Grounded Theoretical Analysis on the Hospital Accreditation Experience of Head Nurses in General Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to conduct a grounded theoretical analysis on the hospital accreditation experience of head nurses in order to understand their behavior on the adaption of this new system. METHODS: The participants were 8 head nurses with more than 3 years of experience. The data were collected through in-depth interviews using audiotape recording analyzed by the constant comparative method described in Strauss and Corbin's methodology. RESULTS: There were 113 concepts, 26 subcategories and 12 categories identified through the open coding process. In the axial coding, the following paradigm model was proposed: 1) the causal conditions were ‘hardware problem’ and ‘software problem’, 2) the contextual conditions were ‘vertical relationship’, ‘individual preference’, and ‘family support’, 3) the intervening conditions were ‘passive conditions’ and ‘active conditions’, 4) the action/interaction strategies were ‘leading role’ and ‘dependent role’, 5) the consequences were ‘positive acceptance’ and ‘negative acceptance’, 6) the central phenomenon was ‘difficult situation’ and 7) the core category was ‘leading in harmony’. CONCLUSION: The new system led head nurses having difficulties as the middleman between the hospital administration and general nurses, but they made a continuous effort to overcome and adapt to it through a number of strategies.

Effects of a Standardized Patient Simulation Program for Nursing Students on Nursing Competence, Communication Skill, Self-efficacy and Critical Thinking Ability for Blood Transfusion / 기본간호학회지

PURPOSE: This study was conducted to identify the effects of a standardized patients (SP) simulation program for nursing students on nursing competence, communication skill, self-efficacy and critical thinking ability for blood transfusion. METHODS: A nonequivalent control group non-synchronized design study was used and included as participants 96 junior nursing students at C University. The SP group (n=48) participated in the teaching class using a SP, while the control group (n=48) received conventional practice education. The outcome measurements were nursing competence, communication skill, self-efficacy, and critical thinking ability for transfusion. RESULTS: Nursing competence, communication skill, self-efficacy, and critical thinking ability improved for students in both groups after training (2.01< or =t< or =13.03, p<.05). Self-efficacy showed greater improvement in students in the SP group compared to the control group (t=3.36, p<.001). CONCLUSION: SP simulation practice may be more effective in enhancing self-efficacy than that of conventional practice education. Whether self-efficacy will contribute to enhancing learning motivation for nursing students needs further examination.

The Development and Evaluation of a New Educational Program, Introduction to Clinical Nursing, for Third Year Nursing Students / 기본간호학회지

PURPOSE: The purpose of this study was to evaluate the effects of a newly developed Introduction to Clinical Nursing (ICN) program on critical thinking skills, communication competence, self-efficacy, and clinical performance self-confidence in nursing students in their third year. METHODS: One group pre-test and post-test design was used with three data collection time points (pre-test, post-test1 and post-test2). Participants were 74 third year nursing students approaching their first clinical practicum. The new program included (a) simulated clinical encounters regarding situations of assessing hospitalized patents and caring for patients with oxygenation needs, (b) objective structured clinical examination of skills, (c) lectures, and (e) field trips. Data were analyzed using paired t-tests. RESULTS: After the ICN course, critical thinking skills(significant only between pretest and post-test2), communication competence, and clinical performance self-confidence improved significantly (p<.05). There was no improvement in the self-efficacy total score but there was significant improvement in the subscale, self-regulatory efficacy. CONCLUSIONS: The study results indicate that the ICN course may be effective in increasing critical thinking skills, communication competence, and clinical performance self-confidence in nursing students. However, the effect size was very small and modifications of this program should be considered to develop more cost-effective educational programs.

Graft Functions and Survivals according to the Serum Creatinine Level at 3 Days after Renal Transplantation in Living-donor Renal Transplantation / 대한이식학회지

PURPOSE: The aim of this study was to evaluate whether serum creatinine levels at 3 days after renal transplantation can predict long-term graft survival and its associated clinical aspects. METHODS: Three hundred and seventy six renal transplant recipients who received grafts from living donors were included. Recipients were classified into two groups according to their serum creatinine levels (1.2 mg/dL group) at 3 days after renal transplantations. Demographic characteristics (age, sex, weight, body mass index, donor/recipient body weight ratio, pre-transplant dialysis type, underlying disease and pre-transplant transfusion), transplant variables (immuno-suppressive agents, HLA mismatch and HLA DR mismatch) and post-transplant variables (routine graft biopsy, number of acute rejection episodes within first year after renal transplantation, serum creatinine level and graft survival at each first, second, and fifth years) were assessed. RESULTS: Among total 376 recipients, serum creatinine 1.2 mg/dL groups were 224 (59.6%) recipients. The characteristics of patients with good graft function (serum creatinine 1.2 mg/dL group (first year, 100% vs. 95.7%; fifth year, 96.7% vs. 89.8%; P<0.05). Conclusion: Serum creatinine levels at 3 days after renal transplantation can predict long-term kidney transplant survival. It was associated with immunological (frequency of acute rejection) and non- immunological aspect (match of kidney size and donor's age).