The Validity and Reliability of the Korean Version of Readiness for Practice Survey for Nursing Students

Purpose@#This study aimed to evaluate the validity and reliability of the Korean version of the Readiness for Practice Survey (K-RPS). Method: The English Readiness for Practice Survey was translated into Korean using the Translation, Review, Adjudication, Pretesting, and Documentation (TRAPD) method. Secondary data analysis was performed using the dataset from the New Nurse e-Cohort study (Panel 2020) in South Korea. This study used a nationally representative sample of 812 senior nursing students. Exploratory and confirmatory factor analyses were also conducted. Convergent validity within the items and discriminant validity between factors were assessed to evaluate con-struct validity. Construct validity for hypothesis testing was evaluated using convergent and discriminant validity. Ordinary α was used to assess reliability. @*Results@#The K-RPS comprises 20 items examining four factors: clinical problem solving, learning experience, professional responsibilities, and professional preparation. Although the convergent validity of the items was successfully verified, discriminant validity between the factors was not. The K-RPS construct validity was verified using a bi-factor model (CMIN/DF 2.20, RMSEA .06, TLI .97, CFI .97, and PGFI .59). The K-RPS was significantly correlated with self-esteem (r = .43, p < .001) and anxiety about clinical practicum (r = - .50, p < .001). Internal consistency was reliable based on an ordinary α of .88. @*Conclusion@#The K-RPS is both valid and reliable and can be used as a standardized Korean version of the Readiness for Practice measurement tool.

Development and Evaluation of a Protocol for Bedside Nursing Handoff with Patient Engagement in a Tertiary Hospital in South Korea / 임상간호연구

Purpose@#This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. @*Methods@#The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. @*Results@#The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse’s perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient’s perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). @*Conclusion@#Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.

Nurses' Perception of the Performance and Necessity of Nursing Services for Patients Engagement / 임상간호연구

PURPOSE: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. METHODS: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and χ² analysis were performed using SPSS 25.0 program. RESULTS: The mean age of participants was 36.6±8.5 years and the mean working experience was 12.92±9.23 years. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals (χ²=28.54, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals (χ²=6.30, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. CONCLUSION: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.

Differences between Perceived Readiness for Interprofessional Learning in Nursing and Other Health-related Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the level of perceived readiness for interprofessional learning and its differences between nursing and other health-related students. Methods METHODS: A web-based survey was conducted from April 25 to June 30, 2017 in one university in Korea. A total of 325 undergraduate nursing students and other health-related disciplines completed the structured questionnaire consisting of Readiness for Interprofessional Learning Scale and general characteristics. Data were analyzed by descriptive statistics, t-test, ANOVA, and multiple linear regression. RESULTS: The scores of readiness for interprofessional learning in nursing students were significantly higher than those in other health-related students (t=3.50, p=.001). Nursing students had higher collaboration, professional identity, and roles and responsibilities than other health-related students. The class experiences with other major students was a significant factor related to the readiness for interprofessional learning both in nursing (p=.001) and other health-related students (p=.001). CONCLUSION: The findings suggest that nursing educators consider the different level of readiness for interprofessional learning between nursing and other health-related students while integrating interprofessional education into nursing education curricula.

Factors Affecting the Intention of Hospital Nurses to Stay at Work: In Relation to Authentic Leadership and Nursing Organizational Culture / 임상간호연구

PURPOSE: The purpose of this study was to examine the relationships of authentic leadership and nursing organizational culture to the intention of hospital nurses to stay in their current position. METHODS: The participants of this study were 503 nurses in 8 hospitals. We collected data using questionnaires for assessing authentic leadership, nursing organization culture and intention to stay. For data analysis, t-test, ANOVA, Cronbach's α, Pearson's correlation coefficient, Tukey test, Multiple regression were performed using SAS ver.9.4 (SAS Institute Inc., Cary, NC, USA). RESULTS: Authentic leadership (β=.12, p=.008) and relation-oriented culture (β=.13, p=.009) affected the intention of the hospital nurses to stay. These variables accounted for 29% of the variance in the intention to stay among hospital nurses. CONCLUSION: The finding of this study shows that the authentic leadership and nursing organizational culture especially relation-focused can influence nurses' intention to stay in their current position. For retaining nurses, it is suggested to use an authentic leadership training program for nursing leaders and to make efforts to establish a relation-focused culture in the hospital.

