Nursing Salary Guideline for Korean Hospitals / 임상간호연구

Purpose@#The purpose of this study is to develop a nursing salary guideline for Korean hospitals. @*Methods@#Literature review and a mobile survey were conducted regarding staff nurses’ salary. Regression analysis and simulation model were applied to develop the nurses’ salary guideline. @*Results@#The United Kingdom, Australia, and Germany have standard salary guidelines which demonstrated the standard salary of nurses. These were determined mainly by nursing experience and expertise. The results of the mobile survey indicated that the maximum to minimum ratio of the salary was as high as 4.5 among staff nurses working in Korean hospitals. Two models (exponential and linear) for a standard nursing salary guideline were developed and the simulation results demonstrated an improved salary structure for staff nurses. @*Conclusion@#This developed salary guideline for staff nurses is recommended to be applied in Korean hospitals which provide total nursing care services.

Nurse Wage Structure and Its Determinants in Hospital Industry / 임상간호연구

PURPOSE@#The purpose of this study was to investigate the wage structure of hospital nurses in Korea and to analyze the factors that determine the level of nurses' wages.@*METHODS@#First, a mobile survey on nurses' wages was conducted with a total of 3,742 nurses working in hospitals. A literature review was also done. Second, a regression model was applied to analyze the determinants of nurses' wages.@*RESULTS@#The average monthly wage of 3,742 nurses based on the survey was KRW 3,588,000 and the standardized monthly income of 3,742 nurses was estimated to be KRW 3,364,000 as of the end of 2018. The results of regression analysis(R2=61.7%) showed that gender, nursing experience, designated night duty, ownership, and number of beds were statistically significant variables for nurses' wages at 1% significance level. The monthly wage of nurses working in total nursing care wards was not significantly different from those working in other wards at 5% significance level.@*CONCLUSION@#The substantial difference in nurses' wages according to job career, hospital size, region, etc may result in the low proportion of nurses with more than three to five years of service experience and the high turnover of less-experienced workers. Consideration should be given to adjust the gap in wage level and a standard nurse wage system could be effective measures.

A Study of Chronic Posttraumatic Stress Disorder in Physically Injured Patients by Motor Vehicle Accidents: A Prospective Study on Incidence, Pattern of Symptom Changes and Predictors / 신경정신의학

OBJECTIVES: This study aimed to report the incidence of chronic posttraumatic stress disorder (PTSD), to identify psychosocial risk factors posttraumatically affecting the severity of PTSD symptoms, to compare the pattern of symptom changes over time, and to find early self-rated measures for the prediction of chronic PTSD in the patients physically injured by motor vehicle accident. METHOD: One-hundred-and-four motor vehicle victims, who were systematically recruited for the study of Kim et al(1998), were reevaluated through interview and questionnaire after twenty-four months. Clinician Administered PTSD Scale(CAPS), Beck Depression Inventory(BDI), Spiel-berger State Trait Anxiety Inventory(STAI), Impact of Event Scale(IES), questions about socioen-vironmental experiences after accident, and The Ways of Coping Checklist(WCC) were included in follow-up assessment. Of these subjects, 68 victims participated in CAPS interview and only 54 victims finished CAPS Interview, and questionnaire. The subjects with PTSD at initial and follow-up assessment were classified as the chronic PTSD group, subjects who recovered from PTSD at follow-up assessment were classified as the recovered group, and subjects who did not meet criteria for PTSD at initial and follow-up assessment were classified as the non-PTSD group. RESULTS: The prevalence of PTSD in motor vehicle victims was 39.8% in follow-up assessment. Compensation of disabilities, return to previous job and financial difficulty were associated with chronicity and poor psychological adjustment of PTSD. In total group of victims, PTSD symptoms that appeared at initial assessment were improved or disappeared at follow-up assessment. However, avoidance and numbing symptoms significantly increased in chronic PTSD group and "acting or feeling as if event were recurring" and "exaggerated startle response" were not recovered over time in recovered group. Only IES at initial assessment showed significant differences among Non-PTSD, PTSD and recovered group. BDI, STAI-II, active coping and passive coping at follow-up assessment showed significant differences among three groups. IES at initial assessment contributed 18.6% to CAPS variance at follow-up. CONCLUSION: This study showed a high risk of developing PTSD among physically injured victims after motor vehicle accident. Risk factors such as event severity, compensation of disabilities, return to previous job and financial difficulty were identified. High IES score at initial assessment was regarded as major factor affecting chronic PTSD.

