Effects of Relational Bonds and Professional Authority in the Organizational Commitment of Intensive Care Unit Nurses / 간호행정학회지

PURPOSE: The aim of this study was to define the effects of relational bonds and professional authority in organizational commitment of Intensive Care Unit (ICU) nurses. METHODS: A questionnaire was distributed to 200 ICU nurses working in 3 tertiary hospitals. The survey content included the Organizational Commitment Questionnaire (OCQ), Relational Bond Questionnaire (RBQ) and Schutzenhofer Professional Nurse Autonomy Scale (SPNA). RESULTS: The score for OCQ was 2.59, for RBQ, 3.23, and for SPNA, 2.93. Organizational commitment was related to relational bonds (β=0.45; p<.001; SE=0.08). These factors accounted for 21.6% of the variability in organizational commitment. CONCLUSION: Results indicate that ICU nurses' organizational commitment could be improved through increasing relational bonds and retaining experienced nurses which suggests a need to develop work systems designed to increase and maintain high relational bonds in ICU nurses.

Influences of Customer Orientation, Emotional Labor, Unit Manager-nurse Exchange and Relational Bonds on Nurses' Turnover Intension / 간호행정학회지

PURPOSE: The study was done to investigate nurses' customer orientation, emotional labor, unit manager-nurse exchange and relational bonds and to identify the factors affecting nurses' turnover intentions. METHODS: A cross-sectional survey was conducted using self-report questionnaires. The participants in this study were 276 nurses in tertiary hospital located in a metropolitan city, Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS program 22.0. RESULTS: The mean scores were 3.74±0.90 (out of 5) for turnover intention, 5.31±0.87 (out of 7) for customer orientation, 4.82±0.96 (out of 7) for emotional labor, 3.58±0.61 (out of 7) for relational bonds, and 3.18±0.57 (out of 5) for unit manager-nurse exchange. Factors influencing turnover intention were 'emotional labor' (β=.39, p<.001), 'unit manager-nurse exchange' (β=-.22, p<.001), 'financial bonds' (β=-.19, p<.001), 'perceived economic status' (β=-.15 p=.003) and 'career' (β=.14, p=.005). These factors explained 34.9% of the variance in turnover intension (F=30.46, p<.001). CONCLUSION: Findings indicate that to reduce nurses' turnover intention in the hospital, there is a need to improve unit manager-nurse exchange and to manage strategies lowering nurses' emotional labor.

A Study on the Relationship between Upper-scale General Hospital Nurses' Experience of Verbal Abuse and Job Stress / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to examine the relationship between upper-scale general hospital nurses' experience of verbal abuse and job stress. METHODS: Subjects were 245 nurses working at 3 upper-scale general hospitals in B city and the data were collected by convenience samples using self-reported questionnaires consist of general characteristics, verbal abuse and job stress. The data were analyzed with descriptive statistics, t-test, ANOVA, Scheffe test and Pearson's correlation coefficients. RESULTS: The mean score of verbal abuse level was 2.2 points and job stress level was 2.5 points. Experience of verbal abuse and job stress among the subjects had a positive correlation, and verbal abuse against nurses especially showed a strong correlation with job stress. CONCLUSION: Results of this study show that nurses' experience of verbal abuse increases their job stress. Therefore, continuous education and training programs that are based on the case studies with coping method according to clinical careers and working areas are required to reduce upper-scale general hospital nurses' experience of verbal abuse and decrease their job stress.

Effects of Head Nurses' Managerial Competencies and Professional Nurse Autonomy in Nursing Performance / 간호행정학회지

PURPOSE: The aim in this study was to identify head nurses' nursing performance according to their managerial competencies and professional nurse autonomy. METHODS: From January 15 to January 31, 2013 a survey was distributed to 200 head nurses working in 5 tertiary hospitals in B city and J city. The response rate was 80% (160 responses). The survey content included the Managerial Competencies Scale (MCS), Schutzenhofer professional nurse autonomy Scale (SPNA), and Nursing Performance Scale (SPNA). RESULTS: The score for MCS was 4.53, for SPNA, 177.05, and for SPNA, 4.62. Nursing performance was related to managerial competencies (beta=0.741; p<.001; SE=0.059) and professional autonomy (beta=0.135; p=.010; SE=0.001). These factors accounted for 64.8~67.3% of the variability in nursing performance. CONCLUSION: Results indicate that head nurses' performance would be improved through increased nursing managerial competencies and expansion of professional autonomy suggesting a need to develop work systems designed to achieve high managerial competency and professional autonomy in head nurses.

