Factors Influencing Turnover Intention in Clinical Nurses: Compassion Fatigue, Coping, Social Support, and Job Satisfaction / 간호행정학회지

PURPOSE: This study was done to construct and verify a model of turnover intention in clinical nurses, considering the effects of compassion fatigue, coping, social support, and job satisfaction. METHODS: For this study a cross-sectional correlational design was used. Participants were 283 clinical nurses in four general hospitals. Data were collected using a questionnaire and were analyzed with descriptive statistics, Pearson correlation coefficient and path analysis. RESULTS: The modified model of turnover intention had a good fit in this study. Turnover intention was influenced by job satisfaction, and job satisfaction was affected by workload, problem-focused coping, peer support, family-friend support and compassion fatigue. Compassion fatigue was associated with occupational trauma events, problem-focused coping and emotional-focused coping. Job satisfaction was the most important factors controlling nurse's turnover intention. CONCLUSION: Findings show that job satisfaction, compassion fatigue, and traumatic events are important factors influencing turnover intention. Nurse managers try to manage job satisfaction, compassion fatigue, support, and coping for nurses, it could be expected making proper nursing circumstance.

The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women

PURPOSE: This study was done to investigate factors influencing successful aging in middle-aged women. METHODS: A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program. RESULTS: Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging. CONCLUSION: Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

Factors Influencing Subjective Happiness in Korean Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to determine subjective happiness related factors in Korean nursing students. METHODS: A purposive sample of 200 nursing students was recruited for the cross-sectional survey design. The instruments were perceived stress scale, major satisfaction scale, resilience scale, and subjective happiness scale. Data were analyzed using descriptive statistics, hierarchical linear regression, and the Sobel test for testing mediating effects. RESULTS: The mean score of stress, major satisfaction, resilience and subjective happiness was 2.21, 3.95, 3.60 and 5.03, respectively. Perceived health status, stress_positive perception, stress_negative perception, resilience_self confidence, resilience_positivity, resilience_social support had significant effects on subjective happiness. Explained variance for the subjective happiness was 53.4%. Resilience had a partial mediating effect in the relationship between stress and subjective happiness (Sobel test: Z=-5.67, p<.001). Also, resilience had a mediating effect in the relationship between major satisfaction and subjective happiness (Sobel test: Z=5.65, p<.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on improving resilience are recommended to improve subjective happiness in nursing students.

Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients

PURPOSE: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. METHODS: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. RESULTS: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. CONCLUSION: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

A Path Analysis on Factors Influencing Second Primary Cancer Screening Practices in Stomach, Colon, and Breast Cancer Survivors

PURPOSE: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. METHODS: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). CONCLUSION: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

Attitude to Death and Life Satisfaction between Groups of Elderly People with and without Cancer

PURPOSE: This study was to examine attitude to death and life satisfaction between groups of elderly people with and without cancer. METHODS: This study used a descriptive research design. Data were collected from January to March 2013. Participants were 66 elderly without cancer and 65 elderly with cancer. A questionnaire was used to collect data. RESULTS: The attitude to death of participants was relatively positive and the degree of life satisfaction was medium or greater. There was no significant difference in attitude to death between the groups with and without cancer. However, the score for the life satisfaction of the group without cancer was significantly higher than that of the group with cancer. Attitude to death was significantly different according to sex, living together with family, and intention to prepare for death. Life satisfaction was significantly different according to gender and religion. The correlation between attitude to death and life satisfaction was not significant in both groups. CONCLUSION: As a result of this study the elderly had a generally positive attitude to death and were satisfied with their lives. Cancer influenced elderly people's life satisfaction, not their attitude towards death. To improve life satisfaction for elderly people with cancer, we need to research which factors could be important.

