEOU (β = .16, p = .008) had significant direct effects on the ITU, which explained 39.5% of the variance. Additionally, SI (β = .27, p < .001), ESE (β = .16, p = .010), RIT (β = - .12, p = .026), AC (β = .28, p < .001), and PEOU (β = .20, p = .001) indirectly affected ITU through PU, which explained 50.7% of the variance. Furthermore, PSE (β = .38, p < .001) indirectly influenced ITU via PEOU, which explained 38.4% of the variance.

Conclusion

This study demonstrates that the TAM II can be used to effectively predict ITU in SBMs among middle-aged inpatients. To expand the intention to use SBMs, it is necessary to develop SBMs that include content and programs that promote PU, SI, and PEOU.

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Experiences of Patients and Their Families Receiving Medical Services Provided by Advanced Practice Nurses at Tertiary General Hospitals
Mi-Kyeong Jeon, Su Jung Choi, Ji Eun Han, Eun Kyung Kwon, Jeong Hee Park, Jeong Hye Kim
J Korean Acad Nurs 2024;54(4):594-606.   Published online November 4, 2024
DOI: https://doi.org/10.4040/jkan.24069
AbstractAbstract PDFePub
Purpose

This study aimed to understand and describe the experiences of patients and their families who have received medical services from advanced practice nurses in tertiary general hospitals in Korea.

Methods

Data were collected through four focus group interviews with 20 patients and their families who had received medical services from advanced practice nurses for more than six months at four tertiary hospitals from November 29 to December 28, 2023. Verbatim transcripts were analyzed using qualitative content analysis.

Results

The four themes extracted from the experiences of patients and their families were as follows: unfamiliar medical personnel encountered during the treatment process, healthcare professionals who exhibited excellence, companions to light my way through the tunnel of illness, and an advanced practice nurse system that must be activated urgently.

Conclusion

The study’s findings indicate that patients and their families view the care provided by advanced practice nurses as excellent, reliable, and holistic. Research suggests that advanced practice nurses are valuable healthcare professionals in team-based care. The findings suggest that hospitals should utilize an advanced practice nurse system to improve patient outcomes and ensure the quality of care.

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Perceptual Factors Associated with Gestational Weight Gain: A Cross-Sectional Survey
Sehee Kim, Sukhee Ahn
J Korean Acad Nurs 2024;54(4):495-508.   Published online November 1, 2024
DOI: https://doi.org/10.4040/jkan.24052
AbstractAbstract PDFePub
Purpose

Recent years have seen an increase in the number of pregnant women whose weight gain during pregnancy exceeds the recommended range. This study was intended to determine the relationships among demographic attributes, key perceptual factors, and gestational weight gain (GWG).

Methods

This cross-sectional study was conducted between April and July 2022. First-time pregnant women beyond 36 weeks of gestation who were recruited via social media completed an online survey. Data were analyzed using one-way ANOVA, chi-square test, and logistic regression, all performed using SPSS software.

Results

Of the 369 participants, 63 (17.1%) exceeded the recommended GWG guidelines, while 148 (40.1%) fell within the recommended range, and the remaining 158 (42.8%) had inadequate GWG. Being overweight or obese before pregnancy significantly increased the risk of excessive GWG (p < .001). This risk was also significantly greater for women with low internal weight locus of control (OR = 0.58, 95% CI 0.41~0.82), high external weight locus of control (OR = 1.75, 95% CI 1.31~2.34), and negative body image (OR = 0.62, 95% CI 0.51~0.75).

Conclusion

The growing trend of excessive GWG among pregnant women is influenced by a combination of prepregnancy body mass index (BMI) and perceptual factors, including weight locus of control and body image. These findings underscore the need to implement weight management intervention strategies before pregnancy, taking into consideration BMI, and to enhance positive body image and internal locus of control.