The Mediating Effect of Professionalism in the Relationship between Clinical Competence and Field Adaptation in Newly Graduated Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the mediating effect of professionalism in the relationship between clinical competence and field adaptation in newly graduated nurses. METHODS: The participants in this study were 213 nurses from four tertiary hospitals who had less than 12 months of nursing experience. Data were collected during January and February, 2013. A structured questionnaire was used for data collection and data were analyzed using descriptive statistics, Pearson correlation coefficients, and path analysis with the SPSS/WIN 21.0 and AMOS 21.0 programs. RESULTS: The mean score for clinical competence was 2.85+/-0.25, for professionalism, 3.10+/-0.30, and for field adaptation, 2.79+/-0.37. There was a significant positive relationship between clinical competence and field adaptation. Also, professionalism was positively correlated with field adaptation. Professionalism showed mediating effects between clinical competence and field adaptation. Improvement of clinical competence increased professionalism and the increased professionalism raised the field adaptation. CONCLUSION: Based on these findings, orientation programs including strategies to increase professionalism, should be established to promote effective field adaptation in newly graduated nurses. These orientation programs can strengthen professionalism, the mediator between clinical competence and field adaptation in newly graduated nurses.

The Relationship between Nursing Professionalism, Clinical Decision Making Abilities, and Job Performance in Advanced Practice Nurses / 간호행정학회지

PURPOSE: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables. METHODS: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. RESULTS: The average score for nursing professionalism of study participants was 81.19+/-7.56. for clinical decision making abilities, 140.42+/-9.62 and for job performance, 102.54+/-10.30. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). CONCLUSION: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

The effects of food safety education on adolescents' hand hygiene behavior: an analysis of stages of change

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.

Postoperative obstructing laryngeal edema in patients with diffuse idiopathic skeletal hyperostosis of cervical spine: A report of two cases / 대한마취과학회지

Two cases were reported in which severe postoperative laryngeal edema were developed after the operation of diffuse idiopathic skeletal hyperostosis (DISH) of cervical spine. In the first case, sudden airway obstruction was developed in the general ward 6 hour after uneventful decompression surgery for osteophyte. In the second patient, an elective preoperative tracheostomy was performed before surgery but the tube could not be removed for 2 months because of laryngeal edema and decreased vocal cord mobility. It should be emphasized that this airway problem can develop during the postoperative as well as the preoperative period, especially in the case of anterior cervical spine surgery.

Involuntary movements after ramosetron injection during propofol anesthesia: A case report

We report here on a case of a female patient with involuntary movements that lasted for approximately 8 hours after being administered a single dose of ramosetron, a highly selective serotonin 5-hydroxytryptamine type 3 5-HT3) receptor antagonist, to prevent postoperative nausea and vomiting (PONV) at the end of general anesthesia with using propofol. To the best of our knowledge, this is the first report of involuntary movement related to ramosetron.

Involuntary movements after ramosetron injection during propofol anesthesia: A case report

We report here on a case of a female patient with involuntary movements that lasted for approximately 8 hours after being administered a single dose of ramosetron, a highly selective serotonin 5-hydroxytryptamine type 3 5-HT3) receptor antagonist, to prevent postoperative nausea and vomiting (PONV) at the end of general anesthesia with using propofol. To the best of our knowledge, this is the first report of involuntary movement related to ramosetron.

