Development of Job Satisfaction Scale for Clinical Nurses / 간호학회지

PURPOSE: This study was performed to develop the Job Satisfaction Scale for Clinical Nurses (JSS-CN) and verify its validity and reliability. METHODS: A preliminary 42-item version of the JSS-CN was developed through literature reviews and in-depth interviews. The draft scale was developed using thirty-seven items selected following content validity evaluation. Finally, thirty-three items with response options on a 5-point Likert scale were selected based on internal consistency reliability and construct validity. Subsequently, the test-retest reliability and convergent validity of the JSS-CN were verified. RESULTS: Six factors, namely, recognition from the organization and professional achievement, personal maturation through the nursing profession, interpersonal interaction with respect and recognition, accomplishment of accountability as a nurse, display of professional competency, and stability and job worth, were identified, which explained 59.7% of the total variance. The JSS-CN's Cronbach's α for the total scale was .95, and the intra-class correlation coefficient was .90. The correlation coefficient between the scores of the JSS-CN and Slavitt's scale was .75, and that between the JSS-CN and job performance was .53. CONCLUSION: Results showed that the JSS-CN has good reliability and validity. Therefore, it is concluded that the JSS-CN could be a useful tool for the measurement of the job satisfaction of clinical nurses in Korea.

Effects of Labor Intensity and Fatigue on Sleep Quality of Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to determine the effects of labor intensity and fatigue on the sleep quality of clinical nurses and provide basic data for preparation of nursing interventions to improve sleep quality. METHODS: Data were collected from 198 nurses in 2 general hospitals with more than 500 beds in D-city. Data analysis was performed using stepwise regression with the SPSS/WIN 22.0 program. RESULTS: The significant factors influencing sleep quality of the clinical nurses were fatigue, absolute labor intensity, and shift type. Explanatory power was 66% in the regression model. CONCLUSION: Findings indicate that nurses with higher level of fatigue, and greater absolute labor intensity which implies extended work hours, had lower sleep quality for all the three shifts. To improve the sleep quality of clinical nurses, an intervention program for fatigue management is needed. In addition, hospitals should establish an internal legal standard to compensate overtime work with breaks. At the same time, as shift work is inevitable for nurses, it is necessary to develop a work system that can minimize the disturbance of daily rhythms.

Role Adaptation Process of Hospice Nurses / 간호행정학회지

PURPOSE: This study was performed to identify the role adaptation process of hospice nurses and suggest a model for the process. METHODS: Grounded theory methodology was used. Twenty nurses participated in individual in-depth interviews. Data were collected until saturated. Questions for the interviews were about phenomenon, conditions, action/interaction strategies, and consequences in the process. Data were analyzed by applying open, axial and selective coding proposed by Strauss and Corbin. RESULTS: Core category of the role adaptation process was ‘building up real capabilities’. Phenomenon of the role adaptation was oppressive feelings when caring for dying patients. Contextual conditions were lack of knowledge, experience and belief about hospice and hospice care being regarded as penance. Intervening conditions were expansion of horizons in understanding life and expansion of social comprehension about hospice. Action/interaction strategies included ‘reflecting on oneself as a hospice nurse’, ‘using oneself with feelings of a calling’ and ‘striving for self-management’. Consequence of the process was being a caring expert for peaceful death. CONCLUSION: The role adaptation process of hospice nurses for the participants was the process of building up real capabilities leading them to become caring experts for peaceful death through overcoming oppressive feeling when caring for dying patients.

Chronically Ill Patients' Perception of Hospital Nurses

PURPOSE: The purpose of this qualitative research was to investigate chronically ill patients' perception of hospital nurses. METHODS: Individual in-depth interviews and qualitative content analysis were used for data collection and analysis respectively. Participants were 13 chronically ill hospitalized patients or outpatients in three universities hospitals. All interviews were recorded and transcribed verbatim. Data were analyzed using the qualitative content analysis suggested by Graneheim and Lundman (2004). RESULTS: Three themes emerged from the 10 sub-themes, which were categorized from the 21 condensed meaning units by interpreting the underlying meanings. The three themes were “person giving comfort and support by caring”, “person facilitating the process of healing”, and “person taking the initiative in power relations”. Two themes involved positive experiences of patients and the other included negative ones. CONCLUSION: The results showed that the participants perceived the hospital nurses as devoted to caring for patients and facilitating treatments, but authoritative in performing their duty. Based on these results, it is recommended that hospital nurses improve their nursing knowledge, skills and humanistic attitude.