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Factors Influencing Clinical Nurses’ Perception of Structural and Content Career Plateau
Ji Hye Kim, Ji Yun Lee
J Korean Acad Nurs 2024;54(4):534-546.   Published online October 23, 2024
DOI: https://doi.org/10.4040/jkan.24002
AbstractAbstract PDFePub
Purpose

This study was intended to provide basic data for reducing the career plateaus of clinical nurses.

Methods

The participants were 288 clinical nurses who worked at five hospitals, general hospitals, and tertiary hospitals in Seoul, Gyeonggi, and Chungcheong provinces and had more than one year of clinical experience. The research data were collected from December 26, 2022, to April 7, 2023, using structured questionnaires and analyzed using SPSS software. The study conducted mean, standard deviation, percentage, t-test, ANOVA, Pearson‘s correlation coefficient, and hierarchical regression analysis.

Results

Perceived organizational support was identified as the factor influencing structural career plateaus. Factors influencing content career plateaus included growth needs, skill variety, organizational justice, and perceived organizational support.

Conclusion

The above research results suggest that to increase the motivation of clinical nurses and reduce career plateaus, it is necessary to improve awareness and systems of human resource management at the organizational level.

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

This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.

Methods

This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.

Results

Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.

Conclusion

These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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Exploring Traumatic Experiences and Posttraumatic Growth among Korean Veterans: A Photovoice Study
Riah Kim, Heese Choi, Minsung Kim
J Korean Acad Nurs 2024;54(4):519-533.   Published online October 14, 2024
DOI: https://doi.org/10.4040/jkan.24049
AbstractAbstract PDFePub
Purpose

This study aimed to explore traumatic experiences and posttraumatic growth among Korean veterans.

Methods

A qualitative study was conducted using photovoice. Purposive sampling strategies yielded five veterans who had experienced traumatic events. Participants engaged in three discussion sessions between August 5, 2023, and October 28, 2023. The collected data were analyzed using photovoice document analysis and thematic analysis.

Results

Study results identified the following themes: ‘The collapse of my life as a result massive trauma,’ ‘Sinking into endless isolation and disconnection,’ ‘The process of finding myself through reflection,’ and ‘My life journey moving forward together.’ Despite the irreversible damage caused by traumatic experiences during military service, the participants continuously reflected on the meaning of their trauma and posttraumatic growth, thereby recovering their authentic selves.

Conclusion

Veterans who have experienced traumatic events face severe difficulties, however through their efforts at recovery, they recognize the individuals they are now. This study suggests the need for social support and highlights the necessity of providing various opportunities and policy assistance to traumatized veterans.

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Development and Effectiveness of Progressive Simulation Education Program on Medication Safety for Nursing Students
Se-Young Jung, Eun-Young Kim
J Korean Acad Nurs 2024;54(4):563-576.   Published online October 14, 2024
DOI: https://doi.org/10.4040/jkan.24054
AbstractAbstract PDFePub
Purpose

This study aimed to develop and verify a progressive simulation education program aimed at enhancing nursing students’ medication safety competency.

Methods

A non-equivalent control group pretest-posttest design was adopted. The participants were 40 third-year nursing students with no prior simulation education experience, comprising 20 each in the experimental and control groups. The experimental treatment utilized a hybrid simulation approach incorporating both full-body mannequins and standardized patients and was, conducted over three sessions with durations of 65, 80, and 95 minutes for the first, second, and third sessions, respectively, for a total of 240 minutes. The program was constructed based on Jeffries’ simulation model.

Results

The levels of medication safety competencies, communication self-efficacy, learning self-efficacy, and problem-solving abilities of the experimental group were significantly higher than that of the control group.

Conclusion

Our results confirm that the program effectively improves nursing students’ medication safety competence, communication self-efficacy, learning self-efficacy, and problem-solving ability. Therefore, this program can serve as a basis for developing educational strategies related to medication safety for nursing education institutions. Furthermore, the program is anticipated to have a positive impact on novice nurses’ education and practice in clinical settings.