Relationships between Knowledge about Early Detection, Cancer Risk Perception and Cancer Screening Tests in the General Public Aged 40 and Over

PURPOSE: This study is to determine knowledge about early detection and risk perception of cancer according to taking cancer screening tests in the general population. METHODS: The participants were 151 people aged 40 yr or older. A questionnaire consisted of knowledge about early detection (warning signs, cancer screening methods, general knowledge for early detection), cancer risk perception and history of cancer screening during past 2 yr. RESULTS: The percentages of correct answers were 64.7% in knowledge about warning signs, 73.7% in knowledge of cancer screening tests and 80.1% in general knowledge for early detection. Participants had the highest knowledge about screening methods for stomach cancer and the lowest for liver and colon cancer. The level of risk perception was medium. The participants who participated in cancer screening showed lower risk perception than those who did not. There was no significant relationship between knowledge and performance of cancer screening. The primary reason for not participating in cancer screening was patient's perception of their own health. CONCLUSION: These results suggest that cancer risk perception can affect the performance of cancer screening and we need to study how to handle this problem. Additionally screening programs should focus on liver cancer and colon cancer.

Prevalence and Precipitating Factors for Delirium in Elderly Patients Admitted to Long-Term Care Hospitals or to General Hospital / 기본간호학회지

PURPOSE: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. METHOD: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. RESULTS: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. CONCLUSION: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

Evaluation of an Education Program for Patients with Asthma who use Inhalers

PURPOSE: This study was done to evaluate the effectiveness of an education program for patients with asthma who use inhalers. METHODS: The research design for this study was a non-equivalent control group quasi-experimental study. Participants in this study were 36 patients for the control group, and 43 patients for the experimental group. The experimental group participated in the education program. The control group received the usual care. Data were collected before and 1 month and 2 months after the program finished and were analyzed using the SPSS 12.0 program. RESULTS: The experimental group had significantly higher scores of knowledge of inhalers, and inhalation technique compared to the control group. However, no significant differences were found between two groups for PEFR, asthma instability, and satisfaction with inhalers. CONCLUSION: According to the results, the education program was effective in improving knowledge of inhalers, and inhalation technique. Therefore, it is recommended that this education program be used in clinical practice as an effective nursing intervention for patients with asthma on inhalers.

The Effect of BSE Education with Practice on Knowledge, Self-Efficacy and Performance in Middle-Aged Women / 기본간호학회지

PURPOSE: Breast cancer is a common cancer in women in Korea. Early detection of breast cancer is very important for the protection of a woman's health. The purpose of this quasi-experimental study was to determine the effect of BSE education on knowledge, self efficacy and performance in middle-aged women. METHOD: The participants were 33 women who agreed to participate in the study. They responded to a questionnaire that included items on knowledge, self-efficacy and performance of BSE. The experimental group was given a 90 minute-session including a lecture and practice with a BSE practice model and their own body. Their knowledge of the BSE was measured using Choi's tool and self-efficacy was measured using the scale by Champion and Scott. RESULTS: Homogeneity for knowledge, self-efficacy and performance of BSE between the experimental and the control groups was confirmed. After 3 months of BSE education, knowledge, self-efficacy and frequency of BSE performance in the experimental group were significantly higher than for the women in the control group. CONCLUSION: A BSE education program would be helpful to enhance health behavior by early detection of breast cancer in middle-age women.

The Effects of Programs Using Strategies for Promoting Self Efficacy in Patients with Lung Cancer / 성인간호학회지

PURPOSE: This study investigated the effects of a 'overcoming cancer program' on knowledge, self efficacy, and quality of life, therapeutic compliance for patients with lung cancer. METHOD: Research design of this study was a nonequivalent control group quasi-experimental study. Subjects for this study were 16 lung cancer patients for the control group, and 12 lung cancer patients for the experimental group. The experimental group participated in the program once a week for 4 weeks. Data were collected before and after the program. Nonparametric statistics were used to analyze the data. RESULTS: The results of this study were as follows: In the pretest, there were no significant differences in general characteristics, knowledge, self efficacy and quality of life between the two groups. In the posttest, there were significant differences in knowledge, self efficacy between the experimental and the control groups. But there were no significant differences in therapeutic compliance and quality of life between the two groups. CONCLUSION: From the results above, it can be concluded that program was effective to improve knowledge and self-efficacy for patients with lung cancer.

