Job Analysis of Visiting Nurses in the Process of Change Using FGI and DACUM

Purpose@#This study conducted a job analysis of visiting nurses in the process of change. @*Methods@#Participants were the visiting nurses working for the Seoul Metropolitan city. On the basis of the Public Health Intervention Wheel model, two times of the focus group interview (FGI) with seven visiting nurses and one time of the Developing a Curriculum (DACUM) with 34 visiting nurses were performed. A questionnaire survey of 380 visiting nurses was conducted to examine the frequency, importance and difficulty levels of the tasks created by using the FGI and DACUM. @*Results@#Visiting nurses’ job was derived as the theme of present versus transitional roles. The present role was categorized as ‘providing individual- and group-focused services’ and ‘conducting organization management’, while the transitional role was categorized as ‘providing district-focused services’ and ‘responding to new health issues’. The job generated 13 duties, 28 tasks, and 73task elements. The tasks showed the levels of frequency (3.65 scores), importance (4.27 scores), and difficulty (3.81 scores). All the tasks were determined as important, exceeding the average 4.00 scores. The group- and district-focused services of the tasks were recognized as more difficult but less frequent tasks. @*Conclusion@#The visiting nurses exert both present and transitional roles. The transitional roles identified in the present study should be recognized as an extended role of visiting nurses in accordance with the current changing healthcare needs in South Korea. Finally, the educational curriculum for visiting nurses that reflects the transitional roles from the present study is needed.

The influence of experienced violence and the clinical learning environment on vocational identity in nursing students / 한국간호교육학회지

Purpose@#The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. @*Methods@#The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. @*Results@#For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. @*Conclusion@#It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.

The Knowledge, Attitudes, Performance, and Barriers of Nurses to Pain in Oncology Settings:A Multi-Center Study

Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

The influence of experienced violence and the clinical learning environment on vocational identity in nursing students / 한국간호교육학회지

Purpose@#The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. @*Methods@#The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. @*Results@#For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. @*Conclusion@#It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.

The Knowledge, Attitudes, Performance, and Barriers of Nurses to Pain in Oncology Settings:A Multi-Center Study

Purpose@#The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. @*Methods@#This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. @*Results@#According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. @*Conclusion@#Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

The effect of achievement motivation on learning agility of nursing students: The mediating effect of self-leadership / 한국간호교육학회지

Purpose@#This study aimed to investigate nursing students’ learning agility and confirm the mediating effect of self-leadership in the relationship between achievement motivation and learning agility. @*Methods@#The study design was a descriptive survey design. The subjects were third- and fourth-year nursing students attending three universities in one region. Data were collected from November 28, 2019, to May 25, 2020, and a total of 202 data were collected using the scale of achievement motivation, self-leadership, and learning agility. Data analysis included frequency analysis, descriptive statistics, and Pearson's correlation coefficient using SPSS 25.0 statistics 25.0 software. The mediating effect of self-leadership was analyzed through regression analysis and bootstrapping using process macro ver. 3.4.1. @*Results@#Self-leadership’s partial mediating effect was confirmed in achievement motivation and learning agility. Achievement motivation was found to affect directly learning agility, with an indirect effect through self-leadership. @*Conclusion@#The study results showed that nursing students could increase their learning agility through self-leadership improvement. Future research should focus on identifying the factors influencing nursing students’ learning agility and develop and apply programs to improve learning agility.

Factors Affecting Unmet Healthcare Needs of Working Married Immigrant Women in South Korea

PURPOSE: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. METHODS: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the ‘National Survey of Multicultural Families 2015.’ Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. RESULTS: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. CONCLUSION: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.