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Review Paper
Legal and Practical Solutions for the Expanding the Roles of Medical Support Staff Nurses
Choi, Su Jung , Kim, Min Young
J Korean Acad Nurs 2024;54(3):300-310.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24075
AbstractAbstract PDF
Purpose
Medical support staff nurses have traditionally performed various supportive tasks for physicians, often extending beyond standard nursing roles. Despite these long-standing practices, there is a notable lack of official recognition and legal protection for these expanded responsibilities, leading to increasing legal concerns. Therefore, there is a need for proposing a rational solution to address these issues.
Methods
The number of medical support staff nurses is rising, particularly as they fill gaps left by the 2024 resident physician strike. The study focuses on identifying potential challenges arising from this shift and developing strategic improvements to address these challenges effectively.
Results
This study proposed legally expanding the scope of nursing duties and creating a robust system for training and certifying nurses to handle these responsibilities effectively, by integrating these roles within the advanced practice nurse (APN) framework.
Conclusion
Integrating these roles within the framework of APN can offer a sustainable and legally sound solution to the ongoing healthcare crisis, ensuring patient safety and safeguarding healthcare workers’ legal rights.
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Research Papers
An Exploratory Study on Non-Contact Nursing Experiences of Clinical Nurses during the COVID-19 Pandemic
Byun, Hye Min , Yun, Eun Kyoung
J Korean Acad Nurs 2024;54(3):446-458.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24045
AbstractAbstract PDF
Purpose
This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic.
Methods
A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences.
Results
During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows: (1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism.
Conclusion
This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.
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How Do We Approach Quality Care for Patients from Middle Eastern Countries? A Phenomenological Study of Korean Nurses’ Experiences
Jang, Dael , Choi, Seonhwa , Hwang, Gahui , Kim, Sanghee
J Korean Acad Nurs 2024;54(3):372-385.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24036
AbstractAbstract PDF
Purpose
Although more people from Middle Eastern countries are visiting South Korea for medical treatment, Korean nurses lack experience in treating them. Understanding and describing Korean nurses’ experiences can help them provide quality care to these patients by enhancing their competency in culturally appropriate care. This study described the experiences of nurses who provide care to Middle Eastern patients in clinical settings in South Korea.
Methods
We conducted a phenomenological study to describe nurses’ experience of caring for patients from Middle Eastern countries. Ten nurses with prior experience in caring for these patients were recruited from a university-affiliated tertiary hospital. Semi-structured face-to-face interviews were conducted between May 1 and June 4, 2020. The transcribed data were analyzed using Giorgi’s phenomenological method to identify the primary and minor categories representing nurses’ experiences.
Results
Four major categories (new experiences in caring for culturally diverse patients, challenges in caring for patients in a culturally appropriate manner, nursing journey of mutual agreement with culturally diverse patients, and being and becoming more culturally competent) and 11 subcategories were identified.
Conclusion
Nurses experience various challenges when caring for Middle Eastern patients with diverse language and cultural needs. However, nurses strive to provide high-quality care using various approaches and experience positive emotions through this process. To provide quality care to these patients, hospital environments and educational programs must be developed that center on field nurses and students and support them in delivering quality care while utilizing their cultural capabilities.
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Temporal Exploration of New Nurses’ Field Adaptation Using Text Network Analysis
Ahn, Shin Hye , Jeong, Hye Won , Yang, Seong Gyeong , Jung, Ue Seok , Choi, Myoung Lee , Kim, Heui Seon
J Korean Acad Nurs 2024;54(3):358-371.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24034
AbstractAbstract PDF
Purpose
This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion: These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.
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Review Paper
Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis
Jo, Sojeong , Lee, Haejung , Park, Gaeun
J Korean Acad Nurs 2024;54(3):311-328.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24019
AbstractAbstract PDF
Purpose
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
Methods
