The effect of verbal violence, clinical practice stress, and coping with stress on nursing students’ major satisfaction during clinical practice / 한국간호교육학회지

Purpose@#This study was conducted to identify the effect of verbal violence, clinical practice stress, and coping with stress on the major satisfaction in nursing students during clinical practice. @*Methods@#A cross-sectional study was used. A survey was conducted from May 3 to May 10, 2022, on 200 nursing students who were in their junior and seneior years at two universities in Gyeongsangbuk-do. Descriptive statistics, frequency analysis, independent t-test, one-way ANOVA, Scheffé’s test, Pearson correlation coefficient, and hierarchical regression analysis were employed to analyze the data. @*Results@#Major satisfaction was found to be significantly negatively correlated with verbal violence (r=-.30, p<.001) and clinical practice stress (r=-.15, p=.032) and to be positively correlated with coping with stress (r=.24, p<.001). Their satisfaction with clinical practice (β=.29, p=.037), verbal violence (β=-.23, p<.001), coping with stress (β=.16, p=.015), religion (β=.14, p=.041), and clinical practice stress (β=-.13, p=.048) explained 19.3% of the variance in nursing students’ major satisfaction during clinical practice. @*Conclusion@#A verbal violence and coping with stress program for nursing students should be developed to increase nursing students’ major satisfaction during clinical practice.

Mediating effect of resilience between post-traumatic stress and emotional exhaustion in nurses during the COVID-19 pandemic / 한국간호교육학회지

Purpose@#This study explored the mediating role of resilience between post-traumatic stress and emotional exhaustion in nurses during the COVID-19 pandemic. @*Methods@#The data were collected from 193 nurses working at a hospital in Daegu from October 16 to 30, 2020, in the middle of the COVID-19 pandemic. Participants conducted self-reported surveys of post-traumatic stress (Impact of Event Scale-Revised Korean version), emotional exhaustion (Maslach Burnout Inventory), and resilience (Korean Resilience Quotient Test). The data were analyzed using descriptive statistics, frequency, t-tests, Mann-Whitney U tests, Kruskal-Wallis tests, Pearson correlation coefficients, and multiple regression. Mediation analysis was performed using the Baron and Kenny method and Sobel test. @*Results@#The mean scores for post-traumatic stress, resilience, and emotional exhaustion were 16.18±16.18, 183.41±18.29, and 32.64±9.66, respectively. A higher level of post-traumatic stress was associated with lower resilience (r=-.20, p=.004) and with higher emotional exhaustion (r=.33, p<.001). A higher level of resilience was associated with lower emotional exhaustion (r=-.35, p<.001). The resilience was confirmed to have a partial mediating effect in the relationship between post-traumatic stress and emotional exhaustion, verified by the Sobel test (Z=2.31, p=.02). @*Conclusion@#Resilience had a partial mediating effect in the relationship between post-traumatic stress and emotional exhaustion. Thus, nurses should develop individual strengths to reduce emotional exhaustion, and managers should also make efforts to increase the nurses’ resilience. It is also necessary to develop and apply a program to strengthen nurses’ resilience.

Nurses’ Experiences of the COVID-19 Crisis

Purpose@#This study aimed to develop a situation-specific theory to explain nurses’ experiences of the COVID-19 crisis. @*Methods@#The participants were 16 hospital nurses who experienced the COVID-19 crisis. Data were collected through in-depth individual interviews from September 2, 2020 to January 20, 2021. Transcribed interview contents were analyzed using Corbin and Strauss’s grounded theory method. @*Results@#A total of 38 concepts and 13 categories were identified through an open coding process. The core category found was becoming a pioneering nurse who turns crises into opportunities. The causal conditions were the chaos of being exposed defenselessly to an unexpected pandemic, fear caused by a nursing care field reminiscent of a battlefield, and moral distress from failing to protect patients’ human dignity. The contextual conditions were feeling like the scapegoat of the hospital organization, increasing uncertainty due to the unpredictable state of COVID-19, and relative deprivation due to inappropriate treatment. The central phenomenon was suffering alone while experiencing the dedication of the COVID-19 hero image. The action/interactional strategy were efforts to find a breakthrough and getting the nurse’s mind right, and the intervening conditions were gratitude for those who care for broken hearts and getting used to myself with repetitive work. The Consequences were becoming an independent nurse and frustration with the unchanging reality. @*Conclusion@#This study provides the foundation for the nurse's situation-specific theory of the COVID-19 crisis by defining the crisis perceived by nurses who cared for COVID-19 patients and suggesting types of coping with the crisis.