Structural Equation Model for Psychosocial Adjustment in North Korean Adolescent Refugees

PURPOSE: This study aimed to identify variables influencing the psychosocial adjustment of North Korean adolescent refugees in order to establish a structural equation model and design an intervention strategy to improve psychosocial adjustment. METHODS: The subjects included 290 North Korean adolescent refugees aged 16~24 years who were enrolled in alternative schools or regional adaptation centers. They were surveyed using a structured questionnaire. RESULTS: The goodness of fit measures of the model were as follows: x²=131.20 (p < .001), GFI=.93, CFI=.91, TLI=.86, RMSEA=.08, and SRMR=.07. The results estimated from the structural equation model indicated a good fit of data to the hypothesized model, which proposed that stress and emotional intelligence are associated with psychosocial adjustment. The major variables influencing psychosocial adjustment were stress, emotional intelligence, which was a significant direct effect, whereas attitude of parenting showed an indirect effect on psychosocial adjustment through emotional intelligence. These variables account for 50.0% of psychosocial adjustment. CONCLUSION: It is necessary to develop a program and intervention plan that can enhance emotional intelligence and thereby relieve the stress of North Korean adolescent refugees. The program should also include parenting education so that parents have positive attitude of parenting.

Effects of a Community Outreach Program for Maternal Health and Family Planning in Tigray, Ethiopia

PURPOSE: We examined the effects of a community outreach program for maternal health in Tigray, Ethiopia, on women's knowledge about pregnancy, childbirth, postpartum care, and family planning, and assessed their participation in antenatal care, postpartum checkups, institutional childbirth, and contraceptive use. METHODS: We recruited Ethiopian women of reproductive age (15 to 49 years) in Tigray, Ethiopia. Two villages in Tigray, Kihen and Mesanu, which have similar population sizes and living environments, were chosen as the intervention and comparison groups, respectively. A two-group pretest-posttest design with cluster sampling was employed. We conducted self-report questionnaire surveys using face-to-face interviews. The 2.5-year community outreach program was developed based on Rogers' diffusion of innovation theory. It consisted of mass media use and health education for lay women in the community, along with training of health care providers, including nurses, midwives, and health extension workers, in maternal health care. RESULTS: The intervention group showed significant increases in knowledge and behaviors regarding maternal health and family planning compared to the comparison group (p < .001). In particular, there was a dramatic increase from 10.8% to 93.5% in the institutional birth rate in the intervention group. CONCLUSION: The community outreach program and health care professional training effectively improved knowledge and behaviors regarding maternal health in Ethiopian women. Mass media and interpersonal communication channels for health education may be useful health interventions in developing countries.

Effect of Stepwise Communication Education Program using SBAR among Nursing Students: Focusing on Scenarios and Nursing Case-based Role Playing / 한국간호교육학회지

PURPOSE: This study intends to examine the effects of a stepwise communication education program among nursing college students, focusing on scenarios and nursing case-based role playing. METHODS: The study design was a one-group repeated measure ANOVA. Participants were 27 nursing students in practice. Students participated in 5-week stepwise communication education program using SBAR; including 1 week of lecture education, 4 weeks of scenarios and nursing case-based role playing. The data were collected at each level of the education process: pre-education, after 1 week of lectures, and after completion of scenarios and nursing case-based role playing. Repeated measures ANOVA was used to determine changes in SBAR technique knowledge and communication self-efficacy. RESULTS: The stepwise communication education program using SBAR was effective in increasing SBAR technique knowledge, and communication self-efficacy. The lecture-based education was effective only in the area of SBAR technique knowledge and its subscale, attitudes towards SBAR. However, scenarios and nursing case-based role playing was broadly effective across communication self-efficacy, SBAR technique knowledge, and its subscale, knowledge of the SBAR. CONCLUSION: Based on this study, we propose that it is necessary to confirm the effect of long-term SBAR communication education using scenarios and nursing case-based role playing in nursing students' practice.

The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty

PURPOSE: This study was designed to determine the effects of health coaching and mediating variables on quantitative aspect of health in low-income hypertensive people. METHODS: The experimental group for the current study consisted of 21 clients who received health coaching services, and the control group consisted of 22 clients who received home-visiting nursing services. Two groups received health coaching or home-visiting nursing services once a week for 8 weeks. The evaluation variables were self-efficacy, nutrition management, health behaviors, self-rated health, and quality of life. RESULTS: The results revealed that the level of nutrition management was significantly higher in the experimental group than the control group (F=10.33, p=.005). CONCLUSION: These results confirm that health coaching is a useful strategy that encourages clients to continuously maintain their own health behaviors. Thus, the findings of the current study provide useful data for establishing measures for the health management of those afflicted with chronic disease, such as hypertension. Furthermore, health coaching may be developed into useful intervention strategies for dealing with chronic diseases and improving home-visiting nursing.