The Relationships among Postpartum Fatigue, Depressive Mood, Self-care Agency, and Self-care Action of First-time Mothers in Bangladesh

PURPOSE: Postpartum fatigue can impact maternal well-being and has been associated with levels of perceived self-care. This study aimed to examine the relationship among fatigue, depressive mood, self-care agency, and self-care action among postpartum women in Bangladesh. METHODS: A descriptive cross sectional survey was done with 124 first-time mothers from two tertiary hospitals in Dhaka, Bangladesh. The Modified Fatigue Symptoms checklist, Denyes' Self Care Instrument, the Edinburgh Postnatal Depression Scale, and items on sociodemographic and delivery-related characteristics, were used in Bengali via translation and back-translation process. RESULTS: High fatigue levels were found in 18.5%(n=23) and 73.4% had possible depression (n=91). There was a significant negative relationship between fatigue and self-care agency (r=−.31, p < .001), and self-care action (r=−.21, p < .05). Fatigue differed by level of self-care agency (t=4.06, p < .001), self-care action (t=2.36, p=.023), newborn's APGAR score (t=−2.93, p=.004), parental preparation class participation (F=15.53, p < .001), and postpartum depressive mood (t=-4.64, p < .001). CONCLUSION: Findings suggest that high level of self-care efficacy and behaviors can contribute to fatigue management, and highlight the need for practical interventions to better prepare mothers for postpartum self-care, which may, in turn, alleviate postpartum fatigue.

Development of the Core Task and Competency Matrix for Unit Managers / 임상간호연구

PURPOSE: The aim of this study was to develop the nursing management core task and competency matrix for hospital unit managers. The perceived level of importance and performance of identified core competencies by unit managers were also investigated. METHODS: Literature review and expert survey identified nursing management core task and competencies. Subsequently, the core task and competency matrix was developed and validated by expert panel. A survey of 196 nurse managers from 3 cities identified perceived importance and performance of core competiences. RESULTS: Thirty-eight nursing management core task and thirty-seven nursing management core competencies were identified comprising five categories; Clinical practice knowledge, Evidence-based practice, Employee development, Strategic planning and Initiative. Based on the core task and competencies, the task and competency matrix for unit managers was developed. In the analysis of importance and performance of core competencies, the mean score of importance (3.50±0.30) was higher than the mean score of performance (3.03±0.34). CONCLUSION: The development of core task and competencies for unit managers in hospitals provides a guide for the development and evaluation of programs designed to increase competence of unit managers.

Analysis of Research Articles Published in the Journal of Korean Academy of Nursing Administration for 3 Years (2013~2015): The Application of Text Network Analysis / 간호행정학회지

PURPOSE: This study aimed to identify research trends in the Journal of Korean Academy of Nursing Administration from 2013 to 2015. METHODS: For this study, 171 articles were analyzed. Research designs, participants, research settings, sampling, and data analyses methods were reviewed using established analysis criteria. Keyword centrality and clusters were generated by keyword network analysis. RESULTS: Most of studies used quantitative methods (82.5%), and sampling mainly focused on nurses (68.8%). The most commonly used data analyses methods were t-test, ANOVA, correlation, and regression. The most central keywords were turnover and empowerment. Network analysis generated four network groups: 1) burnout; 2) turnover; 3) happiness; and 4) nursing professionalism. CONCLUSION: The results of this study identify current trends and interests in Korean nursing administration research. The findings from this study suggest that future studies include a variety of research methods and maintain appropriate research ethics.