Application and Efficacy Evaluation of Nutritional Screening Tool

PURPOSE: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no 'gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. METHODS: Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within 24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion for malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid- arm muscle circumference, serum albumin and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statdtatistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic (ROC) curve was drawn to choose a cutoff value that maximizes sensitivity and specificity. RESULTS: The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified 7 patients (13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. CONCLUSION: The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.

The Effects of 'Cancer Overcome Program' Using Strategy for Promoting Self-Efficacy among Family Caregivers with Lung Cancer in Korea / 성인간호학회지

PURPOSE: This study investigated the effect of a structured group intervention on knowledge about lung cancer, self efficacy and quality of life for family caregivers of patients with lung cancer using a nonequivalent control group quasi-experimental design. METHODS: Subjects were 11 family caregivers for both the control and the experimental group. The experimental group participated in once a week for 2-hour session for 4 weeks. Four topics of educational program were lung cancer and treatment, side effects of treatments, symptoms management, and health management. Every session consisted of lecture, sharing experiences, and meditating time. Quality of life was measured using Jang(1996)'s tool. The tools for knowledge and self-efficacy were developed by the authors. RESULTS: After the intervention, the experimental group showed higher self-efficacy in caring for the patients than did the controls. However, there were no significant differences in knowledge about lung cancer and quality of life between the two groups. CONCLUSION: Findings indicate that the group intervention would be effective for family caregivers of lung cancer patients.

Research Related Activities and Its Related Factors in Clinical Nurses / 기본간호학회지

PURPOSE: This study was done to describe research-related activities and attitudes toward research, barriers to and support needs for undertaking research in clinical nurses. METHOD: Data were collected by a questionnaire from 238 clinical nurses with over one year clinical experience working at 2 university hospitals. RESULTS: Research related activities included courses or lecture about Nursing Research 85.7%, journal reading at least once every 2 to 3 months 30.0%, memberships in academic societies 29.4%, participation in academic conferences 45.0%, conducting research 45.4%, research utilization 24.6%. The score for attitudes toward research was 3.08(range 1-5). The score of barriers to undertaking research was 3.37(1-5) and the score for support needs for undertaking research 4.14(1-5). Attitudes toward research significantly correlated with barriers to undertaking research(r=.- 36, p=.000). Barriers to undertaking research significantly correlated with support needs for conducting research(r=.23, p=.000). Nurses with experience in conducting research had more negative attitudes toward research(t=-2.130, p=0.034) and more barriers to undertaking research than those without experience in conducting research (t=2.194, p=0.029). CONCLUSION: These results suggest that it is necessary to increase positive attitudes toward research in clinical nurses and nursing organizations need to provide strong supports for nurses conducting research.

Anorexia, Nausea and Vomiting, and Food Intake Patterns in Patients on Chemotherapy / 기본간호학회지

PURPOSE: The purpose of this study was to identify the relationship between anorexia, nausea, and vomiting (ANV) and food intake patterns in patients with cancer on chemotherapy. METHOD: Ninety-one patients from a university hospital in Seoul were recruited and were asked to record food intake and ANV during one cycle of chemotherapy. RESULTS: Caloric and protein intake decreased significantly. The mean caloric intake was 808.75 Kcal (SD=177.54), 48.2% of the recommended intake and the mean of protein intake was 28.44 g (SD=16.44) only 34.7% of the recommended intake. The mean score for dietary diversity was 3.57 (SD=.73) indicating that the patients had taken 3 or more of the 5 food groups. ANV had a significant negative correlation with caloric and protein intake and dietary diversity (r=-.29~-.56, P<.05) and dietary diversity had a significant positive correlation with caloric and protein intake (r=.46 and .57, P=.000). CONCLUSION: Patients receiving chemotherapy had a very poor intake that could lead to malnutrition and a compromised immune system. These findings suggest the need to develop interventions that encourage for food intake.

