Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis

Purpose@#It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment. @*Methods@#We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model. @*Results@#The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice. @*Conclusion@#Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

Effects of Professional Autonomy and Teamwork on Clinical Performance of Nurses in Tertiary Hospitals / 간호행정학회지

Purpose@#This study was aimed to identify the effects of professional autonomy and teamwork on clinical performance to improve the clinical performance of tertiary hospital nurses. @*Methods@#Data were collected from June 1 to June 30, 2017 and a total of 172 nurses from three tertiary hospitals participated in this study. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation and stepwise multiple regression analysis using SPSS 25.0. @*Results@#Clinical performance showed a statistical difference depending on the number of education session for competency, and it showed a positive correlation with professional autonomy and teamwork. The factors affecting the clinical performance of the tertiary hospital nurses included in teamwork (β=.40, p<.001), professional autonomy (β=.27, p<.001). These factors accounted for 31% of clinical performance (p<.001). @*Conclusion@#It is important to find ways to improve clinical performance of tertiary hospital nurses. Furthermore, there is a need to include continuous and systemic education programs for professional autonomy and suitable programs to elevate teamwork.

Effects of Career Management and Organizational Justice on Job Rotation Attitude among Hospital Nurses / 간호행정학회지

Purpose@#The purpose of this study was to identify the relationship between career management, organizational justice, and job rotation attitude among tertiary hospital nurses. @*Methods@#A cross-sectional descriptive design was used. The participants were 195 nurses with more than one year of experience working at tertiary care hospitals.Data was collected with self-reported questionnaires from April to May 2018. Data was analyzed using SPSS Statistics version 25.0 for windows including descriptive statistics, bivariate analysis, and multiple regression analysis. @*Results@#The mean score of career management of participants was 3.14±0.49 (range 1~5), organizational justice was 2.95±0.53 (range 1~5), and job rotation attitude was 4.02±0.97 (range 1~7). There were significant positive correlations among the participants' career management, organizational justice, and job rotation attitude. 37% of job rotation attitude was explained by position, organizational justice, career management, and the frequency of job rotation experience in the regression model. @*Conclusion@#This study provided the empirical evidence that it is necessary to improve the perception of organizational justice, and to establish a systematic job rotation in order for nurses to positively recognize job rotation.

A Comparative Study on Trust, Collaboration and Teamwork of Other Healthcare Personnel by Nurses Working on Integrated Nursing Care Service Wards versus Nurses on General Wards / 간호행정학회지

Purpose@#This study was performed to compare the perceived level of trust, collaboration, and teamwork about other healthcare personnel, professionals and assistants between nurses who work on integrated nursing care service wards and general wards. @*Methods@#Participants were 216 nurses working on integrated nursing care service wards and general wards of 5 general hospitals located in Kyeongido and Kyeongsangbuk-do (integrated nursing wards: 109, general wards: 107). Data were collected using structured questionnaires and analyzed using x 2 test, two sample independent t-test and Multivariate Analysis of Covariance (MANCOVA) with SPSS/WIN 23.0 programs. In particular, MANCOVA was conducted after controlling two independent variable covariants which are marital status (p=.045) and work department (p=.022) which had significant differences for both groups and three dependent variables which is trust, collaboration, and teamwork that highly correlated. @*Results@#There were significant differences in the dependent variables of trust (p=.001), collaboration (p=.014), and teamwork (p<.001) between the two groups of nurses. The mean scores for trust, collaboration, and teamwork with other healthcare personnel as perceived by nurses working on integrated nursing care service wards were significantly lower than that of nurses on general wards. @*Conclusion@#These findings show that strategies are needed to strengthen the trust, collaboration, and teamwork among nurses working on integrated nursing care service wards and other healthcare personnel.