Predictors of Hypertension among Middle-aged and Elderly Self-employed Workers: Results from a Baseline Survey of the Korean Longitudinal Study of Aging / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to investigate the individual and working environment-related factors affecting hypertension among middle-aged and elderly self-employed workers in South Korea. METHODS: This was a secondary data analysis of data from the Korean Longitudinal Study of Aging (KLoSA). The study sample included 1,319 middle-aged and elderly self-employed workers who were diagnosed without hypertension and older than 45 years at Wave 1 of the KLoSA. Data were analyzed using descriptive statistics and Cox proportional hazards regression analysis using SPSS 20.0. RESULTS: About 20% of the middle-aged and elderly self-employed workers were diagnosed with hypertension within about 8 years from the baseline. the significant predictors of hypertension among the participants were age, diabetes mellitus, body mass index, frequency of health examinations, working hours per week, the presence of regular day off, and the type of job. CONCLUSION: Middle-aged and elderly self-employed workers are vulnerable to work-related health problems. In order to prevent hypertension among self-employed workers, it is necessary to improve the work environment-related factors as well as individual life styles.

Trends in Nursing Research in Korea: Research Trends for Studies Published from the Inaugural Issue to 2010 in the Journal of Korean Academy of Nursing and the Journals Published by Member Societies under Korean Academy of Nursing Science

PURPOSE: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS: A total of 6890 studies were analyzed using descriptive statistics. RESULTS: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9% ) as dependent variables. CONCLUSION: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Nurses Attitudes toward Death, Coping with Death and Understanding and Performance Regarding EOL Care: Focus on Nurses at ED, ICU and Oncology Department / 한국호스피스완화의료학회지

PURPOSE: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. METHODS: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. RESULTS: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). CONCLUSION: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.

Effective Intervention Strategies to Improve Health Outcomes for Cardiovascular Disease Patients with Low Health Literacy Skills: A Systematic Review

PURPOSE: Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. METHODS: This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. RESULTS: Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. CONCLUSION: With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes.

Development of the Quality Indicators in Long Term Care Service / 간호행정학회지

PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.

Suitability and Readability Assessment of Printed Educational Materials on Hypertension

PURPOSE: The aim of this study was to assess the suitability and readability of printed educational materials for patients with hypertension in Korea. METHODS: A total of 33 written educational materials related to hypertension were collected from public health centers, hospitals, and internet web site. Among them, we analyzed 19 materials which fit the inclusion criteria: leaflets (n=9), booklets (n=3), and guide book (n=7). Two trained nurses evaluate the materials using suitability assessment tool (SAM; Doak, Doak, & Root, 1996a) and graded lexical items for teaching Korean (Kim, 2003). RESULTS: Overall, 14 (73.7%) of 19 materials scored adequate, and 5 (26.3%) scored inadequate. On the average, the education materials contained 36.1% to 50.5% of 1st grade reading level words and 12.9% to 21.6% of 4th grade level and over. CONCLUSION: The reading level of the materials was higher than a 6th grade reading level. It is proposed that the written educational materials should be developed by health professionals according to suitability and quality by taking the target group's literacy capacity into consideration.

Structural Factors Influencing the Quality Management Activities in Nursing Homes / 간호행정학회지

PURPOSE: Nursing home quality indicators have been focused widely on result outcomes, not for the environment in that quality of service are delivered. This study aimed to examine structural factors influencing quality management activities in nursing homes. METHOD: Sample was 170 nursing homes responded to the survey questionnaire which was distributed to the 543 nursing homes nation-wide. Data were collected on structural characteristics, types of services, and quality management activities. Data were analyzed with the descriptive statistics, Pearson correlations, and multiple regression. RESULT: Most of the nursing homes were operated as free of charge by the social welfare ownership. Average number of residents was 52.1 with severe and mild dementia and bedridden status. In terms of quality management activities, 34% of the sample had CQI committee that focused their activities on services delivery process, performance appraisal, record keeping regularly. 30.6% of quality management activities were accounted for by the number of residents with dementia, the ratio of RN to residents, rehabilitation services, and social wefare services in nursing homes. CONCLUSION: We recommend that more comprehensive quality management activities should be developed as process quality indicators in conjunction with the outcome indicators.