Development of Job Satisfaction Scale for Clinical Nurses

PURPOSE@#This study was performed to develop the Job Satisfaction Scale for Clinical Nurses (JSS-CN) and verify its validity and reliability.@*METHODS@#A preliminary 42-item version of the JSS-CN was developed through literature reviews and in-depth interviews. The draft scale was developed using thirty-seven items selected following content validity evaluation. Finally, thirty-three items with response options on a 5-point Likert scale were selected based on internal consistency reliability and construct validity. Subsequently, the test-retest reliability and convergent validity of the JSS-CN were verified.@*RESULTS@#Six factors, namely, recognition from the organization and professional achievement, personal maturation through the nursing profession, interpersonal interaction with respect and recognition, accomplishment of accountability as a nurse, display of professional competency, and stability and job worth, were identified, which explained 59.7% of the total variance. The JSS-CN's Cronbach's α for the total scale was .95, and the intra-class correlation coefficient was .90. The correlation coefficient between the scores of the JSS-CN and Slavitt's scale was .75, and that between the JSS-CN and job performance was .53.@*CONCLUSION@#Results showed that the JSS-CN has good reliability and validity. Therefore, it is concluded that the JSS-CN could be a useful tool for the measurement of the job satisfaction of clinical nurses in Korea.

Experience of Spiritual Conflict in Hospice Nurses: A Phenomenological Study

PURPOSE: This aim of this phenomenological study was to describe and understand the experience of spiritual conflict in hospice nurses by identifying the meanings and structures of the experience. METHODS: Participants were 12 nurses working for one year or more at hospice units of general hospitals in a metropolitan city and experiencing of spiritual conflict as hospice nurses. Over six months data were collected using individual in-depth interviews and analyzed with the method suggested by Colaizzi. RESULTS: The experience of spiritual conflict in participants was organized into three categories, six theme-clusters, and 13 themes. The participants felt existential anxiety on death and a fear of death which is out of human control and skepticism for real facts of human beings facing death. They also experienced agitation of fundamental beliefs about life with agitation of the philosophy of life guiding themselves and mental distress due to fundamental questions that are difficult to answer. Also they had distress about poor spiritual care with guilty feelings from neglecting patients' spiritual needs and difficulties in spiritual care due to lack of practical competencies. CONCLUSION: Findings indicate the experience of spiritual conflict in hospice nurses is mainly associated with frequent experience of death in hospice patients. The experience of spiritual conflict consisted of existential anxiety, agitation of fundamental beliefs and distress over poor spiritual care. So, programs to help relieve anxiety, agitation and distress are necessary to prevent spiritual conflict and then spiritual burnout in hospice nurses.

Experience of Becoming a Father of a High Risk Premature Infant

PURPOSE: This study was performed to identify the experience of becoming a father of a high risk premature infant. METHODS: Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used. RESULTS: For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was ‘striving through with belief and patience’. The phenomenon was ‘being frustrated in an unrealistic shock’. Contextual conditions were ‘uncertainty in the health status of the premature baby’ and ‘no one to ask for help’ and intervening conditions were ‘possibility in the health recovery of the premature baby’ and ‘assistance from significant others’. Action/interaction strategies were ‘withstanding with belief in the baby’ and ‘enduring with willpower as head of the family’ and the consequence was ‘becoming a guardian of the family’. CONCLUSION: For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.

Effect of Work Environment on Nursing Performance of Nurses in Hemodialysis Units: Focusing on the Effects of Job Satisfaction and Empowerment / 간호행정학회지

PURPOSE: This study was performed to investigate the effect of work environment on nursing performance and the effect of job satisfaction and empowerment on nurses performance in hemodialysis units. METHODS: Participants in this study were 206 nurses from 22 hemodialysis units in local clinics, general and university hospitals in two metropolitan areas. The work environment, nursing performance, job satisfaction and empowerment of the participants were measured using four self-report questionnaires. Data were analyzed using SPSS/WIN 18.0. RESULTS: Nursing performance correlated significantly with work environment, job satisfaction, and empowerment in the participants. Predictability of work environment for nursing performance was 28%. Job satisfaction and empowerment showed complete mediating effects, but not moderating effects in the relationship of work environment and nursing performance in the participants. CONCLUSION: Findings indicate that work environment is an important variable affecting nursing performance in nurses in hemodialysis units and that job satisfaction and empowerment are mediating variables in the relationship of work environment and nursing performance in nurses in hemodialysis units. Improvements in the work environment are needed to induce the high job satisfaction and empowerment that can lead to improvement of nursing performance.