ICU nurses’ experiences of feeling hurt by medical personnel / 한국간호교육학회지

Purpose@#The purpose of this study is to explore the experiences of nurses who have suffered from hurt feelings in their relationships with medical personnel in intensive care units (ICUs). @*Methods@#Data were collected from May 2019 to August 2020 through individual in-depth interviews with 8 ICU nurses. Verbatim transcripts were analyzed using the MAXQDA program, employing a phenomenological method designed by Colaizzi. @*Results@#Four theme clusters and nine themes were identified. The themes cluster that emerged were as follows: high-handedness from a lack of understanding and consideration, not being respected as a professional, having to endure sadness alone, and strategies for accepting pain. @*Conclusion@#In ICUs, nurses are being emotionally wounded, resulting in a variety of hurt feelings, not only by doctors, but also by other nurses. Nurses were heavy-hearted because they wanted the participants to do their part and care for critically ill patients proficiently. However, they did not treat ICU nurses as specialized professionals. The participating nurses said they felt pressure, fear, and intimidated. In addition, they felt lonely because their head nurses, seniors, or colleagues did not protect or support them. This study helped develop a program to decrease the nurses’ emotional distress and create a safe work environment where they respected and cared for each other without undergoing anguish.

Effects of clinical practice stress and moral sensitivity on clinical competency in nursing students / 한국간호교육학회지

Purpose@#This study was conducted to explore how clinical practice stress and moral sensitivity affect the clinical competency of nursing students. @*Methods@#Participants had completed at least a one year (2 semesters) clinical nursing practicum through K University in D Metropolitan City. A total of 188 nursing students were recruited: third grade (n=104) and fourth grade (n=84). The questionnaires were adopted with clinical practice stress, Korean version of moral sensitivity questionnaire (K-MSQ), and the clinical competency. @*Results@#Clinical competency was positively correlated with patient-oriented care (r=.27, p<.001) and the professional responsibility (r=.32, p<.001) of the moral sensitivity (r=.27, p<.001). The attitude of medical personnel experiencing clinical practice stress shows a significant positive relationship with clinical competency (r=.15, p=.038). The attitude of medical personnel (ß=.09, p=.194) experiencing clinical practice stress, patient-oriented care (ß=.16, p=.041) and professional responsibility (ß=.23, p=.003) of the moral sensitivity explained 12% of the variance in clinical competency (F=9.17, p<.001). Therefore, the influential factors on clinical competency were two sub-factors of moral sensitivity. @*Conclusion@#Moral educational programs should be considered to develop a nursing students' clinical competency.

Association between Cardio-Cerebro Vascular Disease and Depression and Factors Influencing Depression: The Korean National Health and Nutrition Examination Survey in 2014, 2016 / 기본간호학회지

Purpose@#In this study investigated the association between cardio-cerebro vascular disease and depression was examined and factors influencing depression in adults with cardio-cerebro vascular disease were identified. The Korean National Health and Nutrition Examination Survey (KNHANES) data (2014, 2016), which is representative of the Korean population was used. @*Methods@#Data on 9,651 people (male 4,148, female 5,503; age≥19 years old from the KNHANES (Ⅵ-2, Ⅷ-1) were analyzed using frequency, percentage, x2 test, and logistic regression analysis. Depression is defined as major depression with doctor diagnosis or Patient Health Questionnaire-9 score ≥10. Ischemic heart disease (IHD)(myocardial infarction or angina) and stroke were defined as a doctor diagnosis. @*Results@#The prevalence of depression was 20.4% in the IHD group and 22.9% in stroke group, which were statistically significant. After adjusting by sociodemographic, health-related, and independent variables in a logistic regression analysis, IHD (OR=1.91, 95% CI 1.36~2.69) and stroke (OR=1.83, 95% CI 1.23~2.72) were associated with depression. In addition, IHD was significantly associated with depression in women, people divorced or separated, current smokers, people with perceived stress, and hypercholesterolemia. In addition, stroke was significantly associated with depression in women, under the age of 65, with perceived stress. @*Conclusion@#The results of this study show that cardio-cerebro vascular disease is associated with the depression and influencing factors on depression were socio-demographic and health-related characteristics. Therefore, intensive management of depression risk factors and development and application of a program reducing depression for patients with cardio-cerebro vascular disease should be developed.

