Perceptions of Medical Personnel toward Burnout using Q Methodology / 간호행정학회지

PURPOSE: This exploratory study was done to categorize medical personnel's perceptions of burnout and analyzed the characteristics. METHODS: Q methodology was applied using a 45 Q-sample categorized on an 11-point scale which was completed by nurses and doctors working at a university hospital in Seoul, Korea. Collected data were analyzed using the PC-QUANL program. RESULTS: Medical personnel's perceptions of burnout were categorized into three types; 33.83% of the total variance was explained. The first type was 'functionally deteriorating pressure' the second type was 'daily powerlessness' and the third was 'achievement-oriented re-energization'. CONCLUSION: There is a need to establish and apply intervention strategies for each type to alleviate medical personnel burnout and increase work efficiency to qualitatively improve medical services.

Subjectivity About Sexual Ethics Among Korean Undergraduate Students Using Q Methodology

PURPOSE: Most undergraduate students are in the phase of gaining mental and physical autonomy from their parents as they expand their worlds. The ways that sexual ethics are established during this time may have an important influence on healthy lifestyles and the maintenance of social order. This study aims to determine a typology of undergraduate students' sexual ethics and the characteristics that compose the types. METHODS: Q methodology, which analyzes the subjectivity of each type of attitude, was used. The 44 selected Q statements from 43 participants were classified into the shape of a normal distribution using a 9-point scale. The collected data were analyzed using the PC-QUANL program. RESULTS: The results revealed three discrete groups of students with respect to sexual ethics: traditional absolute purity type, open-minded compromise type, and rational responsibility type. CONCLUSIONS: The results of this study indicate that different approaches to educational programs on sexual ethics are recommended for undergraduate students based on the three types studied.

Development and Testing of a Nurse Turnover Intention Scale (NTIS)

PURPOSE: The purpose of this study was to develop a measurement tool of nurse's turnover intention. METHODS: Data were collected from questionnaires completed by 678 nurses who worked in 3 university hospitals in South Korea and analyzed using the SPSS 18.0 and AMOS 18 programs. Thirty-seven preliminary items were selected from 161 basic items extracted via a literature review and in depth interviews with 6 hospital nurses. Three steps with factor analysis were undertaken to verify the reliability and validity of the preliminary instruments. Finally, confirmative factor analysis was carried out. RESULTS: As a result of the analysis, 3 factors including 10 items were selected. Cronbach's Alpha for the 10 items was .83, for job satisfaction (4 items), .78, for interpersonal relationships (3 items), .80, and for work performance (3 items), .74, which was stable. CONCLUSION: This study is meaningful because through it a scale reflecting Korean culture was developed to measure turnover intention in nurses. Further studies that test the psychometrics of this scale in more diverse samples are warranted.

Subjectivity of Nursing College Students' Awareness of Gender Equality: An Application of Q-methodology

PURPOSE: This study was done to identify the awareness of gender equality among nursing college students, and to provide basic data for educational solutions and desirable directions. METHODS: A Q-methodology which provides a method of analyzing the subjectivity of each item was used. 34 selected Q-statements from each of 20 women nursing college students were classified into a shape of normal distribution using 9-point scale. Subjectivity on the equality among genders was analyzed by the pc-QUANL program. RESULTS: Four types of awareness of gender equality in nursing college students were identified. The name for type I was 'pursuit of androgyny', for type II, 'difference-recognition', for type III, 'human-relationship emphasis', and for type IV, 'social-system emphasis'. CONCLUSION: The results of this study indicate that different approaches to educational programs on gender equality are recommended for nursing college students based on the four types of gender equality awareness.

Factors Influencing Health Promoting Behavior among Hospital Registered Nurses - Mood States, Resourcefulness, and Health Perception - / 간호행정학회지

PURPOSE: This study was done to examine the effects of mood state, resourcefulness, and health perception on health promoting behavior of hospital nurses. METHODS: Convenience sampling was conducted for nurses working at three University hospital and 336 nurses were selected. Data were analyzed using SPSS 18.0. RESULTS: The results of the analysis showed that the score for nurses' mood state was 41.76+/-18.90; for resourcefulness, 11.30+/-20.63; for health perception, 3.32+/-.77, and for health promoting behavior, 111.55+/-17.76. Mood state, resourcefulness, and health perception were significantly correlated with health promoting behavior. The overall explanatory power of the effects of nurses' mood state, resourcefulness, and health perception on health promoting behavior was 27.8%. CONCLUSION: Study results indicate that better mood state, higher resourcefulness, and higher health perception result in more health promoting behavior.

