Advanced Practice Nurses' Organization Commitment: Impact of Job Environment, Job Satisfaction, and Person-Organization Fit *

Purpose@#The demand for advanced practice nurses (APNs) has increased globally due to a shortage of physicians and an increased demand for high-quality healthcare. Research is needed on the enhancement of advanced practice nurses' organization commitment. Organization commitment (OC) directly impacts the retention of APNs. This study aims to identify the key factors affecting the OC of advanced practice nurses.MethodA cross-sectional survey was conducted at the largest hospital in South Korea. A total of 189 APNs answered survey questions. A partial least squares-structural equation modeling method was employed to analyze the survey responses. @*Results@#A pay scale of APNs is positively associated with person-organization fit (POF). However, the effect of job location and computer self-efficacy on POF is not significant. Job satisfaction plays a salient direct role in supervision and POF. Job satisfaction is also a significant moderator in the relationship between supervision and POF. POF is significantly associated with both OC and supervision. Supervision has a positive effect on organization commitment. @*Conclusions@#Pay scale, job satisfaction, supervision, and POF are significant factors affecting organization commitment. Establishing an intra-organization entity, such as APN steering committee, to ensure mutual consensus and transparent communication between administrators and APNs would enhance POF, the rating of supervision, and organization commitment.

Key competencies for Korean nurses in prenatal genetic nursing: experiential genetic nursing knowledge, and ethics and law / 보건의료교육평가

Purpose@#This study aims at determining the competencies of Korean nurses in prenatal genetic nursing. @*Methods@#First, a 3-round Delphi survey was conducted to establish prenatal genetic nursing competencies. Second, a prenatal genetic nursing education program (PGNEP), incorporating the findings from the Delphi survey, was designed. Third, a single group pre- and post-quasi-experimental study at a PGNEP workshop was conducted to assess the effectiveness of the integration of the competencies into the PGNEP with the measurements of knowledge about prenatal genetic testing and nursing (K-PGTN) and information needs about prenatal genetic testing and nursing (I-PGTN). Finally, the identified competencies were reexamined for their clarity. @*Results@#Based on the Delphi survey 78 competency components were identified. The components were then classified under 10 categories, which were organized under 4 domains. The domain of “experiential genetic nursing knowledge” and the domain of “ethics and law” were ranked as the first and the second in significance. The quasi-experimental study showed that the mean scores in K-PGTN were significantly increased from 8.19±2.67 to 11.25±2.51 (P<0.001). The mean scores of “ethics and law” in I-PGTN decreased significantly (P=0.023). The headings of 4 categories and 2 domains were revised. @*Conclusion@#This study identified competencies for prenatal genetic nursing and nursing education in Korea. There is a need for nursing instructors and researchers to improve the competencies of nurses in the identified areas. Particular emphasis should be placed on experiential nursing knowledge and on ethics and law related to prenatal genetic nursing.

Husserlian Phenomenology in Korean Nursing Research: Analysis, Problems, and Suggestions / 한국간호교육학회지

This paper is a critical review of descriptive phenomenological methodology in Korean nursing research. We propose constructive suggestions for the improvement of descriptive phenomenological methodology in light of Husserl's phenomenological approaches. Methods: Using the key words of 'phenomenology,' 'experience,' and 'nursing,' we identify and analyze 64 Korean empirical phenomenological studies (selected from 282 studies) published in 14 Korean nursing journals from 2005 to 2018. The PubMed and the Korea Citation Index were used to identify the studies. Results: Our analysis shows that all the reviewed articles used Giorgi's or Colaizzi's scientific phenomenological methodology, without critical attention to Husserl's philosophical phenomenological principles. Conclusions: The use of scientific phenomenology in nursing research, which originated in North America, has become a global phenomenon, and Korean phenomenological nursing research has faithfully followed this scholarly trend. This paper argues that greater integration of Husserlian phenomenological principles into scientific phenomenological methodology in nursing research, such as participant-centered bracketing and eidetic reduction, is needed to ensure that scientific phenomenology lives up to its promise as a research methodology.