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Results
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Conclusion
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).
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Research Papers
Effectiveness of the Eye Care Protocol in the Intensive Care Unit Patients: A Randomized Controlled Trial
Lim, Kyu Won , Ha, Shin Young , Kang, In Soon
J Korean Acad Nurs 2024;54(3):432-445.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24017
AbstractAbstract PDF
Purpose
This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU).
Methods
This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations.
Results
On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention.
Conclusion
The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume.
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Development of the Hybrid Clinical Practicum Environment Scale for Nursing Students
Yoon, Seoyoung , Yeom, Hye-Ah
J Korean Acad Nurs 2024;54(3):340-357.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24016
AbstractAbstract PDF
Purpose
This study aimed to develop a Hybrid Clinical Practicum Environment Scale for Nursing Students (HCPES-NS) and verify its validity and reliability.
Methods
The HCPES-NS was constructed following the DeVellis guidelines. The initial items were written based on a literature review and individual in-depth interviews. Content validity was verified through an expert panel review. To confirm the validity and reliability of the scale, a survey was conducted with 449 nursing students enrolled in 12 nursing colleges. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability tests.
Results
Factor analysis showed that the HCPES-NS consists of 15 items on five subdomains: clinical site atmosphere, interpersonal relationship, alternative online practicum contents, provision of learning information, and clinical performance facilitation. A higher score indicated a more positive perception of the clinical practicum environment. The concurrent validity of the HCPES-NS was confirmed by its positive correlation with the Clinical Learning Environment Scale (r = .77). The Cronbach’s α reliability of the HCPES-NS was .84.
Conclusion
The HCPES-NS is both valid and reliable. This scale reflects the clinical practicum environment and includes an online practicum factor. It may be used effectively by faculty members and educators to evaluate nursing students’ perceptions of clinical practicum environments.
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Effects of a Pre-Conception Care Program in Women with Inflammatory Bowel Disease: A Mixed-Methods Study Including a Randomized Controlled Trial
Lee, Young Jin , Kim, Hae Won , Kim, Yeon Hee , Yang, Suk-Kyun , Kim, Ji-Yeon
J Korean Acad Nurs 2024;54(3):386-402.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24010
AbstractAbstract PDF
Purpose
The purpose of this study was to conduct a pre-conception care program for women of childbearing age with inflammatory bowel disease (IBD) in Korea and verify its effects on self-efficacy for IBD management, IBD-related pregnancy knowledge, and IBD-related pregnancy anxiety. It also aimed to explore the changes in participants through the program.
Methods
A convergent mixed-methods study design was adopted. In the quantitative phase, 35 women (17 and 18 in the intervention and control group, respectively) participated. The intervention group attended a program that included small-group sessions and individual tele-coaching. To confirm the effects, data were collected before and one and four weeks after the intervention. In the qualitative stage, focus group interviews and tele-coaching were conducted with the intervention group.
Results
After the program ended, significant differences were observed over time between the intervention and control groups for self-efficacy for IBD management (Wald χ2 = 4.41, p = .036), IBD-related pregnancy knowledge (Wald χ2 = 13.80, p < .001) and IBD-related pregnancy anxiety (Wald χ2 = 8.61, p = .003). Qualitative data analysis revealed the following themes: (1) improving confidence in IBD management and awareness for planned pregnancy; (2) improving IBD awareness related to pregnancy and childbirth; and (3) relieving anxiety about and actively facing pregnancy.
Conclusion
This study is meaningful in that, to the best of our knowledge, it is the first to develop a pre-conception care program for women diagnosed with IBD and confirm its effectiveness. Furthermore, this program is expected to be suitable for patient counseling and education in clinical practice.
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Moderating Effect of General Self-Efficacy on the Relationship between Pregnancy Stress, Daily Hassles Stress, and Preterm Birth Risk in Women Experiencing Preterm Labor: A Cross-Sectional Study
Cho, Hyun-Jeong , Kim, Jeung-Im
J Korean Acad Nurs 2024;54(3):329-339.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24008
AbstractAbstract PDF
Purpose
This study investigated the moderating role of general self-efficacy (GSE) on how stress caused by pregnancy and daily hassle affect the risk of preterm birth (PTB) in women experiencing preterm labor.