Leadership Experience of Clinical Nurses: Applying Focus Group Interviews

PURPOSE: The purpose of this study was to understand and describe the leadership experience of clinical nurses. METHODS: During 2014, data were collected using focus group interviews. Three focus group interviews were held with a total of 20 clinical nurses participating. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. RESULTS: Fifteen categories emerged from the five main themes. 1) Thoughts on the leadership category: to lead others, to cope with problem situations adequately and to serve as a shield against difficulties. 2) Situations requiring leadership: situation that requires correct judgement, coping and situations that need coordination and cooperation. 3-1) Leadership behaviors: other-oriented approach and self-oriented approach. 3-2) Leadership behavior consequences: relevant compensation and unfair termination. 4-1) Facilitators of leadership: confidence and passion for nursing and external support and resources. 4-2) Barriers to leadership: non-supportive organization culture and deficiency in own leadership competencies. 5) Strategies of leadership development: strengthen leadership through self-development and organizational leadership development. CONCLUSION: In conclusion, the results indicate that it is necessary to enhance clinical nurses' leadership role in healthcare. Enhancement can be achieved through leadership programs focused on enlarging leadership experience, constant self-development, leadership training, and development of leadership competencies suited to the nursing environment.

Effects of an Integrated Internet Addiction Prevention Program on Elementary Students' Self-regulation and Internet Addiction

PURPOSE: The purpose of this study was to develop an integrated internet addiction prevention program and test its effects on the self-regulation and internet addiction of elementary students who are at risk for internet addiction. METHODS: A quasi-experimental study with a nonequivalent control group pretest-posttest design was used. Participants were assigned to the experimental group (n=28) or control group (n=28). Contents of the program developed in this study included provision of information about internet addiction, interventions for empowerment and methods of behavioral modification. A pre-test and two post-tests were done to identify the effects of the program and their continuity. Effects were testified using Repeated measures ANOVA, simple effect analysis, and Time Contrast. RESULTS: The self-regulation of the experimental group after the program was significantly higher than the control group. The score for internet addiction self-diagnosis and the internet use time in the experimental group were significantly lower than the control group. CONCLUSION: The effects of the integrated internet addiction prevention program for preventing internet addiction in elementary students at risk for internet addiction were validated.

Role Adaptation Process of Elementary School Health Teachers: Establishing Their Own Positions

PURPOSE: The purpose of this study was to explore and identify patterns from the phenomenon of the role adaptation process in elementary school health teachers and finally, suggest a model to describe the process. METHODS: Grounded theory methodology and focus group interviews were used. Data were collected from 24 participants of four focus groups. The questions used were about their experience of role adaptation including situational contexts and interactional coping strategies. Transcribed data and field notes were analyzed with continuous comparative analysis. RESULTS: The core category was 'establishing their own positions', an interactional coping strategy. The phenomenon identified by participants was confusion and wandering in their role performance. Influencing contexts were unclear beliefs for their role as health teachers and non-supportive job environments. The result of the adaptation process was consolidation of their positions. Pride as health teachers and social recognition and supports intervened to produce that result. The process had three stages; entry, growth, and maturity. CONCLUSION: The role adaptation process of elementary school health teachers can be explained as establishing, strengthening and consolidating their own positions. Results of this study can be used as fundamental information for developing programs to support the role adaptation of health teachers.

