The influence of Moral Sensitivity, Knowledge of Advanced Directives, Good Death Perception on Nurses’ Attitudes toward the Withdrawal of Life-Sustaining Treatment in a General Hospital / 재활간호학회지

Purpose@#This study aimed to identify the influence of moral sensitivity, knowledge of advanced directives, good death perception on nurses’ attitudes toward the withdrawal of life-sustaining treatment (WLST) in a general hospital. @*Methods@#189 nurses in a general hospital completed structured questionnaires including the Korean Moral Sensitivity Questionnaire, Knowledge of Advanced Directives Questionnaire, Concept of Good Death Measure, and Attitudes toward WLST Questionnaire. Data were analyzed with independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and hierarchical regression using SPSS/WIN 22.0 program. @*Results@#Nurses’ attitudes toward WLST was significantly affected by experience of life-sustaining treatment, moral sensitivity and knowledge of advanced directives. In hierarchical multiple regression, nursing experience of life sustaining treatment (β=.27, p<.001), moral sensitivity (β=.23, p=.001), and knowledge of advanced directives (β=.39, p<.001) determined the attitudes toward WLST. These factors explained 48% of the total variability in WLST in this sample. @*Conclusion@#For patients’ dignified death, it is necessary to develop and apply nursing interventions considering the influencing factors on nurse's attitudes toward life-sustaining treatment, and suggest follow-up research on nurse's behavior related to WLST.

Individual and School Factors Affecting Critical Thinking Ability among Nursing Students / 의학교육논단

The purpose of this study was to investigate factors associated with the critical thinking ability of nursing students at the individual and school levels. The study adopted a descriptive design and recruited 465 nursing students from four nursing schools from November 2014 to September 2015 through convenience sampling. The Clinical Critical Thinking Skill Test was used to measure critical thinking ability, and the data were analyzed with the SAS ver. 9.4 program (SAS Institute Inc., Cary, NC, USA) for descriptive statistics, t-test, analysis of variance, and multi-level model. The results showed that clinical practicum experience (β=−0.72, p=0.025), taking critical thinking courses (β=0.63, p=0.010), and taking simulation courses (β=0.56, p=0.035) improved critical thinking ability in the individual level model. In the school level model, the interaction effect between the years of clinical practice done by the student and the presence of full-time clinical instructors was significant (β=1.29, p=0.011). These results suggest that critical thinking ability improves with the more years of clinical practice individual nursing students have, and this improvement is greater with the presence of full-time clinical instructors in the school. Therefore, it is recommended that nursing students undergo critical thinking and simulation courses to develop their critical thinking ability, and dedicated clinical instructors in nursing schools should play a vital role.

Effects of Image-Use Medication Education on Knowledge, Self-Efficacy, and Misuse of Medication in Elderly Inpatients / 임상간호연구

PURPOSE: This quasi-experimental study was done to develop image-use medication education for older inpatients and to evaluate the effects on their knowledge, self-efficacy, and misuse of medication.

Current Status and Future Direction of Interprofessional Education in Nursing Education / 의학교육논단

This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.

A Study on the Falls, Fear of Falling, Depression, and Perceived Health Status among the Older Adults / 성인간호학회지

PURPOSE: The purpose of this study was to investigate the relationships between a experience of falling, fear of falling, depression, and perceived health status in urban areas. METHODS: After obtaining Institutional Review Board (IRB) approval, a one-time, face-to-face, and private interview was conducted with each participant who was eligible and agreed to participate in this study from May 2007 to August 2007 by trained graduate-level nursing students. The questionnaires consisted of Fall Efficacy Scale, K-GDS, and SF-36. The collected data were analyzed with SPSS/PC 12.0 program, which was used for frequency, percentage, mean, standard deviation, t-test, and hierarchical regression. RESULTS: The major findings of this study were as follows; 1) approximately 9% of participants had fallen within one year. Study participants reported moderate fear of falling(M=43.80); moderate physical health (M=42.31) and mental health(M=46.05); and low depression status(M=10.38). 2) there were significant differences in fear of falling according to gender, experience of falling, exercise, and depression. 3) significant factors influencing on fear of falling were experience of falling and physical health status. CONCLUSION: The results of this study indicate that nurses working closely with older adults should be taught the impact of previous falls and physical health status on fear of falling and need to reinforce exercise behavior for older adults who are vulnerable to fear of falling.

A Longitudinal Study of Critical Thinking Dispositions & Critical Thinking Skills in Baccalaureate Nursing Students / 간호학회지

PURPOSE: This longitudinal study was done to investigate critical thinking dispositions and critical thinking skills of nursing students enrolled in a 4-year baccalaureate program at a university in Korea. METHOD: The study used a longitudinal design. A convenience sample of 32 nursing students who were completing their 1st, 2nd, 3rd, and 4th year in a baccalaureate program at a selected university was included. The subjects completed the California Critical Thinking Dispositions Inventory (CCTDI), the California Critical Thinking Skill Test (CCTST), and a demographic questionnaire. Data was analyzed by descriptive statistics, repeated ANOVA, adjusted p-values, and Pearson's correlation coefficient with SAS 8.12. RESULTS: There was statistically significant improvement according to academic year in the CCTDI total mean score (F=7.54, p= .0001) and subscales of Open-mindedness, Self-confidence, and Maturity. Contrarily, no statistically significant difference was found in the CCTST total mean score and subscales' score except Analysis. CONCLUSION: There is no significant correlation between critical thinking dispositions and skills, so it will be necessary to repeat a study like this, and the translated instruments should be modified by considering Korean culture.