Mixed Method Research Investigating Turnover Intension with ICU Nurses / 기본간호학회지

Purpose@#This study was done to investigate the mediating effect of occupational stress on the relationship between ICU nurse’s authentic leadership and turnover intention, and to analyze the causes of turnover in ICU nurses. @*Methods@#A convergent mixed method was used. Participants were 100 out of 207 ICU nurses in the original data that were acquired in Daegu, Ulsan, and Busan, in February and March 2017. Participants were asked with open-ended question: "what are the causes for turnover intention" and summative content analysis and thematic analysis were done. @*Results@#The mean scores for authentic leadership, occupational stress, and turnover intention were 3.09, 43.74, and 45.66, respectively. Occupational stress showed full mediation in the relationship between authentic leadership and turnover intention. The qualitative data showed that the most causes of turnover intention were in the organization (60.6%) instead of individuals (39.4%). @*Conclusion@#Authentic leadership influenced the ICU nurse’s turnover intention via the full mediating effect of occupational stress. The ‘organization-oriented variables’ play a more important role than 'individual-oriented variables' in the reduction of the turnover intention of ICU nurses. The findings from this study may be useful in reducing turnover intention.

Literature Review and Meta-Analysis of Problem-Based Learning in Nursing Students / 기본간호학회지

Purpose@#The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing student nurses’ critical thinking, problem solving, and self-directed learning. @*Methods@#To conduct the meta-analysis, 1,963 studies were retrieved from eight databases (Pubmed, EMbase, CINAHL, Cochrane Library, KERIS, KISS, NDSL, KoreaMed) without restriction on publication year. Articles published up to March 2019 were selected for this study. Fourteen studies were selected for meta-analysis based on satisfaction of inclusion criteria and low risk of bias. Baseline demographic data, exercise features, and outcome data were extracted from all trials included. The data was analyzed using the RevMan 5.3 program. @*Results@#Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students’ critical thinking (ES=0.29, 95% Cl=0.04~0.54,p=.002), problem solving (ES=0.39, 95% Cl=-0.09~0.87,p=.11), and self-directed learning (ES=0.35, 95% Cl=-0.22~0.91,p=.23) compared with traditional lectures. @*Conclusion@#PBL help improve the critical thinking in nursing students. Although problem solving and self directed learning were not affected, more research with a larger sample size and repeated meta-analysis of PBL are required

Predictors of Emotional Labor and Resilience on Clinical Competency in Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate predictors of emotional labor and resilience on clinical competence in nursing students. METHODS: A cross-sectional, descriptive study was distributed to 120 nursing students. Structured questionnaires addressing emotional labor, resilience, and clinical competence were employed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and regression were used to analyze the data. RESULTS: A total of 116 surveys were analyzed. Satisfaction of clinical practice and major showed statistically significant differences in clinical competence (F=6.59, p=.002; F=11.32, p<.001, respectively). Clinical competence was positively associated with resilience (r=.67, p<.001). Regression analyses showed that satisfaction of clinical practice and major, and resilience were statistically significant in predicting clinical competence with the explanatory power of 46.4% (F=20.91, p<.001). CONCLUSION: The results showed that resilience was the critical predictor of clinical competence in nursing students. It is therefore necessary to develop resilience programs to help improve clinical competence in nursing students.

The Influence of Chronotype and Self-Efficacy on Problem Drinking in Undergraduate Students

PURPOSE: The aim of this study is to identify the influence of chronotype and self-efficacy on drinking problem in undergraduate students. METHODS: A cross-sectional survey design was adopted for the 177 undergraduate students in D, G, and K city in 2017. The data was analyzed for descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis using the SPSS 18.0 program. RESULTS: Chronotype (β=−.31, p<.001), self-efficacy (β=27, p<.001) and religion (β=−.19, p=.005) were identified as the factors influencing drinking problem in the subjects. The model explained 19% of variance in drinking problem (F=11.36, p<.001). CONCLUSION: It is necessary to develop and apply a program that would consider chronotype and self-efficacy factors to reduce the drinking problem in undergraduate students.

