Development of Psychiatric Inpatient Classification System based on Nursing Care Needs / 정신간호학회지

Purpose@#The purpose of this study was to develop and validate the Psychiatric Inpatient Classification System (PICS) based on nursing care needs of psychiatric inpatients. @*Methods@#The preliminary items of the PICS based on the Korean Patients Classification System-1 (KPCS-1) were revised through literature review and interviews with psychiatric nurses. Content validity was assessed by 11 psychiatric nursing experts. In a convenience sample of 154 psychiatric inpatients, nurses reported nursing activities performed for their patients using the PICS. Criterion validity of the PICS was evaluated by testing correlation between the PICS and the Subjective Patient Classification (SPC). To identify groups of patients, the cluster analysis was performed with the PICS as a cluster variable, and cluster analysis was used. @*Results@#The final PICS comprised 12 nursing areas, 61 nursing activities, and 104 items. Significant correlation between the PICS and the SPC showed criterion validity of the PICS. @*Conclusion@#Results suggest a patient classification system based on psychiatric nursing needs. This will improve the quality of psychiatric nursing by providing substantial data on an appropriate ratio of psychiatric nursing staffing.

An Exploration of Essentials of Psychiatric and Mental Health Nursing / 정신간호학회지

PURPOSE: This study aimed to explore the essentials of psychiatric and mental health nursing by identifying the care experience of the psychiatric nurses. METHODS: Eleven psychiatric nurses were recruited across five geographical areas in the Korea. Data were collected using semi-structured interviews from two focus groups, which were analyzed with an inductive content analysis. RESULTS: Participants constructed two categories including ‘nursing tasks for the client’ and ‘nursing tasks for the organization’. Subcategories of nursing tasks for the client are ‘staying alert on crisis prevention’, ‘leading them to be real with eager and persistent will’, ‘nursing beyond role boundaries’, ‘tuning the needs of clients' family’, ‘taking journey with clients' personal life history’, and ‘doing invisible but recognizable nursing’. Subcategories of nursing tasks for the organization are ‘working as a responsible team member’, ‘integrating team competencies at the center of team’, and ‘balancing protection and control’. CONCLUSION: Psychiatric nurses played professional and holistic care roles for the clients, and managerial roles for the organizations. This study provides essential data for defining psychiatric nursing and estimating the appropriate ratio of psychiatric nursing staffing.

The Development and Application of Core Fundamental Nursing Skills Improvement Education Program for New Nurses in Comprehensive Nursing Care Ward / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the effect of the development and application of the new nurses' core skill program on the clinical skill, confidence, knowledge and performance of new nurses. METHODS: This study was a nonequivalent control group post-test design on 46 new nurses with 3 to 6 months work experience in a general hospital. Data were collected from August 2015 to August 2016. A training program of core fundamental nursing skills was applied on 23 new nurses from 2016 in the experiment group, and an existing training method was applied on 23 new nurses from 2015 in the comparison group. The collected data were analyzed using SPSS/WIN 23.0. RESULTS: The experimental group (89±4.29) showed higher score in practical skill assessment compared to the control group (85.09±3.99) and showed a statistically significant difference (p<001). CONCLUSION: A training program of core fundamental nursing skills for new nurses proved effective in improving practical skills. Further research on the development of a systemic training program that can improve clinical nursing knowledge and work ability for new nurses according to the extended enforcement of a Nursing Care Integrated Service ward is needed.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting

PURPOSE: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. METHODS: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. RESULTS: In the experimental group, the occurrence of vomiting (z=2.147) was significantly decreased, the maintenance PCA (χ²=4.212) and the satisfaction of patients (z=5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z=3.791), awareness (z=2.982) and self-efficacy (z=2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z=2.446) was significantly positive. CONCLUSION: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Structural Equation Model for Caregiving Experience of Families Providing Care for Family Members with Mental Disorders

PURPOSE: This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder. METHODS: The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires. RESULTS: Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators. CONCLUSION: Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

Level and Correlation Factors of Uncertainty in Members of Families of a Patient with Mental Illness / 정신간호학회지

PURPOSE: The purpose of this study was to measure the level of uncertainty, credible authority, severity of illness and event familiarity in members of families where there is a patient with a mental illness and to examine the relationships among these variables. METHODS: Research data were collected from November 23 to December 7, 2010. Participants in the study were 96 family members who visited patients in a closed ward or out-patient department of one hospital in Goyang City. Self-report questionnaires were analyzed using the SPSS 18.0 Program. RESULTS: Mean scores were 79.8+/-11.23 for level of uncertainty in family members, 15.5+/-2.17 for credible authority, 13.3+/-2.02 for severity of illness, and 14.5+/-2.43 for event familiarity. Uncertainty in family members was significantly related to credible authority (r=-.52, p<.001), event familiarity (r=-.41, p<.001) and severity of illness (r=.22, p<.031). CONCLUSION: The results of the study indicate that credible authority, severity of the illness and event familiarity are major factors perceived uncertainty in members of families of these patients. This outcome suggests the need for a new trials in nursing interventions considering the effects of these variables.

Stressful Life Event., Close Relationship, Self-Esteem, and Depression in College Women / 간호학회지

Koreans rarely complain of depression or other psychological problems because mental illness is viewed as a stigmatizing and threatening experience. This study examined the relationships among stressful life events, close relationships, self-esteem, and depression in 400 college women aged 18 to 30 years. Depression was positively related to stressful life events(r=.21 p=<.01). Depression and stressful life events were negatively associated with self-esteem(r=-.67: r=-.11, p<.01; p<.05 respectively). Close relationships with women and men friends were each negatively associated with depression (r=-.24; r=-.16, p<.05). Close relationships with women and men friends were positively associated with self-esteem (r=.23; r=.20, p<.01). Forty nine percent of variance in depression rates in this sample was explained. After adjustment for degrees of freedom, a total of 49% of the variance in depression was explained by self-esteem and stressful life event. This investigation into the relationships among the variables influencing depression for college women is a critical issue as health professional interventions are those designed for specific populations to meet unique care needs and since young Korean women may be at considerable risk for depression.