Psycho-Social Well-being, Health Perception and Behavior among Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to investigate the relationships among psycho-social well-being, and health perception and behavior in clinical nurses. METHODS: The data were collected from 362 nurses employed at five general hospitals. A self-reported questionnaire was used to assess demographics and job characteristics, health perception and behavior, depression, and psycho-social stress. The data were analysed using Cronbach's alpha, descriptive statistics, t-test, and ANOVA. RESULTS: While nurses perceived themselves to be in good health, represented by a high mean for health perceptions, actual health behavior was poor as the mean for health behavior was low. Forty two percents of the subjects were categorized as having major depression and high-stress levels. There were statistically significant differences in psycho-social well-being according to age, marital status, years of employment, and monthly salary. Also, there were significant differences in psycho-social well-being according to health perception, regular meals and exercise, sufficient sleep, job related injury and accident, and absences for ill. CONCLUSION: In order to prevent depression and improve psycho-social well-being among clinical nurses, organizational support and health management needs to be focused on high-risk nurses. Furthermore, it is essential to consider the health perception and behavior of clinical nurses.

Psycho-Social Well-being, Health Perception and Behavior among Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to investigate the relationships among psycho-social well-being, and health perception and behavior in clinical nurses. METHODS: The data were collected from 362 nurses employed at five general hospitals. A self-reported questionnaire was used to assess demographics and job characteristics, health perception and behavior, depression, and psycho-social stress. The data were analysed using Cronbach's alpha, descriptive statistics, t-test, and ANOVA. RESULTS: While nurses perceived themselves to be in good health, represented by a high mean for health perceptions, actual health behavior was poor as the mean for health behavior was low. Forty two percents of the subjects were categorized as having major depression and high-stress levels. There were statistically significant differences in psycho-social well-being according to age, marital status, years of employment, and monthly salary. Also, there were significant differences in psycho-social well-being according to health perception, regular meals and exercise, sufficient sleep, job related injury and accident, and absences for ill. CONCLUSION: In order to prevent depression and improve psycho-social well-being among clinical nurses, organizational support and health management needs to be focused on high-risk nurses. Furthermore, it is essential to consider the health perception and behavior of clinical nurses.

Eating habits, obesity related behaviors, and effects of Danhak exercise in elderly Koreans

The aims of this study were to evaluate obesity-related dietary behaviors and to determine long-term exercise effects on obesity and blood lipid profiles in elderly Korean subjects. A total of 120 subjects, aged 60-75 yr, were recruited, and obesity-related dietary behaviors were determined. An exercise intervention was conducted with 35 qualified elderly females for 6 months, and body composition and blood lipids were measured 6 times at 4 week intervals. At baseline, mean BMI (kg/m2) was 24.8 for males and 23.1 for females. The females had better eating habits than the males and were more concerned with reading nutrition labels on food products (P < 0.001); they also preferred convenience foods less than the male subjects (P < 0.05). Obese individuals were more likely than overweight or normal weight individuals to misperceive their weight (P < 0.001). Those with a high BMI responded feeling more depressed (P < 0.01), lacking self-confidence (P < 0.01), and feeling isolated (P < 0.01), as well as having more difficulty doing outdoor activities (P < 0.01). After exercise, body fat (%) and WHR were significantly reduced (P < 0.05), while body weight and BMI were also decreased without statistical significance. Total cholesterol and blood HDL were significantly improved (207.1 mg/dl vs. 182.6 mg/dl, HDL: 45.6 mg/dl vs. 50.6 mg/dl, P < 0.05). Other benefits obtained from exercise were improvements in self-confidence (26.4%), movement (22.6%), stress-relief (18.9%), and depression (13.2%). In conclusion, elderly females had better eating habits and were more concerned with nutrition information and healthy diets compared to elderly males. However, misperceptions of weight and obesity-related stress tended to be very high in females who were overweight and obese, which can be a barrier to maintain normal weight. Long-term Danhak practice, a traditional Korean exercise, was effective at reducing body fat (%) and abdominal obesity, and improved lipid profiles, self-confidence, and stress.

Food safety knowledge and practice by the stages of change model in school children

In this study, 342 grade 4-6 elementary school students in Gyeonggi-do were recruited to determine their readiness to change food safety behavior and to compare their food safety knowledge and practices by the stages of change. The subjects were divided into three stages of change; the percentage of stage 1 (precontemplation) was 10.1%, the percentage of stage 2 (contemplation and preparation) was 62.4%, and that of stage 3 (action and maintenance) was 27.5%. Food safety knowledge scores in stage 3 (4.55) or stage 2 (4.50) children were significantly higher than those in stage 1 children (4.17) (P < 0.05). The two food safety behavior items "hand washing practice" and "avoidance of harmful food" were significantly different among the three groups (P < 0.05). Stages of change were significantly and positively correlated with food safety knowledge and practice. Age was significantly and negatively correlated with the total food safety behavior score (r = -0.142, P < 0.05). The most influential factor on the stage of change was a mother's instruction about food safety (P < 0.01).