An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group

PURPOSE: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. METHODS: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. RESULTS: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. CONCLUSION: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

The Relationships among Social Discrimination, Subjective Health, and Personal Satisfaction of Immigrants

PURPOSE: This study aims to examine the relationships among social discrimination, subjective health, and personal satisfaction based on the country of origin. METHODS: The analysis was based on 16,958 immigrants who participated in the National Survey of Multicultural Family 2015 in Korea. This study conducted stratified cross-analysis of social discrimination for the differences in subjective health and personal satisfaction. Multivariate-adjusted odds ratios and 95% confidence intervals for the relationships among social discrimination, subjective health, and personal satisfaction were examined with multivariable logistic regression. RESULTS: There were differences in experience of social discrimination, subjective health status, and personal satisfaction according to the country of origin. Groups without the experience of social discrimination had better subjective health and personal satisfaction than the other groups. CONCLUSION: This study demonstrates that a discrimination prevention program needs to be developed based on a cultural approach.

A Concept Analysis of Uncertainty in Epilepsy

PURPOSE: This concept analysis was done to clarify ‘uncertainty in epilepsy’. METHODS: Walker and Avant's methodology guided the analysis. In addition, the concept was compared with uncertainty in other health problems. RESULTS: ‘Uncertainty in epilepsy’ was defined as being in the condition as seen from the epilepsy experience where cues were difficult to understand because they changed, were in discord with past ones, or they had two or more contradictory values at the same time. Uncertainty in epilepsy is evolved from appraisal of the epilepsy experience. As a result, uncertainty leads epilepsy patients, their family or health care providers to impaired functioning and proactive/passive coping behavior. CONCLUSION: Epilepsy patients with uncertainty need to be supported by nursing strategies for proactive, rational coping behavior. This achievement has implications for interventions aimed at changing perception of epilepsy patients, their families or health care providers who must deal with uncertainty.

Factors Influencing Health-related Quality of Life of Young Adults and Elderly with Multimorbiditiy: A Secondary Analysis of the 2013 Korea Health Panel Data

PURPOSE: This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life. METHODS: Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using χ²-test, t-test, ANOVA and multiple regression analysis. RESULTS: Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity. CONCLUSION: The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.

A Comparison of Characteristics between Success Group and Failure Group of 1-year Continuous Smoking Abstinence in Young Adult and Middle-aged Male Workers: with Focus on the First-year Analysis of Korean Cross-sectional Survey

PURPOSE: This study examined the characteristics differences associated with 1-year continuous smoking abstinence in Korean young adult and middle-aged male workers. METHODS: 'Korea National Health and Nutrition Examination Survey (KNHANES)' is an ongoing surveillance system that assesses the health and nutritional status of Koreans. For a secondary analysis of cross-sectional data from KNHANES VI-1, this study selected 683 Korean male workers as a subpopulation, who were young adult or middle-aged. The subpopulation was composed of success or failure group of 1-year continuous smoking abstinence. Binomial logistic regression analysis was performed. RESULTS: Success group was more likely to be older, live in urban areas, rate their health status as excellent or good, and have ever been diagnosed with hypertension than failure group. Additionally, Success group was less likely to have used electronic cigarettes (e-cigarettes), drink more than once a month, and have been exposed to secondhand smoking in workplace within a week. CONCLUSION: Developing smoking cessation programs requires consideration of resources in rural areas, promoting self-efficacy, restricting e-cigarettes and drinking, and promoting a smoke-free workplace.

Qualitative Research on Nurses Experiencing Taeoom / 한국직업건강간호학회지

PURPOSE: The purpose of this empirical research was to describe the contents what had happened to nurses experiencing taeoom. METHODS: This study explored the phenomenological ways to understand lived experiences in nurses' 'Taeoom' and investigated the 'Taeoom' through the deductive content analysis. For the this study, the data was collected through individual interviews with 11 nurses who worked over 12months in 1 hospital, lived in 5 areas, working 7 nursing unit of 10 hospitals. The interviews conducted by semi structured questions about participants' lived experiences in 'Taeoom'. RESULTS: Inductive contents analysis identified 5 categories and 15 subcategories. Main themes in this study included a failed membership, difficult of practical field adaptation, feared with nursing unit life, self-centered peer relationships and rite of passage. CONCLUSION: This study results have been illuminated with edged sword which has a dark side and a light side to experienced in 'Taeoom'. Newly employed nurses have suffering from 'Taeoom' as well as retained nurse. Therefore, policy and practice programs for a diminution of suffering and management for nurses 'Taeoom' should be developed and implemented.