Husserlian phenomenology in Korean nursing research: analysis, problems, and suggestions / 보건의료교육평가

Purpose@#This paper is a critical review of the descriptive phenomenological methodology in Korean nursing research. We propose constructive suggestions for the improvement of descriptive phenomenological methodology in light of Husserl’s phenomenological approaches. @*Methods@#Using the keywords of ‘phenomenology,’ ‘experience,’ and ‘nursing,’ we identify and analyze 64 Korean empirical phenomenological studies (selected from 282 studies) published in 14 Korean nursing journals from 2005 to 2018. The PubMed and the Korea Citation Index were used to identify the studies. @*Results@#Our analysis shows that all the reviewed articles used Giorgi’s or Colaizzi’s scientific phenomenological methodology, without critical attention to Husserl’s philosophical phenomenological principles. @*Conclusion@#The use of scientific phenomenology in nursing research, which originated in North America, has become a global phenomenon, and Korean phenomenological nursing research has faithfully followed this scholarly trend. This paper argues that greater integration of Husserlian phenomenological principles into scientific phenomenological methodology in nursing research, such as participant-centered bracketing and eidetic reduction, is needed to ensure that scientific phenomenology lives up to its promise as a research methodology.

Key competencies for Korean nurses in prenatal genetic nursing: experiential genetic nursing knowledge, and ethics and law / 보건의료교육평가

Purpose@#This study aims at determining the competencies of Korean nurses in prenatal genetic nursing. @*Methods@#First, a 3-round Delphi survey was conducted to establish prenatal genetic nursing competencies. Second, a prenatal genetic nursing education program (PGNEP), incorporating the findings from the Delphi survey, was designed. Third, a single group pre- and post-quasi-experimental study at a PGNEP workshop was conducted to assess the effectiveness of the integration of the competencies into the PGNEP with the measurements of knowledge about prenatal genetic testing and nursing (K-PGTN) and information needs about prenatal genetic testing and nursing (I-PGTN). Finally, the identified competencies were reexamined for their clarity. @*Results@#Based on the Delphi survey 78 competency components were identified. The components were then classified under 10 categories, which were organized under 4 domains. The domain of “experiential genetic nursing knowledge” and the domain of “ethics and law” were ranked as the first and the second in significance. The quasi-experimental study showed that the mean scores in K-PGTN were significantly increased from 8.19±2.67 to 11.25±2.51 (P<0.001). The mean scores of “ethics and law” in I-PGTN decreased significantly (P=0.023). The headings of 4 categories and 2 domains were revised. @*Conclusion@#This study identified competencies for prenatal genetic nursing and nursing education in Korea. There is a need for nursing instructors and researchers to improve the competencies of nurses in the identified areas. Particular emphasis should be placed on experiential nursing knowledge and on ethics and law related to prenatal genetic nursing.

Knowledge and Information Need for Prenatal Genetic Screening and Diagnosis and Attitude toward Terminating Pregnancy among Pregnant Women in South Korea / 한국간호교육학회지

PURPOSE: This study identifies correlations among information needs and knowledge about prenatal genetic screening and diagnosis (I-PGSD & K-PGSD), and attitude toward terminating pregnancy (ATP) among pregnant women in South Korea. METHODS: A descriptive survey was conducted from January 2013 to April 2014 in South Korea. 222 pregnant women responded to three questionnaires developed by the authors. The questionnaire for I-PGSD consisted of 19 questions; 18 questions for K-PGSD; and 10 questions for ATP. RESULTS: Mean scores were 80.46±11.73 for I-PGSD; 14.86±3.74 for K-PGSD; and 33.71±6.13 for ATP. The ATP score was positively correlated with the I-PGSD and K-PGSD scores, but statistically significant with only I-PGSD (p=.006). I-PGSD scores were higher than average on three genetic syndromes (Down, Patau, and Edwards syndrome), on management after the diagnosis of positive fetal aneuploidy, and on test result interpretation after the amniocentesis and level II fetal ultrasonogram. CONCLUSION: In light of current legal and moral controversy regarding terminating pregnancy and rapidly advancing prenatal genetic testing technology, more prenatal genetic education for nurses and nursing students who teach pregnant women is needed. In addition, more professional counseling services provided by trained nurses are also required.

The Effect of a Teaching Model for Improving Undergraduate Nursing Students' Cultural Competency / 한국간호교육학회지

PURPOSE: This study evaluated the effect of a teaching model to improve cultural competency (TMCC) for Korean undergraduate nursing students. METHODS: A nonequivalent control group pretest/posttest quasi-experimental study was conducted with a convenience sample of 168 undergraduate nursing students in South Korea. The experimental group of 121 seniors was taught a 13-week teaching model in order to improve cultural competence. A control group with 47 junior students underwent nursing major courses, but did not take this teaching model. Before and after the program, students' level of cultural competency was measured using the Questionnaire for Cultural Competence (QCC) consisting of three sub-scales: “awareness and desire,” “encounter,” and “nursing skill and knowledge.” RESULTS: After the experiment, the experimental group showed significantly higher improvement in the Questionnaire for Cultural Competence in the three sub-scales of “awareness and desire,” “encounter,” and “nursing skill and knowledge” than the control group (p= < .050). CONCLUSION: A teaching model to improve cultural competence was effective in improving Korean undergraduate nursing students' cultural competency. Further studies need to be repeated in order to identify the effectiveness of the teaching model to improve cultural competency with graduate or clinical nurses.