An Effect of the Secondary Stroke Prevention Education Program on Self-care of Acute Ischemic Stroke Patients / 성인간호학회지

PURPOSE: This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. METHOD: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using chi2-test, Fisher's Exact Test, t-test, Kolmogorov- Smirnov Z, and Repeated Measures ANOVA. RESULT: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. CONCLUSION: It is considered that the program can be used as an effective nursing intervention in clinical practice.

Development of a Nursing Professional Values Scale / 간호학회지

PURPOSE: The purpose of this study was to develop an instrument to measure nursing professional values. METHOD: Forty preliminary items were selected by classifying 223 basic items extracted via a literature study and in-depth interviews of subjects and testing the relevance of their contents. In order to verify the reliability and relevance of the preliminary instrument, data was collected from 504 nurses in 3 general hospitals. RESULT: As a result of the item analysis, 29 items were selected from a total of 40 items. Five factors were extracted by factor analysis, and the total variance was 51.5%. For the explanation of variances by factors, the 1st factor, 'self-concept of the profession' accounted for 14.8%, the 2nd factor, 'social awareness' 12.1%, the 3rd factor, 'professionalism of nursing' 9.8%, the 4th factor, 'the roles of nursing service' 9.1%, and the 5th factor, 'originality of nursing', 5.6%. Cronbach's Alpha of those 29 items was .9168, which was high. CONCLUSION: This paper is meaningful in a way that it developed a tool capable of measuring nursing professional values, which reflects the characteristics of our country. In order to re-verify the relevance and stability of this tool, it is necessary that comparative studies should be conducted.

A Q-methodological Study on Nursing Students' Attitudes toward Nursing Ethics / 간호학회지

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decisionmaking that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

Correlational Study on Health Behaviors, Menopausal Symptoms and Sexual Satisfaction in Korean Middle-aged Women / 성인간호학회지

PURPOSE: The purpose of this study was to identity the relationships among self reported health behaviors, menopausal symptoms, and sexual satisfaction in middle-aged women. METHOD: The subjects of this study were 155 women from 40 to 60 years. The data was analyzed using SPSS program for frequency, percentage, mean, t-test, ANOVA, Duncan and Pearson's correlation coefficients. RESULTS: 1. The mean score of health behaviors was 3.10 out of maximum 4. 2. The mean score of self-reported menopausal symptoms was 1.73 out of maximum 2. 3. The mean score of sexual satisfaction was 2.73 out of maximum 4. 4. Women's degree of menopausal symptoms had negative correlations with the degree of health behaviors(r=-0.437, p<.001) and the degree of sexual satisfaction(r=-0.439, p<.001). The degree of health behaviors had a positive correlation with the degree of sexual satisfaction (r=0.470, p<.001). CONCLUSION: In conclusion, menopausal symptoms-based complaints by middle-aged women were negatively correlated to health behavior and sexual satisfaction. Therefore, health behavior should be considered when developing nursing strategies for middle- aged women, especially when dealing with menopausal symptoms and sexual satisfaction.

The Experience of Decision Making to Donate Organs / 성인간호학회지

PURPOSE: The aim of this study was to identify the process of experience toward decision making to donate organs. METHOD: Eleven subjects who registered at the Association for Organ Sharing in Korea were recruited. Using in-depth interviews and tape-recordings, data was collected from Jun. 2001 to Feb. 2002 and the contents of these were analyzed by Glaser's grounded theory analysis method. RESULT: Basic Social- Psychological Problem(BSPP) of subjects were 'attachment to body' and the core theme, that is Basic Socialization Progress(BSP) were discovered to 'find out what is the meaning of life'. Also it consisted of four steps: 1st 'hesitate', 2nd 'look into self', 3rd 'realize the tie up to self' and last 're-find the meaning of life'. CONCLUSION: These findings indicate the Korean's Basic Socialization Progress of decision making regarding organ donation, so possible development of promoting decision making is necessary strategies for people who is having his/her potential of organ donation in mind.