Predictors of Nursing Service Need for Nursing Homes Residents

PURPOSE: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. METHODS: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). RESULTS: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (beta=-.533) was the most significant predictor of nursing service need. CONCLUSION: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.

Development of a Performance Measurement Scale for Hospital Nurses / 간호학회지

PURPOSE: The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale. METHODS: This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients. RESULTS: The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was .92. CONCLUSION: The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a steping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.

A Study of Complementary and Alternative Medicine used by Cancer Patients in Korea / 성인간호학회지

PURPOSE: The purpose of this study was to study complementary and alternative medicines (CAM) used among cancer patients in Korea. METHOD: This study was a descriptive survey. Study participants were 1,150 cancer patients selected from 28 representative hospitals in Korea. Data were collected between December 1, 2004 and March 30, 2005. RESULTS: Their diagnosis were as follows : 20.0% for breast cancer, 15.6% for stomach cancer, 14.4% for liver cancer, 10.8% for lung cancer, 10.0% for colon cancer, and 10.0% for uterine cancer. 75.0% of cancer patients had used CAM. The most popular categories of CAM use were diet with 153.2%, non-prescription of oriental medical doctor 47.9% and mind-body control 20.3%. CAM use gender, age, cancer type, cancer treatment method, and current treatment type was significantly different in. CONCLUSION: CAM use among cancer patients in Korea was very popular (75.0%) and so systemic guidelines of CAM use are needed.

Health Status, Health Perception, and Health Promotion Behaviors of Low-income Community Dwelling Elderly / 간호학회지

PURPOSE: The purpose of the study was to investigate the health status(present illness, ADL and IADL), health perception, and health promotion behaviors of low-income elderly who are receiving the visiting nurse service in the community. METHOD: The sample of the study was 735 elderly over 65years old with basic livelihood security, who were conveniently selected from 245 public health centers nation-wide. Data collection was done using a structured questionnaire through interviews by visiting nurses. RESULT: The average number of present illnesses in the study subjects was 4.18. The average scores of ADL and IADL were 15.903.39and 9.772.97 respectively, which indicates a relatively independent everyday life. However, 64.2% of the subjects perceived their health status as 'not healthy'. In terms of health promotion behaviors, 77.8% of the subjects had ceased smoking, 83.9% stopped drinking, 56.4% had a regular diet, 45.8% received regular physical check-ups during the past two years, and 66% received flu shots. Approximately 50% of the subjects were practicing 3-4 health promotion behaviors. Significant factors associated with health promotion behaviors were ADL, IADL and self-efficacy. CONCLUSION: Health promotion programs which focus on regular diet, exercise, and regular physical check-ups should be developed to improve independence of everyday life and quality of life among low-income elderly.

Health Problems and Health Behaviors of Preschoolers / 간호학회지

PURPOSE: This study was conducted to understand the health status and health behaviors of preschoolers to provide baseline data for developing health promotion programs. METHOD: Parents of children attending day-care centers were recruited for the study. Participating day-care centers were selected using a stratified sampling method. Data was collected from June to August 2002 using a questionnaire. RESULT: Among 754 preschoolers, 17.3% were overweight, while 18.2% were underweight. The most frequent infectious diseases that children have had previously were hand-foot-mouth disease (20.2%) and chicken pox (18.7%). Current health conditions that children have frequently are respiratory disease (28%) and atopic dermatitis (23.8%). Only 61% brush their teeth everyday at bedtime, 54.3% wash their hands every time after returning home, 8.8% wear bicycle helmets, 9.3% use a child car seat, and 8.1% eat fruits and vegetables five times a day. Children residing in the metropolitan area were more likely to have positive health behaviors, and children of parents with an advanced college level education were more likely to have positive health behaviors than those with only a high school level education. CONCLUSION: Based on the study results, health professionals could plan and develop health promotion programs to change unhealthy behaviors of preschoolers targeting high-risk groups.