New Nurses' Experience of Turnover: A Qualitative Meta-Synthesis / 간호행정학회지

Purpose@#The aim of this research was to identify, appraise and synthesize available evidence exploring new nurses' experiences of turnover. @*Methods@#The qualitative meta-synthesis method suggested by Thomas and Harden was used. Qualitative research articles considered for inclusion in the review were identified through an extensive search of relevant literature in scientific databases. Data were extracted from the aforementioned articles, and qualitative research findings were pooled according to Thomas and Harden's review process. This process involved the categorization of findings according to similarity of meaning and aggregation of these sub-themes to produce a comprehensive set of synthesized themes. @*Results@#A total of 4 research articles met the inclusion criteria and were included in the review. The review process resulted in 30 sub-themes that were aggregated into 10 themes: ineffective education; overwhelming work; personal maltreatment by doctors, career nurses, patients and caregivers; lack of professional vision; suffering; fear; loss of confidence; isolation; cynical reaction to turnover; new beginning and growth. @*Conclusion@#These findings illuminated the necessity of educational, organizational, emotional and social support for new nurses to help them accomplish their developmental tasks during their transition, as well as the need for this support to continue even after the turnover.

Effects of Hospital Characteristics on Employment Rate, Working Period and Retirement of Ward Nurses in Korea: A Retrospective Cohort Study Based on HIRAS Data

Purpose@#The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. @*Methods@#Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. @*Results@#The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital.Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. @*Conclusion@#This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses’ retirement are needed.

Effects of Hospital Characteristics on Employment Rate, Working Period and Retirement of Ward Nurses in Korea: A Retrospective Cohort Study Based on HIRAS Data

Purpose@#The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. @*Methods@#Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. @*Results@#The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital.Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. @*Conclusion@#This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses’ retirement are needed.

Demand and willing to pay for oral hygiene service in long-term care insurance of elderly / 대한구강보건학회지

OBJECTIVES: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. METHODS: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ○○. For analysis, semi-structured questionnaires that required about 20–30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. RESULTS: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. CONCLUSIONS: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.

Quality of Life of Women with Urinary Incontinence: A Systematic Literature Review / 대한배뇨장애요실금학회지

PURPOSE: The purpose of this study was to review studies that have examined the quality of life of women with urinary incontinence. MATERIALS AND METHODS: A review was conducted that used the databases PubMED, Proquest, CINAHL, and Sciencedirect. Articles were included that were published in English between 2005 and 2010 the key words use were urinary incontinence, women, and quality of life. RESULTS: A total of 18 studies were identified, and the prevalence of urinary incontinence varied depending on the definition of incontinence used and the age of the population studied. The Incontinence Quality of Life (I-QoL), Incontinence Impact Questionnaire-short form (IIQ-7), and King's Health Questionnaire (KHQ) were the most commonly used instruments. Demographic, medical, physical, psychological, health, and intervention factors were reported as influencing factors on the quality of life of women with incontinence. Age, severity of urinary incontinence, type of urinary incontinence, number of urinary incontinence episodes, body weight, stress, and help-seeking behavior were statistically significant variables influencing quality of life. CONCLUSION: Future studies are needed to identify factors related to quality of life among women with incontinence and to use validated instruments according to specific subjects.

Development of an Integrated Breast Health Program for Prevention of Breast Cancer among Middle-aged Women / 여성건강간호학회지

PURPOSE: This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies. METHODS: This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area. RESULTS: Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors. CONCLUSION: Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.

Effects of a Symptom Focused Self-Management Program on Symptom and Functional status, Health Perception, and Quality of Life of Patients with Chronic Heart Failure / 성인간호학회지

PURPOSE: The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF. METHODS: Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires. RESULTS: Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group. CONCLUSION: By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.

A Descriptive Study for Developing a Program to Promote Compliance with Regular Breast Self-Examination(BSE) / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify knowledge, facilitators, and barriers of breast self -examination(BSE) in Korean couples for developing a continuous regular BSE promotion program. METHOD: This descriptive study was undertaken with a focus group methodology including 27 couples of husbands and wives recruited by convenience-sampling. Data transcribed from audiotapes was analyzed to identify common themes. RESULTS: Knowledge of breast cancer and BSE included 'the risk factors of breast cancer', 'prevention of breast cancer', and 'how to do BSE'. Facilitators to BSE included 'self, health professional, and spouse-facilitating factors'. Barriers to BSE included 'cognitive, psychological, informational, and physical barriers'. CONCLUSION: To promote compliance with BSE among women, tailored programs according to the stage of change of BSE adoption are crucial, not only reflecting the specific needs of the individual by the stage of change, but also utilizing husbands as facilitators.

Relationship between Psychosocial Factors and Symptom Experience in Patients with Cardiovascular Disease: Over a Six-month Follow-up Period / 기본간호학회지

PURPOSE: The purpose of this study was to identify the relationship between psychosocial factors and symptom experience of patients with cardiovascular disease over a 6-month follow-up period. METHOD: Baseline data for each of the 138 patients were collected. Eighteen patients were dropped for a final total of 120 patients in the present study. To monitor patients' symptom experience after discharge, each patient was interviewed by telephone, and interviewed directly with a questionnaire at each clinic visit. RESULTS: Mean scores for hostility, anger, anxiety, and depression were 51.63, 22.87, 48.95, and 41.21, respectively. Mean scores for the level of symptom experience at discharge, 3 months and 6 months after discharge were 32.83, 24.79, and 26.70, respectively. There were significant differences in the level of hostility by gender, BMI, job, and monthly income. Also the differences in the level of anxiety and depression were statistically significant according to gender and existence of spouse. In the regression analysis, depression was identified as the significant factor associated with symptom experience at discharge, 3 months, and 6 months after discharge. CONCLUSION: This study presented baseline data to elucidate whether psychosocial factors were associated with the progression of cardiovascular diseases. Accordingly, it suggests that nurses need to take into consideration psychosocial factor as well as physiological factor in symptom management for patients with cardiovascular disease.