Effect of Parenting Stress and Co-worker Support on Work-Life Balance in Nurses Reinstated after Parental Leave / 간호행정학회지

Purpose@#This was a descriptive study aimed at providing basic data on readaptation of hospital nurses after parental leave by exploring levels of parenting stress, co-worker support, and work-life balance and identifying factors affecting work-life balance. @*Methods@#A survey using a convenience sampling was conducted with 86 nurses who were within their first year reinstatement after parental leave. Structured questionnaires were used, including the above named main variables and other general characteristics. Data were collected from February to May, 2019 from three tertiary hospitals in Seoul. Data were statistically analyzed using independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis. @*Results@#Work-life balance showed a statistical difference depending on the level of education; it showed negative correlations with commuting time and fatigue and positive correlations with the attitude to job rotation, health status, and quality of sleep. There was a negative correlation between parenting stress and work-life balance and a positive correlation between co-worker support and work-life balance. Work-life balance was influenced by fatigue, parenting stress, health status, and co-worker support in the regression model. @*Conclusion@#Parenting stress, co-worker support, health status and fatigue of nurses reinstated from parental leave should be improved to enhance their work-life balance.

The Influence of Nurses' Communication Competency, Critical Thinking Disposition, and Perception of Patient Safety Culture on Patient Safety Competency in Armed Forces Hospitals / 한국직업건강간호학회지

Purpose@#This study examined the influence of nurses' communication competency, critical thinking disposition, and perception of patient safety culture on patient safety competency in armed forces hospitals. @*Methods@#A crosssectional design was employed with a convenience sample of 204 nurse officers from four armed forces hospitals in South Korea. Data were collected through a self-administered questionnaire from August 10~23, 2019, and analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression. All analyses were conducted using SPSS for Windows 21.0. @*Results@#Patient safety competency scores were 4.35±0.40 for patient safety attitudes, 3.63±0.64 for patient safety knowledge, and 3.94±0.51 for patient safety skill. Communication competency, critical thinking disposition, and perception of patient safety culture were positively correlated with patient safety competency. Communication competency (β=.30, p=.002) and perception of patient safety culture (β=.24, p=.001) were identified as particularly important factors influencing patient safety competency. @*Conclusion@#This study’s results suggest that education programs to enhance communication competency and patient safety culture could increase patient safety competency among nurses in armed forces hospitals.

Factors Influencing Korean Nurses' Intention to Stay: A Systematic Review and Meta-analysis / 간호행정학회지

PURPOSE: To systematically review research articles that examined factors affecting Korean clinical nurses' intention to stay in their jobs. METHODS: Articles related to Korean clinical nurses and published both in Korean and English languages were retrieved from computerized databases using a manual search. Data extraction, quality assessment, and analysis including meta-analysis were completed. RESULTS: The review included 15 studies. There was strong evidence for the effects of 19 factors on Korean clinical nurses' intention to stay. Factors were categorized into three major categories; demographic, extrinsic, and intrinsic factors. In the meta-analysis of 10 articles, career experience of more than 6 years was the main factor that led to high intention to stay (OR=−0.5, p < .001). Job performance related factors (28.1%) and nursing work environment or organizational climate for caring (21.9%) were studied as the main extrinsic factors. Job related attitude (28.1%) including job satisfaction and organizational commitment and nursing value (15.6%) were studied as the main intrinsic factors. CONCLUSION: Expert nurses are more likely to retain their current positions as well as quality workplace environments or psychological capitals. Healthcare organizations must be responsible for improving professional and psychological capital of beginner nurses and affecting change for a warm organizational environment.

Factors affecting the Perception of Social Responsibility of Nursing Students / 간호행정학회지

PURPOSE: The purpose of this study was to identify the perception and factors affecting social responsibility in nursing students. METHODS: The participants for this study were 301 nursing students in three universities and three colleges located in Seoul, Gyeonggi or Gyeongbuk in South Korea. Data were collected in Dec, 2015 using structured questionnaires and analyzed using independent t-test, one way ANOVA, Pearson correlation coefficient, multiple regression analysis with the SPSS/WIN 18.0 program. RESULTS: The mean score for social responsibility of nursing students had a significant positive correlation with satisfaction with nursing major, nursing professionalism and sociality. Sociality, nursing professionalism and nursing major satisfaction were the major predictors of social responsibility and explained 51.0%(F=142.67, p < .001) of the total variance in the study. CONCLUSION: The results suggest that it is necessary to develop strategies to promote the various nursing curricular programs that reinforce social responsibility in nursing college students.