An Inquiry into Exercise Behaviors of Middle-aged Women in Korea: A Q-methodological approach / 성인간호학회지

PUPPOSE: This study was performed to identify the factors which affected exercise and the perceived exercise behaviors in women according to Q-methodology and to provide basic strategies for health promotion of middle-aged women in Korea. METHOD: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty subjects in Seoul, Incheon, Chung-buk classified 35 selected Q-statements in to 9 points standard. The collected data was analyzed by using a QUANL pc program. RESULT: Principal component analysis identified 3 types of exercise behavior of middle-aged women in Korea and named by the researcher. They are called persistent activity preference type, living-exercise preference type, exercise mania type. In persistent activity preference type, the middle-aged women thought activity was very helpful to achieving health and releasing stress or fatigue. Also, they recognized the relationship between physical health and psychological health. In living- exercise preference type, the middle-aged women preferred maintaining stability or nonactivity to intended exercise or activity for health. In exercise mania type, the middle-aged women thought there was no other way to keep her health than to exercise. CONCLUSION: The findings of this study will provide the health care provider including nurse with useful information. It's very important to offer appropriate exercise intervention to the middle-aged women of each type by taking into consideration the characteristics of individual types.

Subjectivity on Coping with Fatigue among Middle-aged Men / 성인간호학회지

PURPOSE: The purpose of this study is to identify factors that affect coping with fatigue in middle-aged men according to Q-methodology and to provide basic strategies for health promotion. METHOD: 25 subjects in Seoul, Incheon, Chung-buk classified 24 selected Q-statements in to 9 points standard. The collected data were analyzed by using a QUNAL pc program. RESULT: Principal component analysis identified 3 types of coping with fatigue among middle-aged Korean men. 1st Type: Coping with fatigue through various kinds of game, using alcohol, smoking cigarette other than rest and sleep. 2nd Type : Coping with fatigue through rest and sleep, taking medicine or food which helps relieving fatigue. 3rd Type : Coping with fatigue through acitivities such as sports or trip other than sleep. CONCLUSION: We have found how Korean middle-aged men cope against fatigue through this research. To setup and apply different nursing intervention on each type based on this result is needed.

A Study on Causal Attribution and Self-Efficacy in the Patients with Cancer / 간호학회지

When people undergo stressful situations such as a cancer diagnosis, they ask, "why me?" The causal attributions people make about cancer influence what kind of coping strategies are chosen. Weiner (1979) suggested three dimensions of causal attributions: focus of causality, stability, and controllability. The purpose of the present study was to test the relation between causal attributions and self-efficacy in patients with cancer. The subjects were 194 patients who had been diagnosed cancer one year ago and attended an outpatient clinic. 1. Each mean score of causal attribution dimensions (focus of control, stability, controllability) that each patient made about cancer was 2.47, 2.73, 2.86, 3.35, and 3.28. The mean score of self-efficacy was 71.03. 2. There was a significant negative correlation between self efficacy and controllability. Particularly, there was a significant negative relationship between self efficacy and external controllability. Based upon these results, it is recommended that the developing nursing interventions to change causal attribution and self-efficacy is necessary. A number of theoretical relationships and empirical finding are confirmed by this data, and future proposals in research is suggested.