Study of Cohort Construction for Development of Early Alarm System (EMS) for Breast Cancer: based on women living in a rural area / 성인간호학회지

PURPOSE: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. METHOD: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). RESULTS: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. CONCLUSION: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.

Factors Influencing Functional Status in Patients with Heart Failure / 간호학회지

PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

Predictors of Mammography Participation Among Rural Korean Women Age 40 and Over / 간호학회지

PURPOSE: The study was conducted to identify predictors of mammography screening for rural Korean women according to 'Stage of Change' from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. METHODS: A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed by Rakowski, et al. (1992). RESULTS: The most frequent stage of mammography adoption was 'contemplation' (40.5%). Predictors of stage of mammography adoption included 'mammogram recommended by health professional' (beta=0.59, t=16.12, p=.000), 'perceived benefits' (beta=0.09, t=2.21, p=.050), 'perceived susceptibility' (beta=0.09, t=1.98, p=.050), and 'perceived barriers' (beta= 0.07, t= -2.05, p=.041). 'Mammogram recommended by health professional' demonstrated the greatest association with having a mammogram. CONCLUSION: Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.

A Study of Knowledge, Attitudes, and Importance of Sexuality in the Aged / 여성건강간호학회지

PURPOSE: The purpose of this research was to identify knowledge of, attitude toward, and the importance of, sexuality in the elderly. METHOD: By convenience sampling, 152 elderly people aged 60 and over who registered at 3 elderly schools located in W city were selected. Knowledge and attitude toward sexuality were measured with ASKAS. Perceived importance toward sexuality was measured with an instrument developed by the investigator. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's correlation. RESULTS: Elderly males, elderly couples, and elders perceiving themselves as healthy reported higher scores in knowledge on and the importance of sexuality. Elderly males, elders with higher education, and elders perceiving themselves as healthy showed a more acceptable attitude toward sexuality. The higher knowledge of sexuality, the more acceptable the sexuality. The higher knowledge of and more acceptable attitude toward sexuality, the higher significance of sexuality. CONCLUSIONS: Sexuality is an important issue in elderly life. To improve knowledge, positive views of sexuality, recognition of its importance, education and consulting programs on sexuality need to be developed, reflecting characteristics of the elderly. These programs should be provided not only to the elderly but also to people caring for the elderly and their families.

Risk Factors and Early Screening Behavior for Breast Cancer in Rural Women / 여성건강간호학회지

PURPOSE: The aim of this study was to identify risk factors for breast cancer and early screening behavior in women in the community. METHOD: The participants were 125 women residing in W city. Data was collected using an instrument developed by the researchers. Analysis was done using descriptive statistics, and the x2 test. RESULT: For risk based on the Gail Model, age (above 50 years) had a distribution of 24.8%, first degree family history, 4.9%, age at first full term pregnancy, 13.8%, and benign breast cancer history, 4.9%. For risk based on other common risk factors, menopause had a distribution of 20.7%, did not breast feed, 15.4%, history of HRT, 7.3%, meat preference, 35.0%, and history of smoking or drinking, 2.4% and 43.5%, respectively. There was a significant difference in BSE and mammography screening behavior (x2=22.5, p< .00), but no difference in distribution of risk factors and screening behavior. CONCLUSION: For effective prevention of breast cancer, it is necessary to develop an instrument for risk assessment and, through assessment, select women at high risk. It is also necessary to provide education and appropriate recommendations on screening behavior.

Factors Related to the Stage of Mammography Screening in Married Korean Women / 성인간호학회지

PURPOSE: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%). CONCLUSION: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

Factors Related to the Stage of Mammography Screening in Married Korean Women / 성인간호학회지

PURPOSE: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%). CONCLUSION: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

Self-efficacy and Compliance in Patients with Chronic Heart Failure: The Effect of a Self-management Program using Decision Tree / 성인간호학회지

PURPOSE: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

Development and Application of a Web-Based Tailored Nutrition Management Program and Change in Knowledge of Nutrition and Eating Habits in Elementary Students / 대한의료정보학회지

OBJECTIVE: This study was undertaken to develop and apply a web-based tailored nutrition management program for elementary school students. METHODS: One group pretest, posttest design was used with a random sample of 5th and 6th grade students in two elementary schools out of the 20 elementary schools in W city. The web-based nutrition program was developed based on previous studies and existing web sites related to nutrition education and management. It consisted of a combination of web-based step-by-step self-checkups and web-based instructions on knowledge of nutrition, eating habits, and perception and satisfaction with body shape etc. Students completed web-based questionnaires on knowledge of nutrition and eating habits at baseline and three weeks later. Data were analyzed using descriptive statistics and paired t-test. RESULTS: Knowledge of nutrition and practice of correct eating habits increased significantly after the students completed the web-based program. CONCLUSION: These results suggest that a web-based nutrition management program is effective for nutrition education for children in terms of accessibility, compliance, and client-initiative.