A Study of Reliability and Validity on the Korean Version of Impact of Event Scale / 신경정신의학

In order to develop a self-report scale measureing posttraumatic distress, the authors translated Horowitz's(1979) Impact of Event Scale(IES) in Korean and explored its reliability and validity. The IES, BDI, STAI-I, II and MMPI-PTSD were administered to 143 college students and 104 patients who had experienced auto vehicle accident. The internal consistency(item-total correlation, students: r=.52, patients: r=.58:Cronbach's alpha, students: alpha=.87, patients: alpha=.89) and test-retest reliability (r=.73) were psychometrically approvable. To examine the validity, patients who were classified PTSD and non-PTSD were compared with IES, BDI, STAI-I, II and MMPI-PTSD. There were significant group differences in IES, BDI, and MMPI-PTSD. The IES was significantly correlated with BDI, STAI-II, and MMPI-PTSD. It was more highly correlated with MMPI-PTSD than BDI or STAI. The results of factor analysis suggested a single factor. IES showed sufficient discriminant validities between PTSD and non-PTSD(74.4%). Finally, the usefulness of the scale, some limitations, and implications for future study were discussed.

A Reliability and Validity Study of A Clinician-Administered PTSD Scale / 신경정신의학

OBJECTIVES: The purpose of this study was to examine the reliability and validity of A ClinicianAdministered PTSD Scale(CAPS). METHODS: CAPS was administered to 28 PTSD subjects, 30 non-PTSD subjects, and 36 normal subjects. Interrater reliability for the CAPS was established by interviewing 10 PTSD subjects. The interviews were conducted by 2 interviewers simultaneously. The authors adminstered to all the subjects Impact of Event Scale(IES), Beck Depression Inventory(BDI), State Trait Anxiety Inventory I, II (STAI-I, II) for measuring concurrent validity. RESULTS: The value of Cronbach's alpha and interrater agreement were .95 and .89, respectively. The CAPS was highly correlated with IES(r=.80), BDI(r=.70), STAI-II(r=.56). But the CAPS was not correlated with STAI-I(r=.20). The CAPS showed an overall agreement with clinical diagnosis of 82.1%. CONCLUSIONS: The CAPS shows a reasonable degree of reliability and validity. The CAPS could be a valuable tool to diagnose PTSD.

Posttraumatic Stress Disorder in Physically Injured Patients after Motor Vehicle Accidents / 신경정신의학

OBJECTIVES: The authors attempted to estimate the incidence of posttraumatic stress disorder (PTSD) and the differences of sociodemographical features, injury severity, depression and anxiety between PTSD and non-PTSD groups artier motor vehicle accident. METHODS: The subjects were 104 patients who had undergone motor vehicle accidents, and been hospitalized to orthopedic surgery hospitals. We administered them clinician-administered PTSD scale(CAPS) for diagnosing PTSD, injury severity scale(ISS) for identifying their physical injury, self-reported questionnaire made to identify socioepidmogrphic data, Beck Depression Inventory(BDI) for measuring depression, and State Trait Anxiety Inventory I, II(STAI- I, II)for measuring anxiety. RESULTS: The incidence of PTSD in subjects was 61.5%. Most of sociodemogrphic factors were not different between PTSD and non-PTSD groups. Only there were signigicant differences between PTSD group and non-PTSD group on the cases that observed the dead or the wounded at the scene of motor vehicle accident( chi2=8.478, p<0.05) and BDI(t=5.03, p<0.05). CONCLUSION: These results indicate that prevalence of PTSD is higher after motor vehicle accident and both of the two groups report much higher depression and anxiety than normal population. In addition, the results of this study show that the observation of dead or wounded at accident situation can be of risk factors to precipitatae PTSD.

Life Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women / 신경정신의학

The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups: a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores (t=15.94, p<.0001), lift events(t=4.73, p<.0001), active coping(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationship(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life event(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<01), social support(r=-.35, p<.001) and family relationships(r=-.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, beta=-.281, T=-3.162, P=.002), lift events(5.1%, beta=.279, T=3.195, F=.002), and active coping(3.5%, beta=-.204, T=-2.225, F=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores ol the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.