Factors Affecting New Graduate Nurses' Intention on Retention in Hospitals: Focused on Nursing Organizational Culture, Empowering Leadership and Organizational Socialization / 간호행정학회지

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

PURPOSE: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). METHODS: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. RESULTS: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. CONCLUSION: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

PURPOSE@#The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI).@*METHODS@#The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis.@*RESULTS@#The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85.@*CONCLUSION@#The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Factors Influencing Nursing Students' Choices of a Place of Employment

BACKGROUND: Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas. METHODS: A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis. RESULTS: Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas. CONCLUSIONS: Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.

Factors Influencing Nursing Students' Choices of a Place of Employment

BACKGROUND@#Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas.@*METHODS@#A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis.@*RESULTS@#Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas.@*CONCLUSIONS@#Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.

Correlates of Depressive Symptoms and Stress among Korean Women Care-workers for Older Adults Dwelling in Community / 한국직업건강간호학회지

PURPOSE: This study identified the prevalence of depressive symptoms and explored correlates of depressive symptoms among Korean women care-workers caring older adults living in community. METHODS: A total of 465 participants were recruited for the study. Depressive symptoms was measured by the CES-D10 and distress was assessed using a single question given 5 Likert scale. RESULTS: The prevalence of depressive symptoms and distress among care-workers were 32.5% and 32.0% respectively. Work environment safety, violence exposure experience, work-family conflict, weekly care work time, and poor health status were significantly associated with depressive symptoms. Only violence exposure experience and poor health status were associated with distress. CONCLUSION: Our findings suggest more attention on mental health of care-workers and their risky work condition such as violence.

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care / 간호행정학회지

PURPOSE: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. METHODS: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. RESULTS: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. CONCLUSION: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

A Literature Review of Team Effectiveness on Hospital Nursing Units / 간호행정학회지

PURPOSE: The purpose of this study was to analyze literature related to nursing team effectiveness and to summarize the definition variables included, measurement tools, and findings. Basic data on operation and research for team effectiveness in nursing units was sought. METHODS: A literature search was performed to identify all studies published between 2003 and 2016 from periodicals indexed in PUBMED, CINAHL, SCIENCE DIRECT, RISS, KISS, and NAL databases. The following keywords were used in the search: ‘team effectiveness’, ‘nurse’, ‘nursing’, and ‘hospital’. Ten studies were analyzed. RESULTS: The analysis included domestic and international literature on nursing team effectiveness. The foreign literature included studies of various organizations including nurses, use of various research tools, leadership programs and/or new nursing delivery systems. In the Korean studies, most of the research on team effectiveness surveyed nurses on team satisfaction, team commitment, and team performance in general nursing units, operating rooms, and intensive care units. CONCLUSION: The findings show the necessity to develop a definition of team effectiveness that can be accepted comprehensively in nursing organizations in Korea. The definition should reflect team effectiveness that includes all cooperating units not only nurses of the nursing unit but also all other related health care teams.

Validity and Reliability of the Korean Version of Empowering Leadership Questionnaire

BACKGROUND: The manager's empowering leadership has been reported to have a positive impact on employees' psychological empowerment, motivation, creativity, and increase commitment and turnover intentions. However, there is a lack of Korean version of empowering leadership tools that have been verified for validity and reliability, so that they can be applied to Korean nursing organizations. The aim of this study was to develop the Korean version of Empowering Leadership Questionnaire (K-ELQ) and to examine its' psychometric properties. METHODS: Translation of the K-ELQ was validated through forward-backward translation. Participants were 322 staff nurses working in four general hospitals in South Korea. To test reliability and validity, content validity index, Cronbach's alpha, Pearson's correlation, confirmatory factor analysis were used. RESULTS: The K-ELQ consisted of 34 items to evaluate empowering leadership of nursing managers. Construct validity of K-ELQ was verified by confirmatory factor analysis (CMIN/DF=2.72, Root Mean square Residual=0.03, Goodness of Fit Index=0.91, Normal Fit Index=0.87). Cronbach's alpha was 0.98. Criterion validity compared to the psychological empowerment of nurses showed significant correlation (r=0.19, P=0.001). CONCLUSIONS: The K-ELQ is an appropriate instrument to measure empowering leadership of nursing managers. Further studies are needed to utilize K-ELQ in leadership education and to identify related factors of empowering leadership.

Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia / 결핵및호흡기질환

BACKGROUND: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. METHODS: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. RESULTS: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. CONCLUSION: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Home Health Resource Utilization Measures Using a Case-Mix Adjustor Model / 간호학회지

PURPOSE: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. METHOD: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). RESULT: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. CONCLUSION: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.