The Influence of Nurses' Emotional Intelligence and Communication within the Organization on Teamwork in Armed Forces Hospitals / 산업간호학회지

PURPOSE: The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals. METHODS: This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses. RESULTS: The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001). CONCLUSION: These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.

The Influence of Nurses' Emotional Intelligence and Communication within the Organization on Teamwork in Armed Forces Hospitals / 한국직업건강간호학회지

PURPOSE@#The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals.@*METHODS@#This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses.@*RESULTS@#The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001).@*CONCLUSION@#These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.

Predicting Patient Safety Behaviors of Nurses in Inter-Hospital Transfer / 간호행정학회지

PURPOSE: The purpose of this study was to investigate predictors of nurses' patient safety behavior during inter-hospital transfer. The study was based on the Theory of Planned Behavior (TPB). METHODS: A descriptive survey design was used. Data were collected with a self-administrated 39-item questionnaire completed by 111 nurses from a university hospital in Seoul, South Korea. The questionnaire was developed based on the Theory of Planned Behavior (TPB) guideline and included measure of self- reported past patient safety behaviors, intentions, attitudes, subjective norms and perceived behavioral controls. Ethical approval was granted by the hospital review board. Hierarchical regression analyses were carried out. RESULTS: The average score of patient safety behavior was 4.21±0.63 (5 point scale). The TPB variables explained 49.9%of the variance in patient safety behavior. Intention and subjective norm were the most significant predictors of nurses' patient safety behavior. Attitude was related to nurses'patient safety behavior. CONCLUSION: TPB variables predicted the nurses'patient safety behavior during inter-hospital transfer of patients except for perceived behavioral controls. The results of this study suggest that better strategies for subjective norms and intentions related to patient safety behavior will be helpful in safety culture reform.

Effects of Job Characteristics, Organizational Culture on Job Satisfaction and Turnover Intention in Public Institution Nurses / 간호행정학회지

PURPOSE: The aim of this study was to examine the relationship between job characteristics, organizational culture, job satisfaction and turnover intention, including the direct and indirect effects of the variables on turnover intention. METHODS: A questionnaire was completed by a convenience sample of 144 nurses working for two public institutions. Data were analyzed using independent t-test, One-way ANOVA, Pearson correlation, Hierarchical multiple regression and Path analysis with SPSS/WIN 21.0 and AMOS 21.0 programs. RESULTS: The mean score for job satisfaction and turnover intention was similar to that of other hospital nurses. The factors affecting job satisfaction were: position, number of job changes, relationship-oriented culture, and hierarchical-oriented culture(Adj. R2=.48, F=14.43, p<.001). The factors affecting turnover intention were: age, position, overtime, and job satisfaction(Adj. R2=.61, F=19.48, p<.001). Job autonomy and relationship-oriented culture had a significant indirect effect on turnover intention. CONCLUSION: In developing intervention strategies to improve job satisfaction and reduce turnover intention there is a need to consider both the job characteristics and organizational culture of nurses in public institutions.

Correlations among Emotional Labor, Servant Leadership, and Communication Competence in Hospital Nurses / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify correlations among emotional labor, servant leadership, and communication competence in hospital nurses. METHODS: A self-administrated survey was conducted with a convenient sample of 210 nurses, using a structured questionnaire. The data were analyzed by descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient using SPSS/WIN 20.0 program. RESULTS: The mean emotional labor score was 3.4+/-0.60. There was very strong and negative correlation between emotional labor and servant leadership (r=-.896, p<.001). Communication competence was positively correlated with servant leadership (r=.298, p<.001) and moderately and negatively correlated with both frequency of emotional labor (r=-.166, p=.016) and the degree of attention to emotional expression (r=-.143, p=.039). CONCLUSION: As a strategy to reduce emotional labor of hospital nurses, the findings suggest training programs for nurses to enhance servant leadership and communication competence.