A Delphi Study to Elicit Policies for Nurse Workforce based on Patient Safety / 간호행정학회지

PURPOSE: This study was done to suggest policies for nurse workforce based on patient safety. METHODS: The two steps in developing the items were items related to what would be desirable policies and items on how the policies should be developed for patient safety regarding nurse workforce. A literature review was done and suggestions from experts through two rounds using the Delphi technique were outlined. The fifteen experts who participated in this study were six representatives of service consumers and nine representatives of service providers (four medical doctors and fives nurses). RESULTS: To guarantee patient safety, accreditation of nursing practice and nursing education were found to be necessary, and to prevent medical and nursing accidents in clinical practice, the professional judgement of the nurses was found to be pivotal to the provision of safe nursing services. CONCLUSION: Polices on nursing for the nurse workforce based on patient safety in clinical settings should be established to ensure that nursing care is provided according to the nurses' clinical judgements based on their professional knowledge and assessment skills.

Experience in Acceptance of Hospice by Patients with Terminal Cancer : A Phenomenological Research

PURPOSE: The purpose of this study was to further understanding of the experience in acceptance of hospice by patients with terminal cancer and to explore the structure of this experience. METHODS: A phenomenological methodology was used for the study. Participants were nine patients who were admitted to the hospice unit of a university hospital. In-depth interviews were done for data collection and the data were analyzed using Colaizzi's method. RESULTS: Four categories, eight theme clusters and 18 themes were identified for the experience in acceptance of hospice by patients with terminal cancer. The three categories were 'Hope for a comfortable death', 'Overcoming barrier of prejudice about hospice', 'Incessant craving for life', 'The last consideration for self and family'. CONCLUSION: While accepting the hospice care, participants experienced inner conflict between giving up medical treatments that prolong life and choosing a comfortable death, and also experienced an incessant craving for life. By accepting hospice care, they showed a human dignity that entails careful concerns for both self and family members.

Foreign Residents' Experience of Korean Health Care Services / 간호행정학회지

PURPOSE: This study was done to identify the experience of health care services by foreign residents in Korea. METHOD: Participants were 12 foreigners from China, North America, and Japan. Qualitative data were collected using three focus group interviews and analyzed with qualitative content analysis. RESULTS: The participants' experience of health services was categorized as 21 sub-categories, 11 categories and three main categories. The main categories were 'Quality of health care', 'Health care personnel', and 'Health care system and infrastructure'. The main category of 'Quality of health care' included three categories, 'Health care personnel' included another four categories, and 'Health care system and infrastructure' included the remaining four categories. The participants reported positive experiences such as favorable feelings and satisfaction particularly, with the high quality of health care but also negative experiences such as apprehension, distrust, difficulties, and inconvenience in the health care service in Korea. CONCLUSIONS: The results of this study can be helpful in the development of strategies to improve health care services for foreigners by providing fundamental information about the foreign residents' experience of health care services in Korea from their perspectives.

Effects of the Mentoring Program as a Strategy for Retention of Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the effect of a mentoring program as a strategy for the retention of clinical nurses. METHOD: Research subjects were 20 mentors, 20 mentees and 22 clinical nurses for a control group of mentees. A mentoring program was developed by an expert committee and applied to the experimental group for six months. Data were collected at three and six months after the application of the program from September, 2008 to March, 2009. Data were analyzed using chi-square-test, t-test, Repeated Measures ANOVA, One-way ANOVA in SPSS/Win 15.0 Program. RESULTS: Job satisfaction, organizational commitment, empowerment, and carrier commitment in the mentees of the experimental group were significantly higher than the nurses of the control group. Intention of resignation in mentees of the experimental group were significantly lower than the nurses of the control group. Also, there were significant interaction between the groups and the times of measurements in all variables. CONCLUSION: The mentoring program showed positive impact on the variables for maintenance of clinical nurses. Recommendation: Based on these findings, retention strategies using mentoring programs were recommended to reduce clinical nurses' resignation and improve the competency of clinical nurses that leads to the productivity of nursing organizations.

Self Role Perception of Health Teachers in Elementary Schools

PURPOSE: The purpose of this study was to describe and understand elementary school health teachers' role perception in their own perspectives. METHODS: Data were collected from three focus groups composed of five participants for each group. Each focus group had an interview for two and a half hours on the average. The main question was "What is your perception on the roles of health teachers in elementary schools?" Qualitative data from transcribed notes and field notes were analyzed using qualitative content analysis. RESULTS: Five main roles were identified from the participants. The participants perceived themselves as 'an expert of health education in school and community', 'a health service provider for school members', 'a health guardian for school members', 'the coordinator of healthcare related works in school', and 'the leader of school health'. CONCLUSION: The participants have multiple role identities, which are very important for health management of school members. And the roles such as an expert of health education and a leader for school health are recently emphasized. The findings of this study can provide useful information to design orientation programs for newly appointed health teachers and continuing education programs for enhancing role performance of health teachers in elementary schools.