An Effect of the Application of Educational Electronic Nursing Record System for Nursing Students / 한국간호교육학회지

PURPOSE: This study aimed to identify the effectiveness of educational Electronic Nursing Record System in terms of nursing process preparation ability and satisfaction about the system itself. METHODS: A one group pre-post experimental study design was utilized in this study. The effectiveness of the system was examined through quality of nursing diagnoses, interventions, and outcomes and electronic nursing record system satisfaction inventory. Junior and senior nursing students were the potential study respondents and evaluation instruments were applied only for the one who agreed to participated in the study. Education about nursing process and electronic nursing record system was carried out as part of regular classes and students were guided to prepare nursing process upon the scenarios developed earlier. RESULTS: 29 juniors and 33 seniors prepare nursing process documentation related to each scenario and both groups showed significant improvement upon nursing process documentation (t=7.53, p<.001, t=3.23, p=.003, respectively) compared to paper based nursing process preparation. Satisfaction about system itself was 2.78(0.81). CONCLUSION: Educational electronic nursing record system seems to be effective to train nursing students for nursing process preparation ability. Effort to enhance its utility are called in the area of education and system itself.

Comparison of Obesity Rates in Early Childhood (4 to 80 months) by Parental Socioeconomic Status Using National Cohort Dataset in Korea

PURPOSE: Child obesity has been on the rise and become a worldwide health issue. Low socioeconomic status (SES) is known as an influencing factor for childhood obesity, but relevant studies on a national level are scarce in Korea. The purpose of this study was to identify the prevalence of obesity for each age group by parental SES and analyze the trends of changes in weight status using a Korean national cohort dataset. METHODS: In Korea, children are eligible for the National Children Health Examination, a mandatory seven-time health checkup for those aged 4 to 80 months. This study tracked 4 to 9-month-old children up to 80 months through seven distinct age groups. A total of 12,362 children had received all seven health exams consecutively. Parental SES was categorized as three stages according to national classifications. Z scores of weight-for-height (for children aged < 24 months) and body mass index (for children aged ≥ 24 months) were used for detecting overweight and obesity. RESULTS: Children with low parental SES showed the highest prevalence of overweight and obesity in all age groups, although there was no consistency in statistical significance. Also, normal and underweight children of 4 to 9 months with low parental SES showed the highest change rate to either overweight or obesity, although no consistency of statistical significance was observed. CONCLUSIONS: Low parental SES can affect the weight status of offspring from early childhood. Thus, early obesity prevention interventions should be provided especially for children in low-income families.

Factors Influencing Confidence in Performance Competence of Core Basic Nursing Skills by Nursing Students / 기본간호학회지

PURPOSE: The purpose of this study was to identify the learning style, learning efficacy, transfer of learning, and confidence in performance competence of Core Basic Nursing Skills (CBNS) and factors influencing confidence in performance competence of CBNS by nursing students. METHODS: A descriptive study design was used. Participants were 148 nursing students. Data were analyzed using SPSS 20.0 for descriptive statistics, ANCOVA, correlation and regression. RESULTS: Learning styles of the participants were assimilator 33.11%, accommodator 26.35%, diverger 23.65%, and converger 16.89%. Learning efficacy was significantly different according to learning styles, however, transfer of learning and confidence in performance competence of CBNS were not significantly different according to learning styles. Confidence in performance competence of CBNS positively correlated with transfer of learning and learning efficacy. Transfer of learning was a significant predictor of confidence in performance competence of CBNS. CONCLUSION: The findings of this study indicate that transfer of learning influences confidence in performance competence of CBNS. Thus, nursing faculty should develop educational strategies to enhance and improve transfer of learning, and development of effective confidence in performance competence of CBNS programs.