Concept Analysis of Health Inequalities / 간호행정학회지

PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.

Factors associated with New Graduate Nurses' Reality Shock / 간호행정학회지

PURPOSE: The purpose of this study was to identify factors that affect reality shock in new nurses. METHODS: Participants were 216 newly graduated nurses with less than 1 year experience in 5 university and 10 general hospitals in Busan, Ulsan and Gyeongnam, A self-report questionnaire was completed by the nurses between November 18 and December 25, 2013. Data were analyzed using t-test, ANOVA and hierarchial multiple regression analysis with the SPSS/WIN 21.0 Program. RESULTS: Average scores for work environment and environmental reality shock were 2.63+/-0.33 and 2.66+/-0.43 points respectively. Regression analysis showed that with the nurses' demographic and work characteristics controlled, work environment explained 4.2% of the reality shock. Factors significantly affecting reality shock included nurses' changing residence because of job (beta=.21, p=.001), whether they were able to work on the unit of their choice (beta=-.13, p=.031) and whether they had a choice in days off (beta=-.14, p=.038). CONCLUSION: When these factors are considered, reduction in nurses' reality shock requires improvement in work environment, placing new nurses in a department of their choice and allowing them a choice in off-duty days. These measures would also help achieve organizational goals and develop the new nurses as professional nurses.

Impact of Unit-level Nurse Practice Environment on Nurse Turnover Intention in the Small and Medium Sized Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to investigate the impact of the unit-level nurse practice environment on nurse turnover intention in the small and medium sized hospitals. METHODS: A cross-sectional study was conducted using a questionnaire survey with 308 nurses in 38 nursing units of 6 small and medium sized hospitals, having over 200 beds and under 300 beds and located in B metropolitan city. Data were collected from July 20 to August 10, 2011. Data were analyzed using hierarchical multiple regression. RESULTS: The mean turnover intention in nurses of small and medium sized hospitals was 3.52+/-0.53. Factors affecting turnover intention in the nurses included age, work unit, monthly income, number of night-duties, work hours per day and unit-level nurse practice environment. The unit-level nurse practice environment accounted for 15% of turnover intention when other variables were controlled. CONCLUSION: The results of the study indicate that nurse turnover intention is associated with the nurse practice environment at the unit level. Small and medium sized hospitals can improve nurse retention and lower turnover intention by changing the nurse practice environment of unit, such as creating better support services and nurse participation in hospital affairs.