Clinical Practice Stress and Burnout in Nursing Students: The Mediating Effect of Empathy / 한국간호교육학회지

PURPOSE: The purpose of this paper was to examine the relationships between clinical practice stress and burnout, and the mediating role of empathy in nursing students. METHODS: A cross-sectional research design was employed. One hundred seventeen nursing students completed questionnaires on clinical practice stress, empathy (perspective-taking, fantasy, empathic concern and personal distress) and burnout in December 2017. IBM SPSS Statistics 23 was used and descriptive statistics, frequency, Pearson correlation coefficient and multiple regression were conducted. Baron & Kenny method and Sobel test were adopted for analysis of the mediation effect (personal distress of empathy). RESULTS: The mean scores of clinical practice stress and burnout were 3.45 and 43.09, and perspective-taking, fantasy, empathic concern and personal distress of empathy were 2.67, 2.42, 2.64 and 2.19, respectively. The highest relationship between clinical practice stress and empathy was personal distress of empathy (r=.32, p < .001). Burnout was positively associated with clinical practice stress and personal distress of empathy (r=.22, p=.015; r=.51, p < .001). Personal distress of empathy demonstrated a complete mediating effect on the relationship between clinical practice stress and burnout (Z=3.22, p=.001). CONCLUSION: These results showed that decreasing personal distress of empathy is important for nursing students, and may help in reducing clinical practice stress and burnout.

Predictive Factors of Turnover Intention among Intensive Care Unit Nurses / 임상간호연구

PURPOSE: The purpose of this study was to understand morality identity, occupational stress and authentic leadership and identify factors contributing to turnover intention among intensive care unit (ICU) nurses. METHODS: Data were collected from 230 nurses at the university hospitals in Daegu, Ulsan and Busan between February 15 and March 23, 2017. Instruments measuring turnover intention, moral identity, occupational stress, and authentic leadership were utilized. Statistical analysis included t-test, ANOVA, Pearson correlational analysis, and hierarchical regression analysis. RESULTS: A total of 207 nurses in ICU participated in this study. The power of explanation with age and dependents on turnover intention was 4.1%. With inclusion of occupational stress, moral identity, and authentic leadership factors put into the model, further 20.4% was explained. The explanatory power of the turnover intention in the final model was 23.6% (F=11.63 p<.001), and occupational stress was the key factor explaining turnover intention (β=.28, p<.001). Predictive factors contributing to turnover intention were age, occupational stress, moral identity, and authentic leadership in final model. CONCLUSION: These findings demonstrated occupational stress, moral identity and authentic leadership as critical factors contributing turnover intention of ICU nurses. It is necessary to promote nursing manager's authentic leadership, and to encourage moral identity in ICU nurses. In addition, providing intervention programs to reduce occupational stress for ICU nurses is necessary.

Nurses' Perception of Patient Safety Culture and Safety Control in Patient Safety Management Activities / 간호행정학회지

PURPOSE: There have been global initiatives and efforts over the last decade to manage patient safety. Thus aims of this study were to examine university hospital nurses' perceptions of patient safety culture and levels of safety control, and to identify factors that affect patient safety management activities. METHODS: Participants were 222 nurses who had worked as nurses for more than one year and who conducted patient safety management activities at a university hospital. Data were collected using structured questionnaires and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis with SPSS/WIN 20.0 computer program. RESULTS: General factors which positively impacted nurses' patient safety management were total length of work in nursing, total length of work in present hospital, and experience of a patient safety accident along with safety factors of perception of communication about accident related events and frequency of reporting accident events. These variables explained 45% of the variance in patient safety management activities. CONCLUSION: The findings from this study suggest solutions to promote patient safety management activities in hospitals and provide basic background for nursing education intervention strategies to promote safety control and patient safety management activities intended for nurses.