A Study on the Curriculum of Global Health Education / 한국간호교육학회지

PURPOSE: This study aimed to understand current global health education and suggest its future direction for Korean undergraduate nursing students. METHODS: After reviewing literature to identify key concepts applicable to global health nursing curricula, the authors analyzed global health curricula from 98 nursing colleges by using a framework that was developed for this study. RESULTS: Among the 201 nursing colleges, 98 (48.8%) schools offered one or more global health-related courses. The titles of these courses were divided into two categories: Multiculturalism and international nursing. Multicultural courses were offered mainly for freshmen (40.5%) or sophomore students (40.5%), whereas international nursing courses were offered mainly for senior students (35.9%). These courses trained nursing students to be culturally competent in providing nursing care for immigrants or foreign travelers living in South Korea. CONCLUSIONS: It is evident that interest in global health education is growing in South Korea. However, the scope and content of global health education needs to be broadened beyond multiculturalism and international nursing so that it can prepare nursing students to promote global health equity, reduce global health disparities, and work competently with globally-focused organizations.

The Relationship between Cultural Competency and the Importance of Nurses' Qualities Perceived by Undergraduate Nursing Students

PURPOSE: This study was conducted to investigate the relationship between cultural competency and the importance of nurses' qualities perceived by undergraduate nursing students. METHODS: Researchers developed two tools for this study after reviewing the related literature and conducting research team workshops: questionnaire of cultural competency and the importance of nurses' qualities. 200 nursing students were recruited in convenient sampling to respond to these questionnaires. Of nurses' 10 qualities, major affecting factors on the cultural competency were identified by stepwise multiple regression analysis. RESULTS: The nursing students perceived technical nursing skills and professional nursing knowledge as nurses' most important qualities. However, 'having a passion for patient care', 'demonstrating strong nursing profession's code of ethics??and 'teaching and research ability' were found as significant influencing factors on the variance of the cultural competency. These three factors explained 16% of the total variances of the cultural competency (F=13.98, p<.001). CONCLUSION: The educational strategies to improve cultural nursing competency need to incorporate students' expectations for the professional nurses' roles. Also, further studies need to develop reliable and valid measurement tools for cultural competency

Development and an Evaluation of Educational Program for Nurse Professionals: Cultural Competency in Cancer Prevention

PURPOSE: This study aimed to develop and evaluate a nursing educational program improving nursing professional's cultural competency in cancer prevention. METHODS: An eight-hour long educational program was developed based on several preliminary research projects, one ethnography and three quantitative projects, to identify the educational needs among nursing students and professionals in Korea. Thirty two nursing professionals were recruited for a one group pretest-posttest design. Three questionnaires were used to measure cultural nursing knowledge about cancer prevention, cultural competency and perceived importance of nurses' quality. RESULTS: After completing the educational program, the clinical nurses showed a significant change in the mean score of the cultural nursing knowledge about cancer prevention from 4.78±2.01 to 8.81±1.52 (t=-8.48, p<.001) and the level of the cultural competency from 72.47±8.96 to 83.59±8.61 (t=-6.16, p<.001). Clinical nurses' perception of 'Communication ability with patients and family members' changed from 6th to 2nd most importance but 'Having a passion for the patient care' remained the most important perceived factor of nurses' quality after completing the educational program. CONCLUSION: The educational program developed was effective in improving nursing professional's cultural competency in cancer prevention. However, it needs to be improved more to be culturally specific to multi-cultural clients.