Relationship Between Fatigue and Nutritional Status in Patients with Cancer Undergoing Radiotherapy / 간호학회지

PURPOSE: The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. DESIGN: A correlational and crossectional study design was used. METHOD: One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. RESULTS: The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. CONCLUSION: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

Trajectory of Fatigue, Quality of Life and Physical Symptoms in Cancer Patients Receiving Radiotherapy / 간호학회지

PURPOSE: The purpose of this longitudinal prospective study was to assess changes in fatigue and quality of life for a 6-week course of radiotherapy. METHOD: A descriptive and longitudinal design was used to this study. Twenty-three subjects receiving radiotherapy from a radiotherapy clinic of a general hospital completed the questionnaires. Fatigue was measured using Lee's scale(1999) and quality of life using Yang's scale(2002) weekly for 6 weeks. RESULT: Fatigue significantly increased(F=6.043, p=.000), and quality of life significantly decreased(F=3.938, p=.003) and physical symptoms also significantly increased(F=2.432, p=.039) during a 6-week radiotherapy. Multiple regression analysis revealed that fatigue at the first week and physical symptoms at the 6th week were the significant affecting variables(60.1% of the variance) on fatigue. And 63.2% of the variance in quality of life was explained by quality of life and fatigue at the first week and body weight change for 6 weeks radiotherapy. CONCLUSION: Based on these results, the fatigue and quality of life at the beginning time of radiotherapy have a lasting impact throughout the course of treatment. It suggests that nurses provide patients with information about the occurrence of fatigue during radiotherapy and the practical methods of intervening physical symptoms.

The Trajectory of Fatigue and Quality of Life in Stomach Cancer Patients Receiving Chemotherapy / 간호학회지

PURPOSE: This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. METHOD: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). RESULT: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. CONCLUSION: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.

The Relationship of Symptoms of Side Effects, Fatigue and Quality of Life in Stomach Cancer Patients receiving Chemotherapy / 성인간호학회지

PURPOSE: The purpose of this study was to investigate the level of nausea, vomiting, anorexia, fatigue and quality of life as well as to determine the relationship between those variables and identify the influencing factors on fatigue and quality of life in stomach cancer patients receiving adjuvant chemotherapy. METHOD: Subjects were 94 stomach cancer patients undergoing postoperational chemotherapy in a general hospital in Seoul. Nausea and vomiting were measured with Rhodes et al(1984) and anorexia with one 5-point item. Fatigue was measured using Lee's tool(1999) except open questions. The tool for quality of life was modified based on the Quality of Life Index by Padilla et al(1983). RESULT: Subjects reported low level of fatigue(mean=3.86, range=0-10) compared with the results of previous researches and moderate quality of life(mean=2.64, range=1-4). Fatigue was positively correlated with nausea, vomiting and anorexia(r=.21 ~ .55, p<.05). Quality of life was negatively correlated with nausea, vomiting, anorexia(r= -.24 ~ -.45, p<.05) and fatigue (r=-.61, p<.01). Multiple regression analysis revealed that activity level, vomiting before admission, anorexia during chemotherapy and age explained 52.8% of the variance in fatigue. Fatigue, anorexia before admission, age and sex explained 50.5% of the variance in quality of life. Fatigue and quality of life were not influenced by the stage of disease, nor weight change. CONCLUSION: These results may contribute to a better understanding of how much the side effects of anticancer drugs can affect fatigue and quality of life in cancer patients undergoing chemotherapy. Also it is the remarkable fact that symptoms remaining after discharge such as vomiting or anorexia continued until re-admission, contributing to patients fatigue and lowered their quality of life.

The Nutritional Status of the Patients with Cancer during the Chemotherapies / 간호학회지

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy. METHOD: To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy. RESULT: 93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake. CONCLUSION: The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.