Subjectivity on Organ Donation and Transplantation / 간호학회지

This study was designed to identify the attitudes of the people on organ donation and transplantation. The purpose of this study was to provide data to help inspire organ donation, and promote registration yield so donor candidates will have more favorable recipients through Q-methodology. A Q-sample was developed through a review of the literature and interviews. Thirty-three statements made up the final Q-sample. The P-sample consisted of twenty-eight subjects, excluding chronic organic disorder. The Q-sorts by each subject were coded and analyzed with the QUNAL computer program. The results were as follows: This study discovered five different types of organ donation and transplantation of twenty- eight subjects. Type I is 'utilitarian.' The people of this type consider human life very valuable and they recognize that organ transplantation is an affirmative medicine that should be performed to extend human life. They believe that are saving others' lives by donating organs. Type II is 'sardonist.' The people of this type approve of organ transplantation usefulness, but they have no intention of participating in the program because of it may trample on human rights. Type III is 'individualist.' The people of this type consider it proper for the activation of organ transplantation by the legal system. They believe that organ donation a valuable too, but needs support through social benefits to donors. Yet, they have not intention of doing what they propose. Type IV is 'familist.' The people of this type have strong attachments to life but they think that organ donation and transplantation should be done between within a family. Type IV is disposition of family intensive consideration rather than altruistic and utilitarianism. Type V is 'deontologist.' The people of this type recognize the benefits of transplantation, but have a negative opinion of activation. They worry about ethical and social problems occurring in the development of modern medicine. They believe that death is the only natural end to life, so they have strong negative opinions of euthanasia and brain death compared to other types. They regard transplantation to be a non-human behavior, because it involves a removing organs and breaking the boundary of death. The findings of this study are only preliminary and serve as a baseline to understanding the subjectivity of individuals on organ donation and transplantation. Therefore, the subjectivity of the five types will be applied to formulate the educational programs and public relations strategies for organ donation because the public's awareness toward organ donation is closely related to their values, beliefs, and attitudes.

Subjectivity toward Death among Health Care Personnel: A Q-methodological Approach / 성인간호학회지

Since 'purpose' and 'aim' are present in all human behaviors, if it is the subject of the research, it must be different from a retributive explanation which focuses on the cause and effect. Since death is an extremely subjective and unique experience, if we take into account the lack of understanding about death due to the difficulty in methodology, it is very important to try to understand the subjectivity of death. In this respect, Q-methodology, which explains and shows the respondent's subjectivity by objectifying his subjectivity, is employed to find the solution to the questions in this study. Therefore the reason this study was initiated was to understand the characteristics and attitudinal types toward death among health care personnel. The results of this study are as follows The First type, the Fate-receipient, consisted of 17 subjects. The main charasteristics of the people in Type 1 are : a) They can talk openly about death, so as to prepare themselves for it. b) They strongly agree with the statements that the spirit does not die. c) They don't want to be put in intensive care when they're in coma. d) A person's death is part of his destiny. To these people, suicide is the most cowardly behavior, and their view of life after death is based on their religion. The Second type, the Reality-oriented, consisted of 11 subjects. These people in Type 2 think that the existence of the spirit or the next world was created by human beings for religious reasons and strongly deny the effect that religion has on our everyday life. So while they're still alive, they concentrate on life itself rather than thinking about death. In conclusion, this study discovered two types of subjectivity of health care personnel concerninig death and their relationship to it. By identifying the nature of the two types, this study suggests efficient strategies for developing educational programs in the university curriculum and continuing educational programs should be employed.

How People Understand Death: a Coorientational Look / 간호학회지

Since death is an extremely subjective and unique experience, if we take into account the lack of understanding about death due to the difficulty in methodology, it is very important to try to understand the subjectivity of death. In this respect, Q-methodology that explains and shows the respondents' subjectivity by objectifying his subjectivity is employed as a solution to the questions in this study. Therefore, the purpose of this study was to provide data on how medical personnel should treat their patients, when, it comes to death ; by finding out the opinions of those who are being treated, namely the patients, and those who are providing the treatment, namely the medical personnel. It also by examined the characteristics and relationships between these two groups on attitudes to death. The results of this study show that medical personnel have two(fate-recipient, reality-oriented) types of response and patients have three(religion-dependent, science-adherent, sardonist) types. Medical personnel saw patients as having three(life-attached, traditionalist, death-rejector) types of response and to patients saw medical personnel as having two(rationalist, humanist)types. The relationship between the above-mentioned types will be examined in a coorientation model, the subjectivity of the medical personnel and the patient toward death indicates a relatively high understanding between the two groups under the great proposition of 'death'. Therefore, in their relationship with people who are facing death, the provider of care, namely the medical personnel, should identify the subjectivity of the patient before approaching them. By doing this, they can minimize the conflicts they might experience in establishing a therapeutic relationship, reduce suffering, and help the patient in greeting a more comfortable death. Throughout the study, Q-methodology expands out understanding of coorientation model that has only been approached with R-methodology. This study confirmed Q's potentiality and its validity in human subjective matters.