Relationship of Experience of Violence and Professional Quality of Life for Hospital Nurses' / 간호행정학회지

PURPOSE: The purpose of this study was to identify the relation between violence experiences and the professional quality of life for hospital nurses. METHODS: The participants for this study were 212 nurses in one general and three special hospitals located in the metropolitan area of Seoul, South Korea. Data gathered through October and November 2013 were analyzed using descriptive statistics and chi2 test. RESULTS: Nurses experienced verbal violence, physical threats and physical violence more frequently from patients and their families rather than from doctors or peer nurses. Nurse's compassion satisfaction was low when nurses experienced violence from peer nurses. Burnout was high when nurses experienced violence from doctors, peer nurses, patients and their families. Secondary traumatic stress was affected by violence from patients and their families. The professional quality of life of nurses was associated with violence from doctors, peer nurses, patients and their families. Of the nurses, 69.3% answered that formation of a positive organizational culture would be the most effective measure for prevention of violence in hospitals. CONCLUSION: The formation of positive organizational culture, development of violence intervention policies and education are crucial to improve the professional quality of hospital nurses' life.

The Development of the Integrated Nursing Practicum Education Matrix based on Learning Outcomes / 한국간호교육학회지

PURPOSE: The purpose of this study was to develop an integrated nursing practicum education matrix based on the learning outcomes of each stage. METHODS: In this Delphi technique study, 10 experts, consisting of six professors and four nurses, participated in the development of the matrix. The first step was an in-depth review for the composition of the questionnaire and the second step was the Delphi technique. The Delphi survey was conducted two times in order to complete the components of the matrix. The survey data was analyzed for statistical averages and standard deviations to decide the order of priority. RESULTS: According to each stage (i.e. fundamental stage, competent stage, and proficient stage), the matrix was composed of education contents, methods, evaluation methods, and curriculum outcomes. CONCLUSION: The integrated nursing practicum education matrix of Y University was completed. The developed matrix will result in a reduction in the gap between nursing education and clinical practice and an improvement in nursing competency.

Analysis of Manuscripts Rejected by the Journal of Korean Academy of Nursing Administration 2012~2015 Jun / 간호행정학회지

PURPOSE: The purpose of this study was to analysis the manuscripts rejected for publication in the Journal of Korean Academy of Nursing Administration during the last three years six months (2012~2015 Jun). METHODS: Seventy eight rejected manuscripts were analyzed focusing on manuscripts characteristics, such as rejection rates, year of submission, occupation of first author and corresponding author, number of authors, funding, thesis or dissertation, article type, study participants, number of reviews prior to rejection, and 3rd reviewer. Also reviewers' quantitative evaluation scores and subjective comments were analyzed. Reviewers' subjective comments were analyzed using content analysis methodology. RESULTS: The mean rate for manuscript rejection was 28.9% and for quantitative research, qualitative research, and review papers the quantitative evaluation scores were 2.54+/-0.70, 2.39+/-0.69, and 2.39+/-0.69 out of 5 points, respectively. The most frequent subjective comment on rejected manuscripts was 'lack of rationale for research need'. CONCLUSION: In this study the characteristics and the reasons for rejecting manuscripts were identified. These findings can be used in developing effective strategies for researchers, reviewers and editors to improve the quality of research and research reviews of nursing administration research.