Methods
This cross-sectional study included 196 pregnant women experiencing preterm labor before 37 weeks of gestation. We used IBM SPSS Statistics 27 and employed Hayes process macro version 4 (model 1) and hierarchical regression to analyze the moderating effect of GSE on the relationship between pregnancy stress, daily hassle stress, and PTB risk.
Results
Stress caused by pregnancy and daily hassle was positively correlated to PTB risk (r = .54, p < .001; r = .25, p < .001, respectively). While GSE did not significantly correlate with pregnancy stress, it negatively correlated with daily hassle stress (r = - .19, p = .009). GSE significantly moderated the relationship between combined stressors and PTB risk. As GSE levels increased, escalation in PTB risk in response to increasing stress levels was a more pronounced, highlighting a complex interaction between higher GSE levels and response to escalating stress levels. This model accounted for 39.5% of the variance in the PTB risk.
Conclusion
Higher GSE may amplify the impact of stress on PTB risk, rather than mitigate it, which suggests a more nuanced role of GSE in the stress response of pregnant women at risk of preterm labor. GSE should be considered in care strategies, and managing its impact on stress perception and responses in pregnant women is crucial.
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Factors Influencing Oncofertility in Gynecological Cancer Patients: Application of Mixed Methods Study
Kim, Minji , Ha, Juyoung
J Korean Acad Nurs 2024;54(3):418-431.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.23151
AbstractAbstract PDF
Purpose
This study aimed to identify factors influencing oncofertility and to explore the oncofertility experiences of patients with gynecological cancer using quantitative and qualitative methods, respectively. Methods: An explanatory sequential mixed-methods study was conducted. The quantitative study involved 222 patients with gynecological cancer recruited from online cafes and hospitals. Data were analyzed using IBM SPSS Statistics 28. For qualitative research, eight patients with gynecological cancer were interviewed. Data were analyzed using theme analysis method. Results: Oncofertility performance was quantitatively assessed in 40 patients (18.0%). Factors that significantly affected oncofertility were fertility preservation awareness (odds ratio [OR] = 14.97, 95% confidence interval [CI]: 4.22~53.08), number of children planned before cancer diagnosis (OR = 6.08, 95% CI: 1.89~19.62; OR = 5.04, 95% CI: 1.56~16.29), monthly income (OR = 3.29, 95% CI: 1.23~8.86), social support (OR = 1.08, 95% CI: 1.01~1.17), and anxiety (OR = 0.79, 95% CI: 0.66~0.95). Qualitative results showed three theme clusters and eight themes: (1) themes for determinant factors affecting oncofertility selection: ‘desire to have children’ and ‘special meaning of the uterus and ovaries;’ (2) themes for obstructive factors affecting oncofertility selection: ‘fertility preservation fall behind priorities,’ ‘confusion caused by inaccurate information,’ and ‘my choice was not supported;’ (3) themes for support factors affecting oncofertility selection: ‘provide accurate and reasonable information about oncofertility,’ ‘addressing the healthcare gap,’ and ‘need financial support for oncofertility.’ Conclusion: Financial support, sufficient information, social support, and anxiety-relief interventions are required for oncofertility in patients with gynecological cancer.
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Concept Analysis of Social Intelligence of Nurses Using Hybrid Model
Lee, Kyung Ran , Lee, Na Kyoung , Oh, Hee , Park, Kyoung Ae
J Korean Acad Nurs 2024;54(3):459-474.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.23121
AbstractAbstract PDF
Purpose
The purpose of this study was to conduct a concept analysis of social intelligence in nurses so that applying social intelligence to the nursing field.
Methods
In this study, we followed the hybrid model procedure, involving the following steps: First, in the theoretical stage, the attributes and definitions of the concept of social intelligence were determined through literature review. Second, the concepts’ reality was confirmed during fieldwork. In the final analysis stage, the results confirmed in the theoretical and fieldwork stages were compared and analyzed to confirm the properties and definition of the concept.
Results
Nurses’ social intelligence consists of three dimensions: social cognitive nursing competency, human-centered social evolution, and skills for solving complex nursing situations. Nurses’ social intelligence is a professional nursing competency that flexibly coordinates complex nursing situations, developed through accumulating experiences of continuous reflection and relationship expansion based on receptive listening and social sensitivity in clinical interpersonal relationships.
Conclusion