The Effects of Continuous Nicardipine Infusion on Blood Pressure and Heart Rate during Endotracheal Intubation / 대한마취과학회지

BACKGROUND: Laryngoscopy and tracheal intubation often induced an undesirable increase in blood pressure and heart rate. We evaluated the preventing effect of nicardipine infusion on the increase of the blood pressure (BP) and heart rate (HR) following a direct laryngoscopy and tracheal intubation. METHODS: Sixty, ASA physical status 1-2, adult patients were selected with informed consent, and randomly allocated into two groups; control group (n = 30) and nicardipine group (n = 30). In the control group, 1.8 ml/kg/h of normal saline was infused, and in the nicardipine group, 5microgram/kg/min of nicardipine was infused continuously from 2 minutes before intubation to 3 minutes after intubation. BP and HR were measured by non-invasive method after arrival at the operating room, before tracheal intubation, shortly after tracheal intubation, and 1, 3, 5, and 10 minutes following intubation. Data were analyzed by repeated measure of ANOVA and t-test. RESULTS: Systolic and diastolic BP were significantly lower in the nicardipine group than in the control group (P < 0.05). HR showed significantly higher value in the nicardipine group (P < 0.05). CONCLUSIONS: The continuous infusion of nicardipine (5microgram/kg/min) was effectively attenuating an increase of BP during tracheal intubation. But the increase in HR is not blunted by nicardipine infusion and there is a significant increase in HR. Although rate-pressure product (RPP) does not increase, the use of nicardipine for blunting hemodynamic responses should be considered carefully in patients with ischemic heart disease.

Concept Analysis of Preparatory Grief in Terminal Cancer Patients / 간호학회지

PURPOSE: The purpose of this study was to conceptualize and clarify a concept of "preparatory grief" in terminal cancer patients. METHOD: A hybrid model of concept development was applied to develop a concept of preparatory grief, which included a field study carried out in Busan, Korea. Participants of this study were 8 cancer patients. RESULTS: On the basis of our literature, research and clinical experience, the concept of preparatory grief emerged as a complex phenomenon playing an important role in five areas; physical, emotional, interpersonal, religious, and transcendental dimensions. Two new attributes were defined through a field phase; trust of the post-mortal world and a serene state of mind. Indicators reflected attitudes of sadness, worry, regret, capability to adapt and hope. The results of preparatory grief were loss of energy and interest, emotional chaos, contemplation, taciturnity and restoration. CONCLUSIONS: Differentiating among preparatory grief and other symptoms in cancer patients is essential because of therapeutic implications. Understanding preparatory grief is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patient's life.

The Effects of Deep Breathing Methods on Pulmonary Ventilatory Function of Pneumothorax Patients undergoing a Thoracotomy / 간호학회지

PURPOSE: This study was to examine the effects of deep breathing exercises with Incentive Spirometer on the pulmonary ventilatory function of pnemothorax patients undergoing a thoracotomy. METHOD: This experiment used anonequivalent control group non-synchronized design which compared pre-experimental measures with post-experimental ones. The subjects of this study were 34 inpatients who were scheduled for a thoracotomy and classified into the experimental group (17 patients) or control group (17 patients) by using an Incentive Spirometer or not. The collected data was analyzed by a SPSS Win / PC (percentage, mean, standard deviation, chi-square test, t-test, repeated measured two-way ANOVA). RESULT: The Pulmonary Ventilatory Function of the experimental and control group were significantly increased on the first day, third day, and fifth day after the thoracotomy, but the group interaction period was not significant. CONCLUSION: This study showed that the deep breathing exercises with an Incentive Spirometer and deep breathing exercise without an Incentive Spirometer were both effective for recovering the pulmonary ventilatory function after a thoracotomy.