Issues and Challenges of Nurse Workforce Policy: A Critical Review and Implication / 간호행정학회지

PURPOSE: In this paper issues and challenges of the workforce policy for nursing were explored and appropriate policy responses identified. RESULTS: Many countries, including South Korea, are facing a shortage of nurses. In South Korea, the number of practicing registered nurses is about half the average for Organization for Economic Cooperation and Development (OECD) member countries. The shortage of nurses is not necessarily a shortage of individuals with nursing qualifications but also includes complex issues, such as lack of well-educated nurses, shortage of nurses willing to work, and geographical imbalances of nurses. The present nurse workforce policies are to increase number of nursing schools, to reduce the length of training, and to replace nurses with nursing assistants. However, the findings of many studies have shown that these attempts resulted in a worsening of patient outcomes and increasingly low quality of care. CONCLUSION: The findings in this study indicate that nurse workforce policy should have a multi-faceted approach in order to address the many factors affecting nurse shortages.

Role Transition of Senior Year Nursing Students: Analysis of Predictors for Role Transition / 간호행정학회지

PURPOSE: The purpose of this study was to identify the perception of role transition from a student nurse to a registered nurse among senior year nursing students and to examine factors affecting their role transition. METHODS: A descriptive survey with convenience sampling was conducted in four nursing colleges in Seoul, South Korea. Data were collected using a self-administrated questionnaire. Four instruments including role transition, self-esteem, interpersonal relationships and anxiety during clinical practicum were used and the students'demographics were also collected. A multiple logistic regression was used to identify predictors for the role transition. RESULTS: A total of 233 nursing students were surveyed and final analysis was conducted utilizing 226 participants. Mean point of perceived role transition (5 point scale) was 3.34+/-0.44. In a multiple regression model, high self-esteem, good interpersonal relationships, low anxiety during clinical practicum, and high satisfaction in college life were significant predictors of a smooth transition (Adj. R2=.32, F=22.28, p<.001). CONCLUSION: The findings suggest that role transition from a student nurse to a registered nurse is facilitated through the establishment of programs to improve self-esteem and interpersonal relationships and to reduce anxiety during clinical practicum.

Factors Influencing Medication Adherence in Patients with Hypertension: Based on the 2008 Korean National Health and Nutrition Examination Survey

PURPOSE: The purpose of this study is to examine factors influencing medication adherence in patients with hypertension. METHODS: This study carried out a secondary analysis of data from the 2008 Korean National Health and Nutrition Examination Survey (KNHANES). Stratified sampling was used to select a participant sample that was representative of patients with hypertension throughout the country. Using the SPSS/WIN 18.0 program, data were analyzed using descriptive statistics, chi2 test, t-test, and logistic regression. RESULTS: Of the patients with hypertension, 8.8% had showed non-adherence to medication. Medication adherence was associated with age, spouse, Medicare insurance, number of other diseases, and current smoking status. The cases with older age, a spouse, Medicare insurance, higher number of other diseases, and no current smoking status showed significantly high medication adherence. CONCLUSION: Nursing interventions and further studies are needed to achieve high levels of medication adherence based on factors influencing medication adherence such as age, spouse, Medicare insurance, number of other disease, and current smoking status.

Determinants of Amount of Service Use in Community-Based Long-term Care for Elders / 간호행정학회지

PURPOSE: This study was done to explore factors related to amount of service use for elders with long-term care needs. METHODS: A descriptive-correlation design was used. The sample included 259 elders and their primary caregivers who had cared for the elders for at least 6 months. Data on long-term care need assessment, service use and interviews with primary caregivers were analyzed. RESULTS: There was no significant relationship between the sociodemographic characteristics and the amount of services use. Amount of service use differed significantly by Long-term care classification. The mean scores for class 1, 2 and 3 were 22.68, 21.47 and 17.87 days respectively. Primary caregiver relationship with the elders and the number of family-friend helpers were also significant. Multivariate regression analysis showed that gender, marital status, activities of daily living, cognitive impairment, and secondary caregiver support explained 17% of the total variance of service use among these elders (F=3.50, p<.001). CONCLUSION: The results of this study indicate that critical factors including secondary caregiver support and individual background, and other functional dependencies except for physical function should be considered in accurately predicting the amount of service use for community dwelling elders with long-term care needs.