Nurses’ social intelligence is widely used in clinical practice and is shown to have a significant direct and indirect impact on clinical nursing. To effectively apply social intelligence in the clinical context, individual and organizational efforts are required to share and transfer knowledge and capacity-building methods through collective intelligence and education.
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The Influence of Diversity Management of Nursing Organization on Organizational Commitment: Double Mediating Effect of Diversity Sensitivity Orientation and Positive Nursing Organizational Culture
Jeon, Hwi Gon , Jang, Keum Seong , Kim, Eun A
J Korean Acad Nurs 2024;54(3):403-417.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.23120
AbstractAbstract PDF
Purpose
The aim of this study was to identify the double mediating effect of effect of diversity sensitivity orientation and positive nursing organizational culture between diversity management and organizational commitment.
Methods
Participants were 245 nurses working in six tertiary hospitals located in 3 different regions. Data collection was conducted from February 13, 2023 to March 6, 2023 through online self-reported questionnaire. The data were analyzed by IBM SPSS Statistics 27 and SPSS PROCESS Macro 4.2 program.
Results
The direct effect of diversity management on organizational commitment was significant (β = .21, p < .001). The indirect effect of diversity management on organization commitment was .34 (95% confidence interval [CI] = .23~.47). The double mediating effect of diversity sensitivity orientation and positive nursing organizational culture in the relationship between diversity management and organizational commitment was .02 (95% CI = .00~.05).
Conclusion
Diversity sensitivity orientation and positive nursing organizational culture show double mediating effect on the relationship between diversity management and organizational commitment. Education program and human resource management strategy for enhancing diversity management, diversity sensitivity orientation and positive nursing organizational culture should be provided to improve organizational commitment, and which are needed active support of the association and nursing organization.
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Review Paper
Factors Related to Emotional Leadership in Nurses Manager: Systematic Review and Meta-Analysis
Jang, Se Young , Park, Chan Mi , Yang, Eun Hee
J Korean Acad Nurs 2024;54(2):119-138.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.24026
AbstractAbstract PDF
Purpose
This study aimed to identify research trends related to emotional leadership among nurse managers by conducting a systematic literature review and meta-analysis. This study sought to derive insights that could contribute to improving emotional leadership in nursing practice.
Methods
A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Research Information Sharing Service, Koreanstudies Information Service System, Korean Medical Database, KoreaMed, ScienceON, and DBpia were searched to obtain papers published in English and Korean. Literature searches and screenings were conducted for the period December 1, 2023 to December 17, 2023. The effect size correlation (ESr) was calculated for each variable and the meta-analysis was performed using the statistical software SPSS 29.0, R 4.3.1.
Results
Twenty-five (four personal, six job, and fifteen organizational) relevant variables were identified through the systematic review. The results of the meta-analysis showed that the total overall effect size was ESr = .33. Job satisfaction (ESr = .40) and leader-member exchange (ESr = .75) had the largest effect size among the job and organizational-related factors.
Conclusion
Emotional leadership helps promote positive changes within organizations, improves organizational effectiveness, and increases member engagement and satisfaction. Therefore, it is considered an important strategic factor in improving organizational performance.
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Research Papers
Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior
Heo, Yeon Jeong , Hyun, Hye-Jin
J Korean Acad Nurs 2024;54(2):178-192.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.24020
AbstractAbstract PDF
Purpose
This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior.
Methods
Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software.
Results
Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant.
Conclusion
Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.
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Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study
Min, Ari , Seo, Jisu , Kang, Minkyung , Hong, Hye Chong
J Korean Acad Nurs 2024;54(2):139-150.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23164
AbstractAbstract PDF
Purpose
This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work.
Methods
This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis.
Results
Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning.
Conclusion
Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.
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Structural Topic Modeling Analysis of Patient Safety Interest among Health Consumers in Social Media