Effects of the Mentoring Program as a Strategy for Retention of Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the effect of a mentoring program as a strategy for the retention of clinical nurses. METHOD: Research subjects were 20 mentors, 20 mentees and 22 clinical nurses for a control group of mentees. A mentoring program was developed by an expert committee and applied to the experimental group for six months. Data were collected at three and six months after the application of the program from September, 2008 to March, 2009. Data were analyzed using chi-square-test, t-test, Repeated Measures ANOVA, One-way ANOVA in SPSS/Win 15.0 Program. RESULTS: Job satisfaction, organizational commitment, empowerment, and carrier commitment in the mentees of the experimental group were significantly higher than the nurses of the control group. Intention of resignation in mentees of the experimental group were significantly lower than the nurses of the control group. Also, there were significant interaction between the groups and the times of measurements in all variables. CONCLUSION: The mentoring program showed positive impact on the variables for maintenance of clinical nurses. Recommendation: Based on these findings, retention strategies using mentoring programs were recommended to reduce clinical nurses' resignation and improve the competency of clinical nurses that leads to the productivity of nursing organizations.

Experiences of Interpersonal Relationships among Head Nurses in General Hospital Settings / 성인간호학회지

PURPOSE: The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. METHODS: The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. RESULTS: Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. CONCLUSION: The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.

Experience of Job Satisfaction in Clinical Nurses: Application of Focus Group Methodology / 간호학회지

PURPOSE: The purpose of this study was to describe the experiences of job satisfaction in clinical nurses. METHODS: Data was collected from three focus groups composed of 17 hospital nurses. Each focus group had an interview for an average of two and a half hours with the guidance of researchers. The main question was "how do you describe your lived experience of job satisfaction as a clinical nurse?" Qualitative data from the field notes and transcribed notes were analyzed using a grounded theory methodology developed by Strauss and Corbin. RESULTS: The core category of experience of job satisfaction in clinical nurses was identified as "Finding success." Supportive interpersonal relationships and environment affected this category. In the process of attaining job satisfaction through finding success, the participants were using four interactional strategies such as giving meaning, finding self-esteem, extending the horizon of life, and strengthening self-capability. The dimensions of job satisfaction in clinical nurses were the sense of achievement, stability, and pride. CONCLUSION: The results of this study yields very useful information for nursing mangers to design a program which enhances job satisfaction of clinical nurses based on interactional strategies.

Importance of Nurses's Caring Behaviors as Perceived by Staff Nurses and Patients / 기본간호학회지

Nurse's caring behaviors are essential to help patients cope with their health problems. The purpose of this study was to investigate the Importance of nurse's oaring behaviors as perceived by staff nurses and patients. The subjects were 295 staff nurses and 340 patients from five medical centers in Taegu. Data collection was done from Dec. 10, 1997 to Jan. 31, 1998. The tool for this study was a 7 point Likert type scale with 27 caring behaviors developed by Lee(1996). Cronbach alpha of the tool was .9701 in staff nurses and .9618 in patients. Data were analyzed with SAS using t-test, ANOVA and Spearman rank correlation program. The results are as follows: 1. The a verage score of perceived importance of nurse's caring behaviors for the 27 items was 5.65 in staff nurses and 4.97 in patients. 2. The most important caring behaviors perceived by the nurses was 'Nurse gives painless and cautious injection and treatment for patients 'and for the patients, 'Nurse gives hygienic treatment and nursing care'. 3. The caring behavior which showed a significant difference between the ranks of perceived importance by staff nurses and patients was 'to treat the patient with tenderness and friendship'. 4. The Spearman rank correlation coefficient between the ranks of importance perceived by staff nurses and patients was 0.8302. With the results of this study, the staff nurses could be recognized to have much enthusiasm and passion about caring. It is suggested that nurses let the public know about the nurses' caring roles. In the future, research to investigate the actual practice of nurses' caring behavior is necessary.