Development and Evaluation of a Nursing Educational Program to Reduce Cancer Worry of Colorectal Cancer Patients' Family Members

PURPOSE: This study was to develop and evaluate the clinical utility of a nursing educational program to reduce the cancer worry of colorectal cancer patients' family members (RCW-FM) in Korea. METHODS: The RCW-FM was developed based on several preliminary studies: an ethnographic and two quantitative studies to understand the educational needs among Korean colorectal cancer patients and their families. A one week clinical genetic educational course for clinical cancer nurses was implemented, and the RCW-FM led by cancer genetic nurses was constructed. A one group pretest-posttest design was implicated to evaluate the change of the family members' knowledge about colorectal cancer (KCR) and the level of the reduction of cancer worry (CWR). RESULTS: The mean score for KCR significantly increased from 11.75+/-1.28 to 13.87+/-1.13 (p<.05). The mean score of CWR was 4.25+/-.89. CONCLUSION: This new RCW-FM is a satisfactory educational program for reducing the cancer worry of the colorectal patients' family members. But it needs to provide more practical, specific information including a long term perspective, tailored specifically for what Korean families want to know. It should also incorporate the preventive guidelines recommended for high risk hereditary or familial colorectal cancer.

The Attitude toward Marriage, Pregnancy and Abortion among Korean Nursing Students / 한국간호교육학회지

PURPOSE: There recurred controversies related to legal allowance of abortion since newly advancing prenatal genetic testing technology. This survey was aimed to identify the attitudes toward marriage, and pregnancy (AMP) and terminating pregnancy (ATP) among Korean nursing students. METHOD: A descriptive study was performed from October to November 2012 in South Korea. 424 nursing students responded to two types of tools developed by authors. Questionnaire for ATP is consisted of 10 items with 5-points Likert Scale. Questionnaire for AMP is 12 items containing 5 categories. RESULTS: Mean score of ATP was 36.90. Students that are enrolled in bachelor degree had a significant higher ATP. Students who are currently dating with an opposite gender showed much higher level of ATP than those are not. Lower group of delayed the time of getting marriage and pregnancy showed highest score of ATP, significantly. CONCLUSION: Individual factor must be primarily considered when assessing ATP of nursing students, for example current relationship with opposite gender and educational background, attitude toward marriage and pregnancy. Further studies are needed to identify personal factors of the young adults affecting on the ATP.

A Proposed Teaching Model to Improve Cultural Competency Care for Undergraduate Korean Nursing Students / 한국간호교육학회지

PURPOSE: The aim of this study was to propose a teaching model to improve the cultural competence care of undergraduate Korean nursing students. METHODS: A literature review was performed from 2000 through 2014 using internet to identify studies that presented nursing curricula and teaching-learning strategies in Korea. We analyzed retrieved Korean seven articles using Campinha-Bacote's ASKED model in combination with reflective experiences of authors observing classrooms in the U.S. RESULTS: Six syllabuses presented information about cultural diversity nursing concepts in Korea. A traditional lecture focused on presenting contents about cultural knowledge by an instructor in the classroom was identified as a commonly used teaching strategy. We found that cultural competency related to cultural desire, awareness, and encounter was lacking. Thus, we developed teaching model based on the Korean nursing education contexts and combined with Campinha-Bacote model to improve cultural competency in nursing. CONCLUSIONS: The proposed teaching model shows promise as a strategy for improving the knowledge, attitudes, and skills related to cultural competent for undergraduate nursing students in Korea. However, evidences that this model improves nursing students' clinical practices reflecting cultural competent care are still lacking. Future research focusing on determining teaching methods and contents in clinical practices will be most effective.

Cancer Worry Experiences among Colorectal Cancer Patients and Families who have a Family History of Colorectal Cancer

PURPOSE: This study aims to understand the worries that patients and families with a history of colorectal cancer experience. METHODS: From January 2011 through January 2013, in-depth interviews and observations were conducted on 3 colorectal patients and 8 family members with a family history of colorectal cancer. The data were analyzed using a micro-ethnographic research method. RESULTS: After colorectal cancer patients and families realized and concerned with their increased chance of getting cancer, Eventually this worry became a motivator causing them to adhere to cancer preventive behavior. Three types of cancer worries were identified: confrontation, uneasiness, and warning. Depending on the type of cancer risk, psychological responses and cancer preventive behavior were found to be varied according on the three types of cancer worries. Patients and families tried to change dietary habits and regulary exercise. To help ease their cancer worries, they started to search for information on colon cancers and attempted to follow recommendations. However, they found that neither detailed guidelines nor systematic management from health professionals existed for families with colon cancer patients. CONCLUSION: A cancer prevention nursing program needs to be developed based on the level of cancer risk and perceived cancer worries of clients.

Effectiveness of Home Health Care Service for Elders after Spinal Surgery

PURPOSE: This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries. METHODS: A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels. RESULTS: The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004). CONCLUSION: Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.