Critical Review of the Effects of Mindfulness-Based Stress Reduction (MBSR) on Stress and Health-related Quality of Life (QOL) / 성인간호학회지

PURPOSE: In numerous studies, MBSR programs have been shown to reduce stress and improve health-related QOL. Although MBSR programs have been shown to be beneficial, its effects have not been well-determined among Korean populations in clinical nursing practice. The purpose of this review was to describe the effects of MBSR on stress and health-related QOL so that the potential benefits of this intervention may be evaluated for wider application in Korea. METHODS: Articles published in peer-reviewed journals in the English or Korean language up to 2009 were reviewed; 14 articles met the inclusion criteria for this review and there were no Korean papers. RESULTS: MBSR groups were found to have significantly reduced stress outcomes relative to non-MBSR groups in 6 of 11 studies. In regards to health-related QOL, participants of the MBSR programs had increased scores after MBSR intervention relative to control groups in 5 of 7 studies. CONCLUSION: MBSR programs was effective in decreasing stress and increased the health-related QOL in the majority of studies reviewed. MBSR merits study in Korean patients to determine whether similar salutary patient outcomes may be obtained.

Analyses of Studies on Cardiac Rehabilitation for Patients with Cardiovascular Disease in Korea

PURPOSE: This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease. METHODS: Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association (AHA) and Scottish Intercollegiate Guidelines Network (SIGN). RESULTS: The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain. CONCLUSION: Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.

The Life of Patients with a Heart Transplant / 간호학회지

PURPOSE: The main purpose of this study was to develop a substantive theory on the life of patients with heart transplantation in the context of Korean society and culture. The question for the study was "What is the life of patients like with a heart transplant?". METHOD: A grounded theory method guided the data collection and analysis. Participants for this study were 12 adults who regularly visited a Cardiovascular ambulatorium in a medical center. The data was collected through an in-depth interview and analyses were performed simultaneously. RESULT: 'Developing a new life to live on borrowed time' was the core category in this study. It revealed two types of life, one is living in peace and another is thinking positive. CONCLUSION: This study provides a framework for the development of individualized nursing interventions to care for patients with Heart Transplantation. The findings may provide pointers for health professionals about ways to improve support for heart transplant recipients.

The Effect of a Simulated Disability Exercise Program on Attitude and Stereotyping toward People with Disabilities by Nursing Students / 성인간호학회지

PURPOSE: The purpose of this study was to identify the effect of a simulated disability program on attitude and stereotyping by nursing students toward people with disabilities. METHODS: A total of 107 undergraduate nursing students attended and completed pre-and post-questionnaires on attitude and stereotyping. The experimental group participated in a simulation exercise program which was composed of wheel-chair mobility and vision modification in Nam-won Rehabilitation Center. The data were analyzed by the SPSS 12.0 program including frequency, percentage, chi-square test and t-test. RESULTS: There was no significant difference in attitude toward people with disabilities between the two groups (t=-.743, p=.459). But there was a significant difference in stereotyping between the experimental and the control group(t=-4.097, p=.000). CONCLUSION: As the result of this study, we can conclude that the program was effective to improve stereotyping toward people with disabilities.

Analyses of the Studies on Cardiovascular Disease-Specific Quality of Life Reported in Korea / 성인간호학회지

PURPOSE: The purpose of the present study was to analyze and evaluate prior studies published in Korea on the cardiovascular disease-related quality of life, in order to make recommendations for further research. METHODS: A total of 15 studies were selected from four databases(Digital library of Research Information Center for Health, Korea Medical Database, MedRic, and National Assembly Library). The selected studies were analyzed according to criteria, such as diagnosis/operation, used instrument, generic/specific instrument, dimension of quality of life, translation/ back-translation, sample size, reliability, validity, responsiveness, number of items, type of scale, time required, and independent variables. RESULTS: Of the 15 cardiovascular disease-related quality of life studies, approximately half of them were conducted with hypertension or ischemic heart disease patients. All studies asserted that the concept of quality of life had multidimensional attributes. With respect to the questionnaire used for measuring the quality of life, only one study used a cardiovascular disease specific- instrument and most studies did not consider whether or not the validity of their instrument had been established. In addition, when using questionnaires developed in other languages, only one study employed a translation/ back-translation technique. The types of variables tested for their influence on quality of life were quite limited. CONCLUSION: It is recommended to develop a reliability and validity established cardiovascular disease specific- quality of life for Korean patients and to identify associated new variables.