Kim, Nari , Lee, Nam-Ju
J Korean Acad Nurs 2024;54(2):266-278.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23156
AbstractAbstract PDF
Purpose
This study aimed to investigate healthcare consumers’ interest in patient safety on social media using structural topic modeling (STM) and to identify changes in interest over time.
Methods
Analyzing 105,727 posts from Naver news comments, blogs, internet cafés, and Twitter between 2010 and 2022, this study deployed a Python script for data collection and preprocessing. STM analysis was conducted using R, with the documents’ publication years serving as metadata to trace the evolution of discussions on patient safety.
Results
The analysis identified a total of 13 distinct topics, organized into three primary communities: (1) “Demand for systemic improvement of medical accidents,” underscoring the need for legal and regulatory reform to enhance accountability; (2) “Efforts of the government and organizations for safety management,” highlighting proactive risk mitigation strategies; and (3) “Medical accidents exposed in the media,” reflecting widespread concerns over medical negligence and its repercussions. These findings indicate pervasive concerns regarding medical accountability and transparency among healthcare consumers.
Conclusion
The findings emphasize the importance of transparent healthcare policies and practices that openly address patient safety incidents. There is clear advocacy for policy reforms aimed at increasing the accountability and transparency of healthcare providers. Moreover, this study highlights the significance of educational and engagement initiatives involving healthcare consumers in fostering a culture of patient safety. Integrating consumer perspectives into patient safety strategies is crucial for developing a robust safety culture in healthcare.
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Support Needs for Health Promotion of Community-Dwelling People with Disabilities: Perspectives of Operators Managing Disability Supportive Housing
Nam, Hye Jin , Lee, Haesun , Park, Han Nah , Lee, Sujin , Kim, Bohye , Yoon, Ju Young
J Korean Acad Nurs 2024;54(2):211-223.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23143
AbstractAbstract PDF
Purpose
Recent studies have focused on policies aimed at supporting the independence of individuals with disabilities in communities. As part of this initiative, supportive housing, integrated care, and residential spaces offer tailored services based on individual needs and autonomy. The attitudes and knowledge of the administrators supporting supportive housing residents regarding health management can influence the well-being of individuals with disabilities. Therefore, this study aimed to explore the challenges faced by supporting housing workers in enhancing the self-management skills of individuals with disabilities.
Methods
In this qualitative study, focus group interviews were conducted in August 2023 with nine administrators working to support housing in Seoul. Qualitative content analysis was used to analyze the interview data.
Results
The needs and challenges in enhancing the self-management skills of individuals with disabilities were as follows: (1) the complexity of health management challenges, (2) bidirectional strategies for strengthening health management capabilities, and (3) support for systematic health management. Additionally, eight subthemes were derived.
Conclusion
By investigating the difficulties experienced and identifying the necessary support requirements for supportive housing workers, this study seeks to uncover insights and identifies areas for improvement and strategies for health management. This study acknowledges the educational and institutional support necessary to improve the health and quality of life of individuals with disabilities residing in supportive housing.
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Development of the Hospital Nurses’ Silence Behavior Scale
Chung, Soojin , Hwang, Jee-In
J Korean Acad Nurs 2024;54(2):279-295.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23138
AbstractAbstract PDF
Purpose
This study aimed to develop a scale to measure hospital nurses’ silence behavior and examine its validity and reliability.
Methods
A total of 52 preliminary items on hospital nurses’ silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson’s correlation coefficient was used for assessing concurrent validity, and Cronbach’s alpha was used for the reliability test.
Results
The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the ‘Organizational Silence Scale (OSS)-the issues on which nurses remain silent’ (r = .60, p < .001) and ‘OSS-the reasons why nurses remain silent’ (r = .68, p < .001). Cronbach’s α of the scale was .92, and α of each subscale ranged from .71 to .90.
Conclusion
The Hospital Nurses’ Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.
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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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