Experiences of Korean-American Women with High Risk Hereditary Breast Cancer

PURPOSE: This micro-ethnographic study aimed to understand coping experiences of Korean-American (K-A) women after diagnosis with breast cancer due to a hereditary gene mutation. METHODS: Participatory observation and in-depth interviews were performed at one breast cancer screening center in Southern California, in 2005 with eleven first generation K-A immigrant women. All transcribed interviews and field notes were analyzed using ethnographic methodology. RESULTS: K-A women's experience varied based on acculturation risk factors including: limited English speaking ability; disrupted family relationships, individualistic family values, or intergenerational communication barriers; lack of Korean speaking nurses; and Korean physicians' who lacked knowledge about hereditary breast cancer risk. These risk factors led to isolation, loneliness, lack of emotional and social support. In comparison to Korean homeland women in a similar medical situation, these K-A immigrants felt disconnected from the healthcare system, family support and social resources which increased their struggling and impeded coping during their survivorship journey. These women were not able to access self-support groups, nor the valuable resources of nurse navigator programs. CONCLUSION: Professional oncology associations for nurses and physicians have a moral obligation to support and promote knowledge of hereditary cancer risk and self-help groups for non-native speaking immigrants.

Current Issues and Tasks of Genetic Cancer Nursing in Korea

PURPOSE: The purpose of this review article is to introduce how the Korean Society of Genetic Nursing (KSGN) has evolved and tried to translate genomic knowledge to nursing practice, and then to suggest the future role of genetic nurses in Korea. METHODS: A literature review was performed and the current status of genetic counselling in Korea was explored. Then the educational and clinical experiences of the authors were incorporated. Finally, the main activities of Korean nursing for genetics were identified. RESULTS: Two types of genetic counsellor certification have been issued in Korea: one is issued by the Korean Society of Genetic Medicine, another by the Korean Society of Breast Cancer since June 2011. A few Korean nursing researchers have continuously performed research related to genetic nursing and undertook several research projects funded by the government since 2003. In February 2011, KSGN was established and is now trying to establish further international networks. CONCLUSION: Nursing genetic experts should be trained to integrate all specialties for genetic counselling, so they can provide holistic genetic services including ethical, legal, and social issues (ELSI).

Communication Patterns in Korean Families during BRCA Genetic Testing for Breast Cancer / 종양간호학회지

PURPOSE: The purpose of this micro-ethnography is to examine whether science and societal changes impact family communication patterns among a convenience sample of 16 Korean women. METHODS: The authors observed family communication in the context of a new breast cancer genetic screening and diagnostic testing program to detect BRCA gene mutations in Korean women at highest risk. RESULTS: Analysis of in-depth interviews and field notes taken during participant observation illustrated that communication patterns in families vary according to a woman's position in the family. If a grandmother tests positive for a gene mutation, her daughters make decisions on her behalf; they open and maintain the communication channel among family members. If a housewife is diagnosed with cancer and a genetic mutation, she immediately consults her husband and her sisters. The husband creates an open communication channel between his wife, his parents and his siblings. As a result, a woman's cancer is a concern for the whole family not merely a woman's secret or crisis. CONCLUSION: Cultural differences are important to consider when designing new genetic service programs in different countries.

Analysis of Research Papers Published by Three Nursing Journals to Suggest the Direction of Journal of Korean Oncology Nursing / 종양간호학회지

PURPOSE: The purpose of this study was to analyze the research papers published in three nursing journals to suggest the direction for Journal of Korean Oncology Nursing (JKON). METHODS: To compare JKON with Journal of Korean Academic Society of Nursing Education and Cancer Nursing, all the research papers published in those three journals, 2010 were reviewed using an analysis criteria developed by the researchers, focusing on type of research, characteristics of authors and subjects, research design, data collection and analysis methods, sample size estimation, and ethical considerations regarding data collection. RESULTS: JKON lacked research papers which were supported by research funds, produced by multidisciplinary teams, addressing cancer survivors or patients with metastatic cancers, and written in qualitative methodologies. However, JKON showed higher ratio of research papers than the other two journals which were adapted from thesis or dissertations, describing sample size estimation process precisely, and participating subjects diagnosed with various cancers. CONCLUSION: The study found out that JKON is presenting well the area of oncology nursing in Korea and also has several weak points that need to be improved. The study therefore suggested several recommendations for the JKON to take the professional and global leader roles.