The Effects of Deep Breathing Methods on Pulmonary Ventilatory Function of Pneumothorax Patients undergoing a Thoracotomy / 간호학회지

PURPOSE: This study was to examine the effects of deep breathing exercises with Incentive Spirometer on the pulmonary ventilatory function of pnemothorax patients undergoing a thoracotomy. METHOD: This experiment used anonequivalent control group non-synchronized design which compared pre-experimental measures with post-experimental ones. The subjects of this study were 34 inpatients who were scheduled for a thoracotomy and classified into the experimental group (17 patients) or control group (17 patients) by using an Incentive Spirometer or not. The collected data was analyzed by a SPSS Win / PC (percentage, mean, standard deviation, chi-square test, t-test, repeated measured two-way ANOVA). RESULT: The Pulmonary Ventilatory Function of the experimental and control group were significantly increased on the first day, third day, and fifth day after the thoracotomy, but the group interaction period was not significant. CONCLUSION: This study showed that the deep breathing exercises with an Incentive Spirometer and deep breathing exercise without an Incentive Spirometer were both effective for recovering the pulmonary ventilatory function after a thoracotomy.

Clinical Characteristics and Risk Factors of Mortality among Severe Burn Patients with Isolation of Vancomycin-Resistant Enterococci

BACKGROUND: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. Patients with burn injury are highly vulnerable to VRE infection. We evaluated the colonization and infection rate of VRE among severe burn patients. MATERIALS AND METHODS: We retrospectively reviewed VRE isolation in a tertiary hospital burn center from January 2000 to December 2003. We analyzed and compared the clinical characteristics of VRE colonized (isolated in rectal swab) and infected patients. We also analyzed the risk factors of mortality in VRE infection group by using univariate and multivariate analyses. RESULTS: VRE was isolated from 104 of severe burn patients. Mean percent of total body surface area of 104 patients was 45.43+/-22.15%. The most commonly isolated VRE was Enterococcus faecium (82.6%). The VRE infection rate of VRE colonization group was 19/93 (20.4%). There were no differences in clinical characteristics, underlying conditions, and isolates species between VRE colonization and infection groups. The mortality rate of VRE infection group was 40%. The risk factors for mortality were bacteremia (P=0.001) and mechanical ventilation (P=0.024) in univariate analysis. However, independent risk factor for death was only VRE bacteremia [odd ratio=32.803, 95% confidence interval (2.884, 373.129), P=0.005] in multivariate analysis. CONCLUSION: Significant portion of severe burn patients with VRE colonization could progress to VRE infection. Severe burn patients with VRE bacteremia have higher risk of death than patients without VRE bacteremia.

Clinical Characteristics and Risk Factors of Mortality among Severe Burn Patients with Isolation of Vancomycin-Resistant Enterococci

BACKGROUND: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. Patients with burn injury are highly vulnerable to VRE infection. We evaluated the colonization and infection rate of VRE among severe burn patients. MATERIALS AND METHODS: We retrospectively reviewed VRE isolation in a tertiary hospital burn center from January 2000 to December 2003. We analyzed and compared the clinical characteristics of VRE colonized (isolated in rectal swab) and infected patients. We also analyzed the risk factors of mortality in VRE infection group by using univariate and multivariate analyses. RESULTS: VRE was isolated from 104 of severe burn patients. Mean percent of total body surface area of 104 patients was 45.43+/-22.15%. The most commonly isolated VRE was Enterococcus faecium (82.6%). The VRE infection rate of VRE colonization group was 19/93 (20.4%). There were no differences in clinical characteristics, underlying conditions, and isolates species between VRE colonization and infection groups. The mortality rate of VRE infection group was 40%. The risk factors for mortality were bacteremia (P=0.001) and mechanical ventilation (P=0.024) in univariate analysis. However, independent risk factor for death was only VRE bacteremia [odd ratio=32.803, 95% confidence interval (2.884, 373.129), P=0.005] in multivariate analysis. CONCLUSION: Significant portion of severe burn patients with VRE colonization could progress to VRE infection. Severe burn patients with VRE bacteremia have higher risk of death than patients without VRE bacteremia.